Madera Rehabilitation & Nursing Center
A nursing home in Madera, California 93638
517 South A Street, Madera, California 93638. (559) 673-9228.
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The short answer
Record last released by CMS on Oct 28, 2026.
- 1of 5 CMS’s overall rating
- 24 health citations at the latest inspection cycle California average: 15.7
- 3.98 nurse hours per resident per day California average: 4.54
- 3 fines in the last three years (needs attention)
Each figure’s source sits beside it, in its section below.
What these words mean8
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
- Scope and severity (A to L)
- CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
- Nurse staffing hours
- The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
- Fines and payment denials
- A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
- Immediate jeopardy
- CMS’s most serious finding: the place’s failure to meet a rule caused, or was likely to cause, serious injury, harm, impairment or death to someone in its care. Source: CMS; 42 CFR 489.3.
- Capacity
- The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.
What did inspectors find?
24 health citations at the latest inspection cycle
The California average is 15.7.
Last standard inspection Aug 14, 2025.
Most serious in three years: immediate jeopardy to health or safety (K), at a complaint inspection on Mar 7, 2025
CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
When those citations happened
58 citations in 11 months of the last 36. Last cited Feb 2026. Most serious: immediate jeopardy to health or safety (K). The last 3 years, to Nov 5, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Dec | |||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
All 59 citations in the last three years
Grouped by inspection, newest first. Each carries CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7)., from A, the least serious, to L, the most. 32 came from complaint inspections.
CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.
Feb 24, 2026: complaint inspection1 citation
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Keep all essential equipment working safely.
Feb 11, 2026: complaint inspection2 citations
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Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
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Provide and implement an infection prevention and control program.
Aug 14, 2025: standard inspection20 citations
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Provide enough food/fluids to maintain a resident’s health.
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Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.
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Ensure that residents are fully informed and understand their health status, care and treatments.
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Ensure each resident receives an accurate assessment.
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Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
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Ensure services provided by the nursing facility meet professional standards of quality.
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Provide care and assistance to perform activities of daily living for any resident who is unable.
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Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
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Ensure each resident’s drug regimen must be free from unnecessary drugs.
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Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
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Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
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Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
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Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
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Provide special eating equipment and utensils for residents who need them and appropriate assistance.
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Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
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Have a policy regarding use and storage of foods brought to residents by family and other visitors.
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Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
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Provide and implement an infection prevention and control program.
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Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Aug 14, 2025: standard and complaint inspection1 citation
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Jun 10, 2025: complaint inspection2 citations
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Honor the resident’s right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
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Provide and implement an infection prevention and control program.
Apr 15, 2025: complaint inspection3 citations
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
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Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
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Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident’s well being.
Mar 7, 2025: complaint inspection11 citations
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
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Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
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Honor the resident’s right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
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Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
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Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
-
Ensure services provided by the nursing facility meet professional standards of quality.
-
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident’s well being.
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Administer the facility in a manner that enables it to use its resources effectively and efficiently.
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Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
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Have a plan that describes the process for conducting QAPI and QAA activities.
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Provide and implement an infection prevention and control program.
Jan 9, 2025: complaint inspection5 citations
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
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Ensure each resident receives an accurate assessment.
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Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
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Ensure services provided by the nursing facility meet professional standards of quality.
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Provide and implement an infection prevention and control program.
Nov 22, 2024: complaint inspection1 citation
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Jun 21, 2024: standard inspection7 citations
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Honor the resident’s right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
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Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
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Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
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Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
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Employ or obtain outside professional resources to provide services in the nursing home when the facility does not employ a qualified professional to furnish a required service.
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Provide and implement an infection prevention and control program.
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Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
May 2, 2024: complaint inspection1 citation
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Apr 4, 2024: complaint inspection3 citations
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Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
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Create and put into place a plan for meeting the resident’s most immediate needs within 48 hours of being admitted
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Ensure services provided by the nursing facility meet professional standards of quality.
Mar 8, 2024: complaint inspection1 citation
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Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Nov 15, 2023: complaint inspection1 citation
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Is it certified, and in good standing?
- Certified for Medicare and Medicaid since Jan 1, 1967.
- Not on CMS’s special focus list.
- No abuse icon from CMS.
- No change of ownership in the last 12 months.
- CMS lists its ownership as for profit, limited liability company.
- 176 certified beds.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
Has it been fined or penalized?
- 3 fines in the last three years, $373,733 in all.
- 2 Medicare payment denials in the last three years.
- 32 citations in the last three years came from complaint inspections.
CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
| Date | Kind | Amount |
|---|---|---|
| Aug 14, 2025 | Medicare payment denial | Not given |
| Aug 14, 2025 | Fine | $126,900 |
| Jan 9, 2025 | Medicare payment denial | Not given |
| Jan 9, 2025 | Fine | $194,145 |
| Mar 8, 2024 | Fine | $52,688 |
Who does the caring?
3.98 nurse hours per resident per day
The California average is 4.54.
CMS publishes staffing about four months after the fact.
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | This home | California average |
|---|---|---|
| Nurse hours per resident per day | 3.98 | 4.54 |
| Of which registered nurses | 0.52 | 0.68 |
| At weekends | 3.66 | 4.10 |
| Nursing staff turnover | 50.3% | 36.6% |
| Registered nurse turnover | 61.3% | 37.8% |
| Administrators who left | 1 | Not given |
Who owns it?
- Crescent Facilities Operations LLC owns 100% directly since Dec 19, 2006.
- Cambridge Healthcare Services LLC runs it.
- 26 owners or officers are people: Jacob Wintner (corporate officer, 50%); Ira Smedra (owns 5% or more through other companies, 5.75%); Julia Bulosan (runs it (operational or managerial control)); Julia Bulosan (additional disclosable party (controls, leases property to, or provides services to the home)); Linda Lutz (runs it (operational or managerial control)); Linda Lutz (additional disclosable party (controls, leases property to, or provides services to the home)); Gregory Bretsch (runs it (operational or managerial control)); Gregory Bretsch (on the governing body (managing control)); Gregory Bretsch (additional disclosable party (controls, leases property to, or provides services to the home)); Lance A Hassell (runs it (operational or managerial control)); Lance A Hassell (additional disclosable party (controls, leases property to, or provides services to the home)); Ira Smedra (runs it (operational or managerial control)); Ira Smedra (additional disclosable party (controls, leases property to, or provides services to the home)); Ranjeet Singh (runs it (operational or managerial control)); Ranjeet Singh (additional disclosable party (controls, leases property to, or provides services to the home)); Jacob Wintner (runs it (operational or managerial control)); Jacob Wintner (additional disclosable party (controls, leases property to, or provides services to the home)); Paulina Salazar (runs it (operational or managerial control)); Paulina Salazar (additional disclosable party (controls, leases property to, or provides services to the home)); Julie Butenko (runs it (operational or managerial control)); Julie Butenko (additional disclosable party (controls, leases property to, or provides services to the home)); Akash Lal (runs it (operational or managerial control)); Akash Lal (on the governing body (managing control)); Akash Lal (additional disclosable party (controls, leases property to, or provides services to the home)); Heidi Capela (runs it (operational or managerial control)); Heidi Capela (additional disclosable party (controls, leases property to, or provides services to the home)).
- Part of Cambridge Healthcare Services (32 homes in CMS’s data).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, All Owners. Checked Nov 5, 2026. Updated monthly.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Organisation | Role | Share | Since |
|---|---|---|---|
| Crescent Facilities Operations LLC | Owns 5% or more directly | 100% | Dec 19, 2006 |
| Win Win Enterprises, LLC | Owns 5% or more through other companies | 35% | Feb 1, 2007 |
| Jenmax Enterprises LLC | Owns 5% or more through other companies | 23% | Feb 1, 2007 |
| Jk-Csh Jv LLC | Owns 5% or more through other companies | 12% | Nov 1, 2006 |
| Manhattan FIVE Partners LLC | Owns 5% or more through other companies | 6.52% | Nov 1, 2006 |
| Bering Properties LLC | Owns 5% or more through other companies | 6% | Oct 10, 2013 |
| Bh Alliance | Owns a share through other companies | 4% | Nov 1, 2006 |
| The Jacob Wintner Trust | Owns a share through other companies | 2% | Nov 1, 2006 |
| The Wintner Living Trust Dated 7/08/1992 | Owns a share through other companies | 1% | Feb 1, 2007 |
| Win Win Enterprises, LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Dec 15, 2006 | |
| Cambridge Healthcare Services LLC | Runs it (operational or managerial control) | Apr 1, 2014 | |
| Cambridge Healthcare Services LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Jul 24, 2025 | |
| Jenmax Enterprises LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Dec 15, 2006 | |
| Jk-Csh Jv LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Dec 15, 2006 | |
| 517 S. A Street LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Dec 15, 2006 |
How do residents fare?
- CMS rates its quality measures 4 of 5 (California average 4.2).
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | Rating |
|---|---|
| Overall rating | 1 of 5 |
| Health inspections | 1 of 5 |
| Staffing | 3 of 5 |
| Quality measures | 4 of 5 |
How does it compare nearby?
- Among the 12 nearest homes, within 19.9 miles, this one had the 2nd most health citations at the latest inspection cycle (24; the middle value was 11).
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Place | Miles away | Citations, latest cycle |
|---|---|---|
| Madera Rehabilitation & Nursing Center This nursing home | 24 | |
| Madera Care Center | 1.7 | 3 |
| Chowchilla Memorial Healthcare District | 16.4 | 5 |
| Palms Care Center | 16.5 | 9 |
| Foundation Skilled Nursing | 17.4 | 26 |
| North Point Healthcare & Wellness Centre LP | 17.7 | 3 |
| The Terraces at San Joaquin Gardens Village | 17.9 | 11 |
| Horizon Health & Subacute Center | 19.1 | 24 |
| Willow Creek Healthcare Center | 19.4 | 19 |
| Community Subacute and Transitional Care Center | 19.6 | 3 |
| Keystone Post-Acute | 19.7 | 11 |
| Oakwood Gardens Care Center | 19.9 | 15 |
What the record doesn’t say
- Complaints that didn’t lead to a citation aren’t published.
- Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
- CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
- Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.
Sources
-
Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).
Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Nov 5, 2026.
From the home
The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.