La Sierra Care Center
A nursing home in Merced, California 95340
2424 M Street, Merced, California 95340. (209) 723-4224.
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The short answer
Record last released by CMS on Oct 28, 2026.
- 3of 5 CMS’s overall rating
- 12 health citations at the latest inspection cycle California average: 15.7
- 3.86 nurse hours per resident per day California average: 4.54
- 0 fines in the last three years
Each figure’s source sits beside it, in its section below.
What these words mean7
- 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.
- 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?
12 health citations at the latest inspection cycle
The California average is 15.7.
Last standard inspection Jan 23, 2026.
Most serious in three years: D: no actual harm, potential for more than minimal harm.
CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
When those citations happened
27 citations in 5 months of the last 36. Last cited Jan 2026. Most serious: no actual harm, potential for more than minimal harm (D). 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 27 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. 3 came from complaint inspections.
CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.
Jan 23, 2026: standard inspection11 citations
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Reasonably accommodate the needs and preferences of each resident.
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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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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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Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
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Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
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Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
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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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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.
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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.
Nov 19, 2025: complaint inspection1 citation
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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
Apr 3, 2025: complaint inspection1 citation
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Ensure services provided by the nursing facility meet professional standards of quality.
Oct 23, 2024: complaint inspection1 citation
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Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Aug 23, 2024: standard inspection13 citations
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Ensure each resident receives an accurate assessment.
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PASARR screening for Mental disorders or Intellectual Disabilities
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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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Provide enough food/fluids to maintain a resident’s health.
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Provide safe and appropriate respiratory care for a resident when needed.
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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 medication error rates are not 5 percent or greater.
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Ensure that residents are free from significant medication errors.
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Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
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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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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 rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
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Post nurse staffing information every day.
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.
- 68 certified beds.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
Has it been fined or penalized?
- No fines in the last three years.
- No Medicare payment denials in the last three years.
- 3 citations in the last three years came from complaint inspections.
CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
Who does the caring?
3.86 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 | 3.86 | 4.54 |
| Of which registered nurses | 0.48 | 0.68 |
| At weekends | 3.48 | 4.10 |
| Nursing staff turnover | 50% | 36.6% |
| Registered nurse turnover | 60% | 37.8% |
| Administrators who left | 0 | Not given |
Who owns it?
- Crescent Facilities Operations LLC owns 100% directly since Feb 7, 2007.
- Cambridge Healthcare Services LLC runs it.
- 26 owners or officers are people: Ira Smedra (corporate officer, 50%); Ira Smedra (owns 5% or more through other companies, 5.75%); 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)); Arun Manoharan (runs it (operational or managerial control)); Arun Manoharan (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)); Jacob Wintner (corporate officer); Jacob Wintner (runs it (operational or managerial control)); Jacob Wintner (owns a share through other companies); Paulina Salazar (runs it (operational or managerial control)); Paulina Salazar (additional disclosable party (controls, leases property to, or provides services to the home)); Michael Darouze (runs it (operational or managerial control)); Michael Darouze (on the governing body (managing control)); Michael Darouze (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)); Skyler Silveira (runs it (operational or managerial control)); 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% | Feb 7, 2007 |
| 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 |
| Jennifer Nurit Smedra Trust 1997 Trust | Owns 5% or more through other companies | 11.73% | Feb 1, 2007 |
| Manhattan FIVE Partners LLC | Owns 5% or more through other companies | 6.52% | Nov 1, 2006 |
| Ira & Rachel Smedra Family Irrevocable Gift Trust | Owns 5% or more through other companies | 6.52% | Feb 1, 2007 |
| Bering Properties LLC | Owns 5% or more through other companies | 6% | Feb 1, 2007 |
| The Hyman & Betty Ingber Family Trust | 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 |
| 2424 M Street LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Dec 15, 2006 | |
| Win Win Enterprises, LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Feb 1, 2007 | |
| 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 15, 2025 | |
| Jenmax Enterprises LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Feb 1, 2007 | |
| Jk-Csh Jv LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Nov 1, 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 | 3 of 5 |
| Health inspections | 3 of 5 |
| Staffing | 3 of 5 |
| Quality measures | 4 of 5 |
How does it compare nearby?
- Among the 12 nearest homes, within 24.3 miles, this one had the 4th most health citations at the latest inspection cycle (12; the middle value was 8).
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Place | Miles away | Citations, latest cycle |
|---|---|---|
| La Sierra Care Center This nursing home | 12 | |
| Merced Nursing & Rehabilitation Ctr | 0.1 | 15 |
| Golden Merced Care Center | 0.3 | 16 |
| Franciscan Post-Acute Care Center | 0.8 | 4 |
| Merced Behavioral Center | 1.4 | 5 |
| Anberry Post Acute | 3.0 | 14 |
| Anberry Nursing and Rehabilitation Center | 7.1 | 7 |
| Grace Home Inc. | 14.5 | 1 |
| Palms Care Center | 17.4 | 9 |
| Chowchilla Memorial Healthcare District | 17.4 | 5 |
| Covenant Village Care Center | 24.2 | 9 |
| North Starr Postacute Care | 24.3 | 7 |
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
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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.