39/100
Poor
517 South A Street, Madera, CA 93638
These are findings in the public CMS record for this home. They are not our opinion — each one comes straight from a federal inspection or enforcement file.
7 citation(s) involving actual harm or immediate jeopardy
Inspectors found violations at scope/severity G or above, meaning residents were harmed or placed in immediate jeopardy.
$373,733 in federal fines
CMS has fined this facility across 3 penalty action(s).
Every point is shown. Nothing is weighted behind the scenes — the full formula is on How we grade.
Citations from state health inspections over the last three surveys, weighted by how much harm CMS says they caused.
Nursing hours per resident per day, adjusted for how sick the residents are, plus RN cover and weekend consistency.
How much of the nursing team leaves in a year. High turnover means a resident rarely sees the same face twice.
The CMS quality-measure rating, built from resident outcomes like falls, pressure ulcers, infections and antipsychotic use.
Fines and payment denials CMS has imposed. A denial of payment means CMS stopped paying for new admissions.
Grade ceiling applied
Hours of nursing care each resident receives per day. The marker on each bar is the national average.
RNs are the licence level most likely to catch a resident deteriorating.
The shift most families visit, and the one thinned first.
The share of nursing staff who left over the last year.
Last standard health inspection: August 14, 2025 (1 year ago).
Environmental Deficiencies
Keep all essential equipment working safely.
No actual harm, potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
No actual harm, potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
No actual harm, potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Actual harm to a resident
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Actual harm to a resident
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
No actual harm, potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
No actual harm, potential for more than minimal harm
Nutrition and Dietary Deficiencies
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.
No actual harm, potential for more than minimal harm
Part of CAMBRIDGE HEALTHCARE SERVICES, which operates 32 homes. Staffing budgets are usually set at chain level, not in the building.
| Owner | Type | Role | Since |
|---|---|---|---|
| BH ALLIANCE | Organization | INDIRECT OWNERSHIP INTEREST | — |
| THE JACOB WINTNER TRUST | Organization | INDIRECT OWNERSHIP INTEREST | — |
| THE WINTNER LIVING TRUST DATED 7/08/1992 | Organization | INDIRECT OWNERSHIP INTEREST | — |
| BRETSCH, GREGORY | Individual | MANAGING CONTROL - GOVERNING BODY | — |
| LAL, AKASH | Individual | MANAGING CONTROL - GOVERNING BODY | — |
| WINTNER, JACOB | Individual | CORPORATE OFFICER | — |
| CAMBRIDGE HEALTHCARE SERVICES LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | — |
| BRETSCH, GREGORY | Individual | OPERATIONAL/MANAGERIAL CONTROL | — |
| BULOSAN, JULIA | Individual | OPERATIONAL/MANAGERIAL CONTROL | — |
| BUTENKO, JULIE | Individual | OPERATIONAL/MANAGERIAL CONTROL | — |
| CAPELA, HEIDI | Individual | OPERATIONAL/MANAGERIAL CONTROL | — |
| HASSELL, LANCE | Individual | OPERATIONAL/MANAGERIAL CONTROL | — |
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Madera Rehabilitation & Nursing Center holds an ElderGrade of F (39 out of 100), which we describe as "poor". The grade combines its inspection citations, nurse staffing levels, staff turnover, resident outcomes and enforcement history from the federal CMS record.
Residents receive an average of 3.82 nursing hours per day across all nursing staff, against a national average of 3.86 hours.
Yes. 7 of the 71 citations on record were scored at scope and severity G or above, meaning inspectors found actual harm to a resident or immediate jeopardy to resident safety.
Yes, Madera Rehabilitation & Nursing Center is certified to accept Medicaid, which is the programme that pays for long-term custodial care once a resident meets their state's income and asset limits.