This section provides a quick overview of the description of the nursing home as well as the quality of the care provided. This includes some data that describes the nursing home capabilities as well as select long-stay and short-stay quality measures.  All measures included in this section are also repeated in their respective sections – Facility Description, Staffing, Quality of Care, and Health and Safety Inspections.

Ratings on the Cal Long Term Care Compare (CLTCC) website are derived both from the federal Centers for Medicare & Medicaid Services (CMS) five-star quality rating system and select performance score ratings analyzed by the CLTCC team. For additional information on a nursing home, see the  California Department of Public Health’s Licensing and Certification Program (L&C).

• CMS uses a five-star rating system where more stars indicate better quality.
• For any measures that are scored by the CLTCC team, click on the score badge for an explanation of the ratings.

CMS 5-Star rating (Data Source: CMS Provider Data: through 9/30/2025)

The U.S. Centers for Medicare & Medicaid Services (CMS) created a five-star quality rating system to help consumers, their families, and caregivers compare nursing homes more easily and to help identify areas about which you may want to ask questions. Nursing homes with five stars are considered to have well above average quality, and nursing homes with one star are considered to have well below average quality. For more information, see the CMS website.

Special Focus Facility (Data Source: CMS Provider Data: through 9/30/2025)

The U.S. Centers for Medicare & Medicaid Services (CMS) created the Special Focus Facility (SFF) initiative to stimulate systematic improvements in quality of care. CMS has found that a small number of nursing homes have more serious problems than most other nursing homes that have persisted over at least three years. CMS requires that SFF nursing homes be visited in person by survey teams twice as frequently as other nursing homes to ensure improvements are being made. CMS limits California to 6 nursing homes on the SFF list at one time. For more information, see the CMS website.

Facility type (Data Source: CMS Provider Data; CDPH Licensed and Certified Healthcare Facility Listing: through 9/30/2025)

There are two basic types of skilled nursing facilities: freestanding or a distinct part of a hospital.

• Freestanding: Freestanding facilities provide 24-hour skilled nursing care to assist with short term recovery from a surgery, injury, or acute illness or provide on-going nursing home care for those who need more permanent long-term care.
• Distinct Part of acute care hospital: A Distinct Part facility is always associated with a hospital. It must be physically distinguishable from the hospital (separate address) and fiscally separate for cost reporting purposes. A Distinct Part facility provides the same services as a freestanding facility as well as treatment for acute illness or injury and intensive rehabilitation services. Most residents stay a brief time, usually a maximum of three weeks, and then are discharged to either a freestanding nursing home or back to their own home.

Payments accepted (Data Source: CDPH Licensed and Certified Healthcare Facility Listing: through 9/30/2025)

All nursing homes in California accept insurance payments directly from insurance companies (including private insurance and long-term care insurance). In addition, many are certified to receive payment from the Medicare program for short term stays defined as the first 100 days (about 3 and a half months) of care. Medicare pays most costs (excluding co-pays) for those who are Medicare beneficiaries. Medicare does not pay for stays beyond 100 consecutive days, at which point residents are considered to be long-term care residents. Some, but not all, facilities accept payment from the Medicaid program (Medi-Cal) for long-term residents with low incomes and few assets. If the resident does not qualify for Medi-Cal, they will be billed for the cost of care.

Number of beds (Data Source: CDPH Licensed and Certified Healthcare Facility Listing: through 9/30/2025)

This indicates the number of licensed beds distributed among private and shared rooms that have been certified to be paid for by Medicare and/or Medi-Cal.

CLTCC Staffing Rating (Data Source: Cal Long Term Care Compare: 1/1/2025 through 3/31/2025)

Most nursing homes in California care for a combination of people who are either recovering from a hospital stay or need long-term care. Evidence shows that staffing levels in nursing homes can affect the quality of care that residents receive in the nursing home. The CLTCC Staffing Rating shows whether the nursing home meets California’s minimum nurse staff hour requirements and whether it also provides enough hours of nursing care to meet the needs of its residents based on their severity of illness.

California Minimum Requirements: California law requires its nursing homes to provide at least 3.5 hours of direct nursing care per resident day, with at least 2.4 hours of that time coming from certified nursing assistants (CNAs). This does not mean that each resident gets 3.5 hours of nursing care every day because residents who are sicker or require complex care will need more hours of care per day while healthier residents will need less nursing care.

Expected Nursing Hours: The best nursing homes not only meet the state’s minimum requirement, but they also increase their staff hours based on the health conditions or severity of illness of their residents. The CLTCC rating includes the number of staff needed based on the severity of all residents in the nursing home during the measurement period.  This calculation can help nursing homes estimate the expected nursing hours needed to care for all their residents’ needs. The number of hours may exceed California’s minimum staffing requirement.

Nursing homes that meet minimum nursing hour requirements and meet or go beyond expected nursing hours get higher ratings.

Rating definitions:

• Poor: Did not provide California’s minimum nurse staff hours requirement. Specifically – failed to meet the California minimum requirement for both CNAs and total nurse staffing.
• Below Average: Met only part of the state requirement. Specifically – met only ONE of the two state minimum staffing requirements, either CNA or total nurse staffing.
• Average: Met or exceeded the California minimum staffing hours, but did not meet the expected hours for either CNA hours or total nursing hours based on residents’ severity of illness.
• Above Average: Had enough staff to meet California’s minimum nurse staff hours requirement and met or exceeded expectations for either CNA hours or total staffing hours based on residents’ severity of illness.
• Superior: Met the state minimum requirements and met or exceeded expected hours for both CNA and total nurse staff hours based on residents’ severity of illness.

Nursing staff turnover (Data Source: CMS Provider Data: 1/1/2024 through 12/31/2024)

The turnover measure shows the percent of all nursing staff (registered nurses, licensed practical/vocational nurses, and certified nursing assistants) who stopped working at the nursing home over a 12-month period. When nursing staff is constantly changing, it may be stressful and disruptive for residents to receive care from new staff who are unfamiliar with their routines or special needs. Evidence shows that the lower the nursing staff turnover rate at a nursing facility, the better the quality, continuity, and stability of care. If a nursing home has high turnover, families should ask about the reasons and how it affects care.

Percent of nursing staff who worked in the facility continuously for 12 months (Data Source: LTC Facility Integrated Disclosure and Medi-Cal Cost Report Data: 1/1/2023 through 12/31/2023)

This measure reflects the percentage of all nursing staff (registered nurses, licensed practical/vocational nurses, and certified nursing assistants) who stayed in their job for the past 12 months. Nursing staff who remain in the nursing home are generally more satisfied with their jobs. Higher retention rates can be associated with higher quality of care because there is more stability of the nursing home workforce. If a nursing home has low staff retention, families should ask about the reasons and how it affects care.

Short-Stay Residents

Percentage of successful return to home and community from a nursing home (Data source: CMS SNF Quality Reporting Program-Provider Data, 10/01/2021 – 09/30/2023)

This measure reports the percentage of short-stay residents admitted to the nursing home from a hospital who were then discharged to the community within 100 calendar days of admission, and who remained in the community for at least 30 consecutive days following discharge to the community. This measure is adjusted to be more fair among nursing homes because it takes into account characteristics about each resident like their age and how sick they are. If nursing homes have high numbers of residents who are readmitted to the hospital after discharge, it may indicate they are not adequately preparing residents for discharge or appropriately evaluating residents’ readiness to successfully care for themselves at home.

Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. (Data source: CMS SNF Quality Reporting Program-Provider Data, 04/01/2023 – 03/31/2024)

This measure reports the percentage of residents who are at or above their expected ability to care for themselves and move around when discharged from the SNF. Reducing difficulties with activities like eating, toileting, and moving around can improve residents’ quality of life. This measure is adjusted to be more fair among nursing homes because it takes into account characteristics about each resident like their age and how sick they are.

Long-Stay Residents

Percentage of long-stay residents who received an antipsychotic medication (Data Source: CMS MDS Quality Measures, 10/01/2023 – 09/30/2024)

Antipsychotic medications are used to treat a very specific group of mental health conditions such as schizophrenia; however, these drugs historically have been used to manage agitated behaviors in residents without schizophrenia or other appropriate medical conditions. This measure reports the percentage of long-stay residents who received an antipsychotic medication during the reporting period. This class of medications can cause serious harm and should not be given to control mood or behavior, particularly in residents with dementia.  Those who have a diagnosis of schizophrenia, Tourette’s syndrome, or Huntington’s disease were excluded from this measure as antipsychotics are appropriate for these residents. Nursing homes should employ alternative methods to reduce agitation such as increased exercise, improved pain management, music therapy, and other non-drug interventions. High rates of antipsychotic use may indicate poor quality of care.  Nursing homes should have non-pharmacological programs to manage resident behavioral issues. This measure is not adjusted for resident characteristics.

Percentage of long-stay residents with pressure ulcers (Data Source: CMS MDS Quality Measures, 04/01/2023 – 03/31/2024)

Pressure ulcers (also known as pressure injuries or sores) are areas of damaged skin caused by the resident staying in one position for too long; prolonged pressure in that area causes breakdown in the skin and underlying tissue resulting in a pressure sore, ulcer or open wound. Long-stay residents who have at least one of the following conditions are considered to be at high-risk for pressure ulcers: impaired mobility (difficulty moving), difficulty staying nourished (poor nutrition), or in a coma. This measure reports high-risk, long-stay residents who have pressure ulcers/injuries. These residents are dependent upon the nursing staff to turn and reposition them frequently to avoid pressure ulcers/injuries. Nursing homes should have a strong pressure ulcer/injury program that emphasizes frequent repositioning in residents at high risk. This measure is not adjusted for resident characteristics.

Percentage of long-stay residents who lose too much weight (Data Source: CMS MDS Quality Measures, 10/01/2023 – 9/30/2024)

Unexpected or unintentional weight loss is often associated with poor health outcomes and could be associated with an underlying illness. However, it may also be associated with certain medications, difficulty chewing or swallowing food, poor dental health, and depression among other causes. Nursing home staff should monitor each resident’s weight regularly and if there is unintentional, significant weight loss (5% or more in the last month or 10% or more in the last 6 months), they should notify the primary care provider who may order diagnostic tests, a dietary consultation, and changes in the type of diet. This measure is not adjusted for resident characteristics.

Percentage of long-stay residents with new or worsened bowel or bladder incontinence. (Data source: CMS MDS Quality Measures, 10/01/2023 – 09/30/2024)

This measure reports the percent of long-stay residents with new or worsened ability to control their bowels or bladder.  Over half of nursing home residents are incontinent of urine, which can increase their risk for falls with injury and pressure ulcers/injuries. Residents who are incontinent often avoid group activities due to embarrassment and may have a lower quality of life. Staff can reduce incontinence episodes by employing strategies such as bladder or bowel training and prompted or scheduled voiding. This measure is not adjusted for resident characteristics.

Combined Federal and State Health Inspections Rating (Data Source: Cal Long Term Care Compare: 10/1/2022 through 9/30/2025)

This rating is based on the number and type of state and federal citations that were found during the reporting period. More weight is given to the most recent health inspection and, therefore, the most recent violations. The state may cite a facility for the same violation that the federal government identifies, while other times the federal and state violations are completely different.

Federal fines issued for violations from the last three years ($) (Data Source: CMS Penalties: through 9/30/2025)

This figure shows the total dollar amount in fines that CMS has charged the nursing home for not following health and safety rules during the specified period. The amount of the fines can vary depending on how many residents were affected or the seriousness of the violation. Most nursing homes do not have any federal fines.

Total federal and state fines ($) (Data Source: CMS Penalties; CA Health Facilities State Enforcement Actions: through 9/30/2025)

This is the total dollar amount charged to the nursing home for not following federal and/or state health and safety rules. Most nursing homes do not have any federal or state fines.

Number of days the facility was denied payment due to unresolved violations (Data Source: CMS Penalties: through 9/30/2025)

This is the number of days the nursing home could not receive Medicare payments for new residents because  of unresolved violations. Most nursing homes do not have any denials of payment.