La Sierra Care Center
Merced, Merced County, California · CCN 055271 · For-profit (LLC) · part of Cambridge Healthcare Services (32 facilities, chain average 2.5 stars)
CMS rates La Sierra Care Center 3 of 5 overall as of August 2026. 68 certified beds, 66 residents a day on average. 38 citations on record from the current inspection cycles; no fines on record.
CMS’s ratings
The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.
| Overall | ★★★☆☆ 3 of 5 |
|---|---|
| Health inspections | ★★★☆☆ 3 of 5 |
| Staffing | ★★★☆☆ 3 of 5 |
| Quality measures | ★★★☆☆ 3 of 5 |
| Quality: long-stay / short-stay | 5 / 1 of 5 |
Staffing
| Total nurse staffing | 3.92753 hours per resident per day |
|---|---|
| Registered nurses | 0.51649 hours per resident per day |
| Weekend total | 3.65718 hours per resident per day |
| Nursing staff turnover | 54.9% (registered nurses 85.7%) |
| Administrators who left | 0 |
Citations from health inspections
Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.
| Survey | Finding | Severity | Status |
|---|---|---|---|
| 2026-01-23 | 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. Nutrition and Dietary Deficiencies · tag F0801 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-02-23 |
| 2026-01-23 | 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. Nutrition and Dietary Deficiencies · tag F0803 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-02-23 |
| 2026-01-23 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. Nutrition and Dietary Deficiencies · tag F0806 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-02-23 |
| 2026-01-23 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · tag F0812 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-02-23 |
| 2026-01-23 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · tag F0842 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-02-23 |
| 2026-01-23 | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Environmental Deficiencies · tag F0912 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-02-23 |
| 2026-01-23 | Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · tag F0558 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-02-23 |
| 2026-01-23 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · tag F0656 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-02-23 |
| 2026-01-23 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · tag F0658 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-02-23 |
| 2026-01-23 | 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. Pharmacy Service Deficiencies · tag F0761 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-02-23 |
| 2026-01-23 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · tag F0880 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-02-23 |
| 2025-11-19 complaint survey |
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies · tag F0655 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-12-11 |
| 2025-04-03 complaint survey |
Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · tag F0658 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-04-21 |
| 2024-10-23 complaint survey |
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. Nutrition and Dietary Deficiencies · tag F0800 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2024-11-04 |
| 2024-08-23 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · tag F0804 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · tag F0812 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Environmental Deficiencies · tag F0912 |
F No actual harm, with potential for more than minimal harm; widespread | Waiver has been granted 2024-09-23 |
| 2024-08-23 | Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · tag F0759 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · tag F0760 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · tag F0641 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | PASARR screening for Mental disorders or Intellectual Disabilities Resident Assessment and Care Planning Deficiencies · tag F0645 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · tag F0657 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | Provide enough food/fluids to maintain a resident's health. Quality of Life and Care Deficiencies · tag F0692 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · tag F0695 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · tag F0755 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · tag F0842 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-23 |
| 2024-08-23 | Post nurse staffing information every day. Nursing and Physician Services Deficiencies · tag F0732 |
C No actual harm, with potential for minimal harm; widespread | Deficient, Provider has date of correction 2024-09-23 |
| 2023-10-09 complaint survey |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · tag F0656 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-10-26 |
| 2021-04-29 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly Administration Deficiencies · tag F0868 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2021-06-10 |
| 2021-04-29 | Honor the resident's right to organize and participate in resident/family groups in the facility. Resident Rights Deficiencies · tag F0565 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2021-04-29 |
| 2021-04-29 | Provide activities to meet all resident's needs. Quality of Life and Care Deficiencies · tag F0679 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2021-06-10 |
| 2021-04-29 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · tag F0689 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2021-06-10 |
| 2021-04-29 | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Environmental Deficiencies · tag F0912 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2021-06-10 |
| 2021-04-29 | Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · tag F0558 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2021-05-11 |
| 2021-04-29 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · tag F0658 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2021-05-20 |
| 2021-04-29 | 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. Pharmacy Service Deficiencies · tag F0761 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2021-05-20 |
| 2021-04-29 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · tag F0812 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2021-06-10 |
| 2021-04-29 | Provide at least one room set aside to use as a resident dining room and for activities, that is a good size, with good lighting, air flow and furniture. Environmental Deficiencies · tag F0920 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2021-05-11 |
Fines and payment denials
No fines or payment denials on record since 2023.
Who owns and runs it
Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.
| Name | Role | Share | Since |
|---|---|---|---|
| Crescent Facilities Operations LLC Organization | 5% or greater direct ownership interest | 100% | 2007-02-07 |
| Bering Properties LLC Organization | 5% or greater indirect ownership interest | — | 2007-02-01 |
| Ira & Rachel Smedra Family Irrevocable Gift Trust Organization | 5% or greater indirect ownership interest | — | 2007-02-01 |
| Jenmax Enterprises LLC Organization | 5% or greater indirect ownership interest | — | 2007-02-01 |
| Jennifer Nurit Smedra Trust 1997 Trust Organization | 5% or greater indirect ownership interest | — | 2007-02-01 |
| Jk-Csh Jv LLC Organization | 5% or greater indirect ownership interest | — | 2006-11-01 |
| Manhattan Five Partners LLC Organization | 5% or greater indirect ownership interest | — | 2006-11-01 |
| The Hyman & Betty Ingber Family Trust Organization | 5% or greater indirect ownership interest | — | 2013-10-10 |
| Win Win Enterprises, LLC Organization | 5% or greater indirect ownership interest | — | 2007-02-01 |
| 2424 M Street LLC Organization | adp of the snf | — | 2006-12-15 |
| Cambridge Healthcare Services LLC Organization | adp of the snf | — | 2025-07-15 |
| Jenmax Enterprises LLC Organization | adp of the snf | — | 2007-02-01 |
| Jk-Csh Jv LLC Organization | adp of the snf | — | 2006-11-01 |
| Win Win Enterprises, LLC Organization | adp of the snf | — | 2007-02-01 |
| Bh Alliance Organization | indirect ownership interest | — | 2006-11-01 |
| The Jacob Wintner Trust Organization | indirect ownership interest | — | 2006-11-01 |
| The Wintner Living Trust Dated 7/08/1992 Organization | indirect ownership interest | — | 2007-02-01 |
| Cambridge Healthcare Services LLC Organization | operational/managerial control | — | 2014-04-01 |
| Bretsch, Gregory Individual | adp of the snf | — | 2019-02-25 |
| Butenko, Julie Individual | adp of the snf | — | 2023-07-24 |
| Capela, Heidi Individual | adp of the snf | — | 2023-04-03 |
| Darouze, Michael Individual | adp of the snf | — | 2025-07-15 |
| Hassell, Lance Individual | adp of the snf | — | 2022-04-25 |
| Lutz, Linda Individual | adp of the snf | — | 2012-02-01 |
| Manoharan, Arun Individual | adp of the snf | — | 2024-08-24 |
| Salazar, Paulina Individual | adp of the snf | — | 2020-12-14 |
| Smedra, Ira Individual | adp of the snf | — | 2014-04-01 |
| Smedra, Ira Individual | corporate officer | — | 2014-04-01 |
| Wintner, Jacob Individual | corporate officer | — | 2007-02-01 |
| Wintner, Jacob Individual | indirect ownership interest | — | 2007-02-01 |
| Bretsch, Gregory Individual | managing control - governing body | — | 2019-02-25 |
| Darouze, Michael Individual | managing control - governing body | — | 2024-01-22 |
| Bretsch, Gregory Individual | operational/managerial control | — | 2019-02-25 |
| Butenko, Julie Individual | operational/managerial control | — | 2023-07-24 |
| Capela, Heidi Individual | operational/managerial control | — | 2023-04-03 |
| Darouze, Michael Individual | operational/managerial control | — | 2024-01-22 |
| Hassell, Lance Individual | operational/managerial control | — | 2022-04-25 |
| Lutz, Linda Individual | operational/managerial control | — | 2012-02-01 |
| Manoharan, Arun Individual | operational/managerial control | — | 2024-08-24 |
| Salazar, Paulina Individual | operational/managerial control | — | 2020-12-01 |
| Silveira, Skyler Individual | operational/managerial control | — | 2021-12-01 |
| Smedra, Ira Individual | operational/managerial control | — | 2014-04-01 |
| Wintner, Jacob Individual | operational/managerial control | — | 2007-02-01 |
What changed
Nothing has changed in this record since it was first loaded. The next CMS refresh is the next chance.
Tell me when this record changes
One email when the monthly CMS refresh brings a new citation, a fine or payment denial, a rating change, a flag, or a change of ownership for La Sierra Care Center.
Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Merced County.