Nursing Care Index

Adventist Health Sonora - D/P Snf

Sonora, Tuolumne County, California · CCN 555209 · Non-profit (Church related) · part of Adventist Health (5 facilities, chain average 4 stars)

CMS rates Adventist Health Sonora - D/P Snf 5 of 5 overall as of August 2026. 68 certified beds, 63 residents a day on average. 39 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★★★★★ 5 of 5
Health inspections★★★★☆ 4 of 5
Staffing★★★★★ 5 of 5
Quality measures★★★☆☆ 3 of 5
Quality: long-stay / short-stay3 / — of 5

Staffing

Total nurse staffing4.71237 hours per resident per day
Registered nurses1.10549 hours per resident per day
Weekend total4.00694 hours per resident per day
Nursing staff turnover28.4% (registered nurses 22.7%)

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.

SurveyFindingSeverityStatus
2026-01-23
complaint survey
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-02-13
2025-06-19 Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0605
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-07-10
2025-06-19 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
2025-07-10
2025-06-19 Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Administration Deficiencies · tag F0867
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-07-10
2025-06-19 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-07-10
2025-06-19 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-07-10
2025-05-20
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
2025-06-27
2024-05-09 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
2024-06-07
2024-05-09 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
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-07
2024-05-09 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
2024-06-07
2024-05-09 Ensure each resident’s drug regimen must be free from unnecessary drugs.
Pharmacy Service Deficiencies · tag F0757
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-07
2024-05-09 Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Pharmacy Service Deficiencies · tag F0758
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-07
2024-05-09 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-07
2024-05-09 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.
Resident Rights Deficiencies · tag F0584
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-07
2024-05-09 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies · tag F0623
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-07
2024-05-09 Assist a resident in gaining access to vision and hearing services.
Quality of Life and Care Deficiencies · tag F0685
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-07
2024-05-09 Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Quality of Life and Care Deficiencies · tag F0688
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-07
2024-05-09 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
2024-06-07
2024-05-09 Provide or get specialized rehabilitative services as required for a resident.
Quality of Life and Care Deficiencies · tag F0825
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-07
2024-05-09 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
2024-06-07
2024-03-21
complaint survey
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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-15
2024-02-20
complaint survey
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0604
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-01
2023-12-15
complaint survey
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-05
2023-12-15
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-05
2023-03-16 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-04-07
2023-03-16 Honor the resident's right to manage his or her financial affairs.
Resident Rights Deficiencies · tag F0567
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-04-07
2023-03-16 Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Quality of Life and Care Deficiencies · tag F0688
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-04-07
2023-03-16 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies · tag F0725
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-04-07
2023-03-16 Implement a program that monitors antibiotic use.
Infection Control Deficiencies · tag F0881
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-04-07
2023-03-16 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
2023-04-07
2023-03-16 Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
Resident Rights Deficiencies · tag F0568
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-04-07
2023-03-16 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-04-07
2023-03-16 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
2023-04-07
2023-03-16 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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-04-07
2023-03-16 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
2023-04-07
2023-03-16 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
2023-04-07
2023-03-16 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
2023-04-07
2023-03-16 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
2023-04-07
2023-03-16 Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control Deficiencies · tag F0883
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-04-07

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.

NameRoleShareSince
Adventist Health System/West
Organization
operational/managerial control1980-06-16
Mcculloch, Gregory
Individual
contracted managing employee2014-05-05
Freedman, John
Individual
corporate director2016-09-26
Gabriel, Melody
Individual
corporate director2015-06-01
Graham, Ricardo
Individual
corporate director2015-06-01
Heinrich, Kerry
Individual
corporate director2014-12-16
Innocent, Larry
Individual
corporate director2015-06-01
Pedersen, James
Individual
corporate director2017-01-16
Reiner, Brian
Individual
corporate director2011-05-13
Reiner, Richard
Individual
corporate director2017-01-16
Rippey, Wesley
Individual
corporate director2015-06-01
Salazar, Velino
Individual
corporate director2015-09-15
Wing, Billy
Individual
corporate director2014-03-31
Jahn, Andrew
Individual
corporate officer2014-02-03
Jobe, Meredith
Individual
corporate officer2014-03-31
Mcculloch, Gregory
Individual
corporate officer2014-05-05
Reiner, Brian
Individual
corporate officer2014-03-14
Wagner, Jack
Individual
corporate officer2014-03-31
Wing, Billy
Individual
corporate officer2014-03-31
Jahn, Andrew
Individual
w-2 managing employee2011-08-08
Mcculloch, Gregory
Individual
w-2 managing employee2014-05-05

What changed

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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 Tuolumne County.