California Nursing Homes: Violations, Fines and Worst Records

California nursing homes average 4.52 hours of nurse staffing for each resident per day, ranking fifth nationwide and topping the 3.86-hour national average. Over a single year, 36.7% of nursing staff left, against a national rate of 45.8%, and that figure puts the state 49th for departures. CMS, the federal Medicare agency, publishes federal nursing home data showing that 1,014 of the state's 1,165 licensed nursing homes run on a for-profit basis.

Across the last three inspection cycles, infection prevention and control was cited 3,391 times, more often than any other rule in California facilities. In cases of actual harm to a resident or immediate danger, inspectors most often cited accident hazards and supervision, with 485 citations statewide. Since September 2023, no federal fine against a home in the state has been larger than $478,110, issued in February 2025 to Rancho Seco Care Center in Galt.

The California Health Facility Information Database, known as Cal Health Find, lets families look up state inspection records; the state health department runs it. It lists each nursing home's licensing status, along with complaints, incidents reported by the facility, state enforcement actions, and deficiencies inspectors found. All 1,165 of the state's homes also appear on Medicare Care Compare, a federal search site formerly named Nursing Home Compare; there, families can open Form CMS-2567, the official deficiency statement, to see federal inspection reports.

The California Department of Public Health, Licensing and Certification, which inspects facilities as the state survey agency, accepts online reports of problems with resident care. Complaint visits accounted for 31.7% of all citations across the state. The Office of the State Long-Term Care Ombudsman at the California Department of Aging helps families with a resident's rights or care; call 1-800-231-4024. If an older or dependent adult may be suffering abuse or neglect, Adult Protective Services also takes reports at 1-833-401-0832.