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CA Nursing Homes:
Violations Key


Be sure to note the effective dates of this information on the county list page.

The information on violations comes to CANHR from the California Department of Public Health (DPH), Licensing and Certification (LCD) Branch; some of it comes from the central state office, some from regional district offices. CANHR organizes the data into a form intended to be easily comprehensible to consumers.

Please note: CANHR makes every effort to ensure that the information posted is accurate and up to date. Because CANHR relies directly on data from the Department of Public Health, CANHR cannot directly guarantee the accuracy of all data. If you are aware of an error in the information, please send a letter with the correct information to CANHR, 650 Harrison Street, 2nd Floor, San Francisco, CA 94107, or you may contact the CANHR office at (415) 974-5171, and we will verify the source of the error. All verified errors will be corrected as soon as possible.

A blank column indicates no violations or complaints (read as zeros).

The average capacity of California skilled nursing facilities is approximately 90. One might expect the number of complaints and citations to scale proportiionately with the capacity of the facility, but that deficiencies would be less affected by size since they are more related to the overall operation of each single facility.

Citations: Citations are issued by the Department of Public Health (DPH) during the annual certification visit, complaint investigations or special incident investigations for violations of state or federal law. Citations come in several classes depending on their severity. The state average is a little less than one per facility per year, but ideally, a facility should not have any citations; many facilities have few or none. Some facilities have numerous citations which indicates potential problems. The state issues the following classes, as well as the less frequent citations for the falsification of medical records (not listed).

  • Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.
  • Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.
  • Class B: Class B citations carry fines from $100 to $2000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.
  • Any Willful Material Falsification (WMF) or Willful Material Omission (WMO) in the health record of a resident carries a fine from $2,000 to $20,000 for each citation.

Complaints: Complaints are primarily consumer complaints filed with the Department of Public Health, but this number does not include complaints filed solely with the Ombudsman program. They may be filed by anyone, residents, relatives, ombudsmen or passers-by. Complaints shown could be filed in writing or by phone; in our view, complaints are not often filed frivolously. The totals shown include the infrequent cases in which a facility must self-report an event when required by law. Complaints can indicate the overall level of consumer satisfaction or dissatisfaction. The state average is shown for each year for comparison.

Deficiencies: Deficiencies are usually federal violations issued during the (approximately annual) inspection by the Department of Public Health, but may be issued at other times, as well. The state average number of deficiencies per facility is listed for each year. If no deficiencies are listed in the most recent year, it may mean that the facility has not had its annual survey yet.

We recommend that, as part of investigating a potential facility, you ask the administrator of the facility to let you read through the facility's most recent licensing inspection ("Survey") report; and that you ask about anything that concerns you as you do; this document is supposed to be available to you on the facility premises and you should be allowed plenty of time to go through it to your satisfaction. Keep in mind that the facility may have received more deficiencies than appear in the survey; call CANHR to see whether we have more complete information.

Tips on interpreting this data

This information should not be used as the sole measure of quality of care in a nursing home. While high numbers of violations generally indicate troubled facilities, a facility with low numbers may not necessarily offer excellent care. Many variables affect these statistics, making an absolute numerical comparison less than perfect for choosing a facility. For example, different DPH branch offices vary widely in their enforcement of the law.

It is important to visit potential facilities. Use the data listed here to select facilities that seem promising in terms of location, services and violation records, but then visit the facilities. CANHR has an evaluation checklist (included with the Pre-Placement Packet which may be ordered from us) to assist in the decision-making process.

If you have questions, call CANHR at (415) 974-5171 or (800) 474-1116 (consumers only, please).

Page Last Modified: December 23, 2014