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Nursing HomeMedicaid Investigative

Madera Rehabilitation & Nursing Center

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

517 South a Street, Madera, CA 93638176 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Google rating
3.6/5

based on 43 Google reviews

5
4
3
2
1
Madera Rehabilitation & Nursing Center Nursing Home in Madera, CA — Street View
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3/ 10
moderate Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low overall rating (2/5 stars)
  • Above-median deficiencies (24 vs median 13.0)

Below average in CA · Below recommended RN staffing · Below chain average · $373,733 in fines

Source: Medicare data

What this means for your family

The facility offers excellent physical therapy and a compassionate daytime staff that can greatly aid in post-surgery recovery. However, you must be extremely vigilant regarding night-shift care, as multiple families have reported significant delays in response to call lights and issues with hygiene during late hours.

Google Reviews

Google Reviews

43 reviews analyzed
Families may find comfort in the facility's highly praised physical therapy and compassionate daytime nursing staff. However, there are significant, recurring reports of delayed response to call lights, neglect during night shifts, and concerns regarding medical oversight and facility maintenance.

Quality Themes

Tap a score for details
Food4.0Staff5.0Clean3.0Activities9.0MedsN/AMemoryN/AComms2.0ValueN/A

Strengths

  • Compassionate therapy and rehabilitation team
  • Friendly and attentive daytime nursing staff
  • Engaging activities and social services
  • Helpful and professional business office staff

Concerns

  • Slow response to call lights and neglect during night shifts (mentioned by 5 reviewers)
  • Issues with facility maintenance and cleanliness (mentioned by 3 reviewers)
  • Inconsistent medical/nursing oversight (mentioned by 2 reviewers)

Rating Trends

Tap a year to see what changed

234'14(3)'16(2)'18(7)'20(2)'22(2)'24(6)'26(4)

Distribution

5
23
4
5
3
1
2
2
1
11

How They Respond to Reviews

0%response rate

Questions for Your Tour

  • 1We've heard wonderful things about your therapy and rehab team; could you tell us more about how they work with residents to regain their independence?
  • 2What specific steps is the facility taking to ensure the rooms and common areas are kept consistently clean and well-maintained?
  • 3How do you ensure that the high level of attentive care provided during the day continues through the night shift?
  • 4Could you describe the daily activity calendar and how you help residents stay socially engaged with one another?
  • 5With the recent focus on improving communication, what is your process for keeping family members updated on a resident's medical status or changes in care?
  • 6How does the nursing team handle medical emergencies or urgent needs that arise during the late-night or early-morning hours?

Personalized based on this facility's data


Key Review Excerpts

The therapist would come in to get him for therapy if he was sleeping they would come back later when he was awake, but always got his therapy in!

Rehab patient's family · 2018★★★★★

The staff, from the business office to the nurses, are very friendly and thorough and they take great care of her. They are super helpful and attentive to her and answer any questions we may have promptly.

Long-term resident's family · 2015★★★★★

I found out tonight that a tall, skinny black nurse with an Afro told my 83 yr old father... that my brother 'no longer wants to care for him and wants nothing to do with him'.

Long-term resident's family · 2025☆☆☆☆
Source: 43 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.60hrs
81%
Registered nurses for medical care
Total Nursing
3.92hrs
96%
All nurses + aides combined
Staff Turnover
40%
Lower is better (< 30% = good)
RN Turnover
48%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
5/ 5
Better Than Avg

10

measures

Worse Than Avg

2

measures

Mixed Results

5

measures

Long-Stay Residents
🚶

Residents whose walking got worse

↓ Lower is better
This Facility21.1%
Worse than Avg
Here
21.1%
US
15.3%
CA
10.5%
Madera
13.8%
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility11.1%
Better than Avg
Here
11.1%
US
19.5%
CA
13.7%
Madera
21.1%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
93.4%
CA
98.6%
Madera
98.6%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility17.2%
Mixed vs Avgs
Here
17.2%
US
19.4%
CA
10.7%
Madera
19.7%
😔

Residents with depression symptoms

↓ Lower is better
This Facility6.9%
Better than Avg
Here
6.9%
US
12.1%
CA
7.0%
Madera
9.2%
💉

Residents vaccinated for the flu

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
95.5%
CA
98.2%
Madera
97.0%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility95.9%
Better than Avg
Here
95.9%
US
79.7%
CA
93.2%
Madera
84.6%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility95.6%
Better than Avg
Here
95.6%
US
81.8%
CA
94.2%
Madera
92.8%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility0.7%
Mixed vs Avgs
Here
0.7%
US
1.6%
CA
1.5%
Madera
0.2%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

24deficiencies
5penalties
Well above state avg (15.4)
38 complaint-triggered
$373,733 in fines

This facility has a concerning pattern of recurring problems, particularly with accident prevention and safety hazards that have persisted across multiple recent complaint-triggered surveys. Families filed 30 complaints leading to inspections, with repeated issues in safety supervision, infection control, and care planning. The facility shows ongoing struggles with preventing accidents and maintaining safe environments, with the same safety deficiency appearing in four separate complaint investigations in 2025. While violations are typically corrected after citation, the frequency of family complaints and repeated safety issues suggest persistent quality concerns that warrant careful consideration before placement.

Feb 24, 2026Complaint
1
0908ModerateCorrected

Environmental Deficiencies

Keep all essential equipment working safely.

Feb 11, 2026Complaint
2
0842ModerateCorrected

Resident Assessment and Care Planning Deficiencies

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

0880ModerateCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Aug 14, 2025Complaint
1
0689ModerateCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Jun 10, 2025Complaint
2
0584ModerateCorrected

Resident Rights Deficiencies

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.

0880ModerateCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Apr 15, 2025Complaint
6
0689ModerateCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0689ModerateCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0726ModerateCorrected

Nursing and Physician Services Deficiencies

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

0726ModerateCorrected

Nursing and Physician Services Deficiencies

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

0609MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

0609MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Mar 7, 2025Complaint
11
0689SevereCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0835ModerateCorrected

Administration Deficiencies

Administer the facility in a manner that enables it to use its resources effectively and efficiently.

0656ModerateCorrected

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

0726ModerateCorrected

Nursing and Physician Services Deficiencies

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

0849ModerateCorrected

Administration Deficiencies

Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.

0865ModerateCorrected

Administration Deficiencies

Have a plan that describes the process for conducting QAPI and QAA activities.

0580MinorCorrected

Resident Rights Deficiencies

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

0584MinorCorrected

Resident Rights Deficiencies

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.

0609MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

0658MinorCorrected

Resident Assessment and Care Planning Deficiencies

Ensure services provided by the nursing facility meet professional standards of quality.

0880MinorCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Federal Penalties

Fine

Aug 14, 2025

$126,900

Payment Denial

Aug 14, 2025

15-day denial

Fine

Jan 9, 2025

$194,145

Payment Denial

Jan 9, 2025

83-day denial

Fine

Mar 8, 2024

$52,688

Ownership & Operations

Who Operates This Facility

Owner / Operator

Madera Rehabilitation & Nursing Center

Organization Type

for profit

Chain Affiliation

Chain Name

Cambridge Healthcare Services

Chain Size

32 facilities nationwide

Chain avg rating: 2.6/5 · Rank 21 of 31

Ownership & Management

Owners

Crescent Facilities Operations LLC

Owner · Organization

100%

Bering Properties LLC

Owner (parent company) · Organization

6%

Jenmax Enterprises LLC

Owner (parent company) · Organization

23%

Jk-csh Jv LLC

Owner (parent company) · Organization

12%

Manhattan Five Partners LLC

Owner (parent company) · Organization

7%

Win Win Enterprises, LLC

Owner (parent company) · Organization

35%

Bh Alliance

Owner (parent company) · Organization

The Jacob Wintner Trust

Owner (parent company) · Organization

The Wintner Living Trust Dated 7/08/1992

Owner (parent company) · Organization

Key personnel

Bretsch, GregoryManaging Control - Governing BodyLal, AkashManaging Control - Governing BodyWintner, JacobOfficer / DirectorCambridge Healthcare Services LLCManagerBretsch, GregoryManager
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 3 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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