SNF

CORNERSTONE CARE CENTER

CCN: 056100 · SANGER, CA 93657 · Fresno County

Overview

Address
2550 9TH STREET, SANGER, CA 93657
Phone
5598756501
Certified beds
99
Avg daily residents
94 (95% of beds filled)
Ownership
For-profit LLC
Provider type
Medicare and Medicaid
Medicare/Medicaid since
1971-01-01
Setting
Urban
2 /5
★★★★★
CMS Overall Rating

CMS 5-Star Ratings

CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.

Overall Rating
Composite of Health Inspection, Staffing, and Quality Measures.
★★★★★ 2/5
Health Inspection
Based on the three most recent standard surveys, with more weight on recent results.
★★★★★ 2/5
Staffing
Weighted combination of RN and total nurse staffing hours per resident per day, case-mix adjusted.
★★★★★ 2/5
Quality Measures
15 resident-level quality measures split between long-stay and short-stay (post-acute) residents.
★★★★★ 4/5
Quality Measures breakdown
Long-Stay Quality Measures ★★★★★ 5/5
Short-Stay Quality Measures ★★★★★ 2/5

Staffing & Workforce

Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.

Role Reported Case-mix expected Adjusted Federal floor
Total nurse
All nursing staff combined: RN + LPN + Aide
 3.76 4.23 3.43 ≥ 3.48
Registered Nurse (RN)
Licensed RN hours. Strongest driver of clinical outcomes.
 0.51 0.74 0.47 ≥ 0.55 Below floor
Licensed Practical Nurse (LPN)
LPN/LVN hours. Often handles medication administration.
 0.92 0.94 0.84 —
Nurse aide
CNA hours. Bulk of direct resident care — bathing, feeding, mobility.
 2.33 2.55 2.13 —
Licensed (RN + LPN)
Combined licensed nurse coverage.
 1.43 — — —
Physical therapist
Rehabilitation therapist hours — important for post-acute / rehab admissions.
 0.10 — — —

Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.

Weekend staffing

Total nurse (weekend)
3.46
hrs / resident / day
RN (weekend)
0.48
hrs / resident / day
Total nurse (adjusted, weekend)
3.16
hrs / resident / day

Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.

Staff turnover

Total nursing staff turnover
44.4%
annual
RN turnover
38.5%
annual
Administrators departed
1
last 12 months

Resident acuity

Nursing Case-Mix Index
1.50
higher acuity than avg
Case-Mix Index Ratio
1.09
facility / state ratio

Health Inspections

CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.

Cycle Date Total defs. Standard Complaint Deficiency score Revisits Total score
Cycle 1 (most recent) 2025-05-01 16 14 2 104 1 104
Cycle 2/3 (prior) 2024-06-10 24 16 8 240 1 240
Total weighted health score
138.0
lower is better

Deficiencies (55)

Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).

48 D/E/F Actual harm — potential for minor
7 G/H/I Actual harm
Tag Description Scope/Severity Survey date Corrected
0628 Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. D 2026-01-29 2026-02-15
0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. D 2025-12-30 2026-01-14
0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. D 2025-05-01 2025-05-16
0637 Assess the resident when there is a significant change in condition D 2025-05-01 2025-05-16
0640 Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. D 2025-05-01 2025-05-16
0641 Ensure each resident receives an accurate assessment. D 2025-05-01 2025-05-16
0658 Ensure services provided by the nursing facility meet professional standards of quality. D 2025-05-01 2025-05-16
0757 Ensure each resident’s drug regimen must be free from unnecessary drugs. D 2025-05-01 2025-05-16
0759 Ensure medication error rates are not 5 percent or greater. E 2025-05-01 2025-05-16
0761 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. E 2025-05-01 2025-05-16
0803 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. E 2025-05-01 2025-05-16
0806 Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. D 2025-05-01 2025-05-16
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. F 2025-05-01 2025-05-16
0814 Dispose of garbage and refuse properly. F 2025-05-01 2025-05-16
0880 Provide and implement an infection prevention and control program. E 2025-05-01 2025-05-16
0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. D 2025-05-01 2025-05-16
0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. E 2025-01-22 2025-02-07
0584 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. D 2025-01-22 2025-02-07
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. E 2025-01-22 2025-02-07
0908 Keep all essential equipment working safely. E 2025-01-22 2025-02-07
0658 Ensure services provided by the nursing facility meet professional standards of quality. E 2024-10-28 2024-10-31
0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. D 2024-06-10 2024-06-27
0577 Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. F 2024-06-10 2024-06-27
0584 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. E 2024-06-10 2024-06-27
0641 Ensure each resident receives an accurate assessment. D 2024-06-10 2024-06-27
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. E 2024-06-10 2024-06-27
0658 Ensure services provided by the nursing facility meet professional standards of quality. D 2024-06-10 2024-06-27
0685 Assist a resident in gaining access to vision and hearing services. G 2024-06-10 2024-06-27
0687 Provide appropriate foot care. E 2024-06-10 2024-06-27
0744 Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. D 2024-06-10 2024-06-27
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. E 2024-06-10 2024-06-27
0757 Ensure each resident’s drug regimen must be free from unnecessary drugs. D 2024-06-10 2024-06-27
0758 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. G 2024-06-10 2024-06-27
0761 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. E 2024-06-10 2024-06-27
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. F 2024-06-10 2024-06-27
0880 Provide and implement an infection prevention and control program. E 2024-06-10 2024-06-27
0925 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. D 2024-06-10 2024-06-27
0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. G 2023-06-23 2023-07-25
0697 Provide safe, appropriate pain management for a resident who requires such services. G 2023-03-03 2023-03-08
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. G 2023-03-03 2023-03-08
0565 Honor the resident's right to organize and participate in resident/family groups in the facility. D 2022-02-15 2022-05-23
0578 Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. E 2022-02-15 2022-05-23
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. E 2022-02-15 2022-05-23
0657 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. E 2022-02-15 2022-05-23
0658 Ensure services provided by the nursing facility meet professional standards of quality. E 2022-02-15 2022-05-23
0676 Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. D 2022-02-15 2022-05-23
0697 Provide safe, appropriate pain management for a resident who requires such services. G 2022-02-15 2022-05-23
0698 Provide safe, appropriate dialysis care/services for a resident who requires such services. D 2022-02-15 2022-05-23
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. E 2022-02-15 2022-05-23
0756 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. E 2022-02-15 2022-05-23

Showing 50 most recent of 55. See the All Data CSV for the full list.

Penalties (2)

Fines issued
2
last 3 years
Total fines
$54,444
Date Type Fine amount
2023-06-23 Fine $26,832
2024-06-10 Fine $27,612

Source: CMS Nursing Home Penalties.

Financial Health (FY 2023)

Payer mix (share of resident days)

Medicare 14.6% Medicaid 16.4% Other 69.0%

Operating performance

Operating Margin
17.6%
Total Margin
17.6%
Occupancy Rate
92.3%
Cost per Resident Day
$44

Revenue & costs

Net Patient Revenue
$13.9M
Total Costs
$1.6M
Net Income
$2.5M

Balance sheet

Total Assets
$4.4M
Total Liabilities
$2.0M
Fund Balance
$2.5M
Current Ratio
2.21

Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.

Ownership & Corporate Structure

Chain: BAYSHIRE SENIOR COMMUNITIES

Chain ID
682
Facilities in chain
12
Legal business name
SANGER SKILLED CARE LLC
Chain-average star ratings (for peer context)
Overall
3.1
Health
2.7
Staffing
2.2
QM
4.4

Owner / manager organizations (2)

Organization Role Association
BAYSHIRE CENTRAL VALLEY LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 12/01/2022
BAYSHIRE LLC 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 12/01/2022

Owner / manager individuals (7)

Name Role Association
CARTER, BENJAMIN 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 12/01/2022
KIRBY, SCOTT 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 12/01/2022
SALOW, DONALD 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 12/01/2022
CARTER, BENJAMIN CORPORATE OFFICER since 12/01/2022
KIRBY, SCOTT CORPORATE OFFICER since 12/01/2022
SALOW, DONALD CORPORATE OFFICER since 12/01/2022
KIRBY, SCOTT W-2 MANAGING EMPLOYEE since 12/01/2022

Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.

Facility Features

CCRC
No
Hospital-based
No
Resident / family council
Both
Sprinkler systems
Yes
Abuse citation flag
No
Methodology & sources

Full methodology →

All Data

Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.

Download CSV

Show 113 rows
Source Metric Value Raw key
Cost Report Cost per Resident Day ($) $44 metrics.cost_per_resident_day
Cost Report Current Ratio 2.21 metrics.current_ratio
Cost Report fiscal_year 2,023 fiscal_year
Cost Report Medicaid Day Share (%) 16.4% metrics.medicaid_day_share
Cost Report Medicare Day Share (%) 14.6% metrics.medicare_day_share
Cost Report Net Income ($) $2,455,345 metrics.net_income
Cost Report Net Patient Revenue ($) $13,946,981 metrics.net_patient_revenue
Cost Report Occupancy Rate (%) 92.3% metrics.occupancy_rate
Cost Report Operating Margin (%) 17.6% metrics.operating_margin
Cost Report Total Assets ($) $4,435,245 metrics.total_assets
Cost Report Total Costs ($) $1,603,404 metrics.total_costs
Cost Report Total Fund Balances ($) $2,455,345 metrics.fund_balance
Cost Report Total Liabilities ($) $1,979,900 metrics.total_liabilities
Cost Report Total Margin (%) 17.6% metrics.total_margin
Provider Information Abuse Icon N Abuse Icon
Provider Information Adjusted LPN Staffing Hours per Resident per Day 0.83966 Adjusted LPN Staffing Hours per Resident per Day
Provider Information Adjusted Nurse Aide Staffing Hours per Resident per Day 2.12525 Adjusted Nurse Aide Staffing Hours per Resident per Day
Provider Information Adjusted RN Staffing Hours per Resident per Day 0.46917 Adjusted RN Staffing Hours per Resident per Day
Provider Information Adjusted Total Nurse Staffing Hours per Resident per Day 3.43408 Adjusted Total Nurse Staffing Hours per Resident per Day
Provider Information Adjusted Weekend Total Nurse Staffing Hours per Resident per Day 3.15749 Adjusted Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Administrator turnover footnote — Administrator turnover footnote
Provider Information Automatic Sprinkler Systems in All Required Areas Yes Automatic Sprinkler Systems in All Required Areas
Provider Information Average Number of Residents per Day 93.6 Average Number of Residents per Day
Provider Information Average Number of Residents per Day Footnote — Average Number of Residents per Day Footnote
Provider Information Case-Mix LPN Staffing Hours per Resident per Day 0.93924 Case-Mix LPN Staffing Hours per Resident per Day
Provider Information Case-Mix Nurse Aide Staffing Hours per Resident per Day 2.55263 Case-Mix Nurse Aide Staffing Hours per Resident per Day
Provider Information Case-Mix RN Staffing Hours per Resident per Day 0.74032 Case-Mix RN Staffing Hours per Resident per Day
Provider Information Case-Mix Total Nurse Staffing Hours per Resident per Day 4.23219 Case-Mix Total Nurse Staffing Hours per Resident per Day
Provider Information Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day 3.73023 Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Chain Average Health Inspection Rating 2.7 Chain Average Health Inspection Rating
Provider Information Chain Average Overall 5-star Rating 3.1 Chain Average Overall 5-star Rating
Provider Information Chain Average QM Rating 4.4 Chain Average QM Rating
Provider Information Chain Average Staffing Rating 2.2 Chain Average Staffing Rating
Provider Information Chain ID 682 Chain ID
Provider Information Chain Name BAYSHIRE SENIOR COMMUNITIES Chain Name
Provider Information City/Town SANGER City/Town
Provider Information CMS Certification Number (CCN) 056100 CMS Certification Number (CCN)
Provider Information Continuing Care Retirement Community N Continuing Care Retirement Community
Provider Information County/Parish Fresno County/Parish
Provider Information Date First Approved to Provide Medicare and Medicaid Services 1971-01-01 Date First Approved to Provide Medicare and Medicaid Services
Provider Information Geocoding Footnote — Geocoding Footnote
Provider Information Health Inspection Rating 2 Health Inspection Rating
Provider Information Health Inspection Rating Footnote — Health Inspection Rating Footnote
Provider Information Latitude 36.7031 Latitude
Provider Information Legal Business Name SANGER SKILLED CARE LLC Legal Business Name
Provider Information Location 2550 9TH STREET,SANGER,CA,93657 Location
Provider Information Long-Stay QM Rating 5 Long-Stay QM Rating
Provider Information Long-Stay QM Rating Footnote — Long-Stay QM Rating Footnote
Provider Information Longitude -119.57 Longitude
Provider Information Most Recent Health Inspection More Than 2 Years Ago N Most Recent Health Inspection More Than 2 Years Ago
Provider Information Number of administrators who have left the nursing home 1 Number of administrators who have left the nursing home
Provider Information Number of Certified Beds 99 Number of Certified Beds
Provider Information Number of Citations from Infection Control Inspections — Number of Citations from Infection Control Inspections
Provider Information Number of Facilities in Chain 12 Number of Facilities in Chain
Provider Information Number of Fines 2 Number of Fines
Provider Information Number of Payment Denials 0 Number of Payment Denials
Provider Information Nursing Case-Mix Index 1.49928 Nursing Case-Mix Index
Provider Information Nursing Case-Mix Index Ratio 1.08829 Nursing Case-Mix Index Ratio
Provider Information Overall Rating 2 Overall Rating
Provider Information Overall Rating Footnote — Overall Rating Footnote
Provider Information Ownership Type For profit - Limited Liability company Ownership Type
Provider Information Physical Therapist Staffing Footnote — Physical Therapist Staffing Footnote
Provider Information Processing Date 2026-03-01 Processing Date
Provider Information Provider Address 2550 9TH STREET Provider Address
Provider Information Provider Changed Ownership in Last 12 Months N Provider Changed Ownership in Last 12 Months
Provider Information Provider Name CORNERSTONE CARE CENTER Provider Name
Provider Information Provider Resides in Hospital N Provider Resides in Hospital
Provider Information Provider SSA County Code 090 Provider SSA County Code
Provider Information Provider Type Medicare and Medicaid Provider Type
Provider Information QM Rating 4 QM Rating
Provider Information QM Rating Footnote — QM Rating Footnote
Provider Information Rating Cycle 1 Health Deficiency Score 104 Rating Cycle 1 Health Deficiency Score
Provider Information Rating Cycle 1 Health Revisit Score 0 Rating Cycle 1 Health Revisit Score
Provider Information Rating Cycle 1 Number of Complaint Health Deficiencies 2 Rating Cycle 1 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 1 Number of Health Revisits 1 Rating Cycle 1 Number of Health Revisits
Provider Information Rating Cycle 1 Number of Standard Health Deficiencies 14 Rating Cycle 1 Number of Standard Health Deficiencies
Provider Information Rating Cycle 1 Standard Survey Health Date 2025-05-01 Rating Cycle 1 Standard Survey Health Date
Provider Information Rating Cycle 1 Total Health Score 104 Rating Cycle 1 Total Health Score
Provider Information Rating Cycle 1 Total Number of Health Deficiencies 16 Rating Cycle 1 Total Number of Health Deficiencies
Provider Information Rating Cycle 2 Number of Standard Health Deficiencies 16 Rating Cycle 2 Number of Standard Health Deficiencies
Provider Information Rating Cycle 2 Standard Health Survey Date 2024-06-10 Rating Cycle 2 Standard Health Survey Date
Provider Information Rating Cycle 2/3 Health Deficiency Score 240 Rating Cycle 2/3 Health Deficiency Score
Provider Information Rating Cycle 2/3 Health Revisit Score 0 Rating Cycle 2/3 Health Revisit Score
Provider Information Rating Cycle 2/3 Number of Complaint Health Deficiencies 8 Rating Cycle 2/3 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 2/3 Number of Health Revisits 1 Rating Cycle 2/3 Number of Health Revisits
Provider Information Rating Cycle 2/3 Total Health Score 240 Rating Cycle 2/3 Total Health Score
Provider Information Rating Cycle 2/3 Total Number of Health Deficiencies 24 Rating Cycle 2/3 Total Number of Health Deficiencies
Provider Information Registered Nurse hours per resident per day on the weekend 0.48429 Registered Nurse hours per resident per day on the weekend
Provider Information Registered Nurse turnover 38.5 Registered Nurse turnover
Provider Information Registered Nurse turnover footnote — Registered Nurse turnover footnote
Provider Information Reported Licensed Staffing Hours per Resident per Day 1.43469 Reported Licensed Staffing Hours per Resident per Day
Provider Information Reported LPN Staffing Hours per Resident per Day 0.92040 Reported LPN Staffing Hours per Resident per Day
Provider Information Reported Nurse Aide Staffing Hours per Resident per Day 2.32961 Reported Nurse Aide Staffing Hours per Resident per Day
Provider Information Reported Physical Therapist Staffing Hours per Resident Per Day 0.09795 Reported Physical Therapist Staffing Hours per Resident Per Day
Provider Information Reported RN Staffing Hours per Resident per Day 0.51428 Reported RN Staffing Hours per Resident per Day
Provider Information Reported Staffing Footnote — Reported Staffing Footnote
Provider Information Reported Total Nurse Staffing Hours per Resident per Day 3.76430 Reported Total Nurse Staffing Hours per Resident per Day
Provider Information Short-Stay QM Rating 2 Short-Stay QM Rating
Provider Information Short-Stay QM Rating Footnote — Short-Stay QM Rating Footnote
Provider Information Special Focus Status — Special Focus Status
Provider Information Staffing Rating 2 Staffing Rating
Provider Information Staffing Rating Footnote — Staffing Rating Footnote
Provider Information State CA State
Provider Information Telephone Number 5598756501 Telephone Number
Provider Information Total Amount of Fines in Dollars 54444.00 Total Amount of Fines in Dollars
Provider Information Total number of nurse staff hours per resident per day on the weekend 3.46111 Total number of nurse staff hours per resident per day on the weekend
Provider Information Total Number of Penalties 2 Total Number of Penalties
Provider Information Total nursing staff turnover 44.4 Total nursing staff turnover
Provider Information Total nursing staff turnover footnote — Total nursing staff turnover footnote
Provider Information Total Weighted Health Survey Score 138.000 Total Weighted Health Survey Score
Provider Information Urban Y Urban
Provider Information With a Resident and Family Council Both With a Resident and Family Council
Provider Information ZIP Code 93657 ZIP Code