The nursing home failed to provide proper pressure ulcer care and failed to prevent new pressure sores from developing. Cited July 2023 — isolated incident, actual harm.
View the original federal record
F-Tag 686 — 42 CFR §483.25(b) — S/S: G
Nursing home report
SMITH RANCH SKILLED NURSING & REHABILITATION CENTE
SAN RAFAEL, CA · Medicare-certified · 80 beds
In good standing
For-profitChain member
4 of 5 overall
4 out of 5 stars overall. Health inspection and staffing are both 3 out of 5, quality measures are 5 out of 5, reported nurse staffing is above the federal benchmark (4.54 vs 4.1 hours per resident per day), and there were no fines in the last 24 months; recent inspection citations involved pressure ulcer care and food/fluids and food handling.
Facility ratings
Health inspections
Staffing
4.5398 hrs/resident/day
Quality measures
Last inspection: February 12, 2026Penalties, last 24 months: $0
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 4.5398.
Staffing detail
- Registered nurses
- 0.52
- Licensed practical nurses
- 1.41
- Nurse aides
- 2.61
- Weekend nursing
- 4.05
Hours per resident per day.
Total staff turnover: 33%
Registered nurse turnover: 25%
Resident outcomes
How often residents experience these outcomes, with the direction over the past year.
Long-stay residents on antipsychotic medication
6.2%Worsening
Residents with a fall causing major injury
2.6%Improving
Residents with pressure ulcers (bedsores)
3.8%Improving
Residents with a urinary tract infection
0%Steady
Residents who lost too much weight
3.3%Worsening
Residents who were physically restrained
0%Steady
Residents needing more help with daily activities
5%Improving
Residents whose ability to walk got worse
0%Steady
Show all measures
Long-stay residents on antianxiety or sleep medication
13.4%Worsening
Short-stay residents newly given an antipsychotic
0.7%Steady
Residents with a long-term catheter
0.4%Steady
Residents with new or worsening incontinence
1.5%Improving
Residents with depressive symptoms
2.2%Worsening
Long-stay residents given the seasonal flu vaccine
100%Steady
Long-stay residents given the pneumonia vaccine
100%Steady
Short-stay residents given the seasonal flu vaccine
100%Steady
Short-stay residents given the pneumonia vaccine
99.8%Improving
What the inspectors found
The home failed to provide enough food and fluids to keep residents healthy. Cited July 2023 — isolated incident, actual harm.
View the original federal record
F-Tag 692 — 42 CFR §483.25(g) — S/S: G
The home failed to make sure food was safely sourced, stored, prepared, and served according to professional standards. Cited May 2025 — widespread issue, potential for harm.
View the original federal record
F-Tag 812 — 42 CFR §483.60(i) — S/S: F
The home failed to post the required contact information for state agencies and advocacy groups, and the notice that residents can file complaints. Cited May 2025 — widespread issue, potential for harm.
View the original federal record
F-Tag 575 — 42 CFR §483.10 — S/S: F
The home failed to have a plan for how it would carry out quality improvement and oversight activities. Cited May 2025 — widespread issue, potential for harm.
View the original federal record
F-Tag 865 — 42 CFR §483.75 — S/S: F
Recent history
- STAFFING
Reported nurse staffing met or exceeded the federal recommendation.
- INSPECTION
Health inspection found 9 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 14 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
Operator & ownership
- Ownership
- For profit - Limited Liability company
- Chain
- Part of GENERATIONS HEALTHCARE · 27 homes · 4.2 stars avg
- Occupancy
- 71.7 residents on an average day (90% of 80 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 32 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.