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 Center
Registered name: SMITH RANCH SKILLED NURSING & REHABILITATION CENTE
SAN RAFAEL, CA · Medicare-certified · 80 beds
In good standing
For-profitChain member
Data as of July 1, 2026
3 of 5 overall
Smith Ranch Skilled Nursing & Rehabilitation Center has a 3 of 5 star overall rating. Its health inspection rating is 2 stars, staffing is 3 stars, and quality measures are 5 stars; reported nurse staffing is 4.19 hours per resident per day, slightly above the 4.1 federal benchmark, and there were no fines in the last 24 months.
Facility ratings
Health inspections
Staffing
4.1905 hrs/resident/day
Quality measures
Last inspection: April 15, 2026Penalties, last 24 months: $0
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 4.1905.
Staffing detail
- Registered nurses
- 0.42
- Licensed practical nurses
- 1.28
- Nurse aides
- 2.49
- Weekend nursing
- 3.75
Hours per resident per day.
Total staff turnover: 33%
Registered nurse turnover: 13%
Resident outcomes
Each measure compares a year ago with the most recent quarter. Green means the facility moved the right way; red means the wrong way.
Negative outcomes
Lower is better — fewer affected residents. A decrease is good (green); an increase is concerning (red).
Long-stay residents on antipsychotic medication
12.5%6.7%Improving
Residents with a fall causing major injury
2.5%2.5%No change
Residents with pressure ulcers (bedsores)
4%4.1%No change
Residents with a urinary tract infection
0%0%No change
Residents who lost too much weight
0%10.8%Worsening
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
6.2%0%Improving
Residents whose ability to walk got worse
—0%—
Long-stay residents on antianxiety or sleep medication
11.8%13.5%Worsening
Short-stay residents newly given an antipsychotic
0.7%1.6%Worsening
Residents with a long-term catheter
1.7%0%Improving
Residents with new or worsening incontinence
0%2.8%Worsening
Residents with depressive symptoms
6.2%0%Improving
Positive outcomes
Higher is better — e.g. vaccinations. An increase is good (green); a decrease is concerning (red).
Long-stay residents given the seasonal flu vaccine
—100%—
Long-stay residents given the pneumonia vaccine
100%100%No change
Short-stay residents given the seasonal flu vaccine
—100%—
Short-stay residents given the pneumonia vaccine
99.6%100%No change
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 5 health deficiencies.
See what inspectors found
- 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
Recent ownership change · Sep 1, 2017
Now operated by Smith Ranch Skilled Nursing & Rehabilitation Center, previously Kindred Transitional Care and Rehabilitation-smith Ranch.
- Ownership
- For profit - Limited Liability company
- Chain
- Part of GENERATIONS HEALTHCARE · 27 homes · 4.2 stars avg
- Occupancy
- 74.3 residents on an average day (93% 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.