Smith Ranch Skilled Nursing & Rehabilitation Cente
1550 Silveira Parkway · San Rafael, CA · 94903 · 4154991000
80 certified beds For profit - Limited Liability company Chain: Generations Healthcare
Why this verdict
- Inspection record is far worse than the national median (deficiency count and severity).
- Staffing hours comfortably above national benchmarks.
- No federal fines or payment denials in CMS’s 3-year window.
- Inspection results have improved across recent cycles.
The composite number cleared 73 points, but Recommended is gated: inspection record below the Recommended bar. That rule is part of the published method.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
No red flags in the current CMS record. Genuinely good news — pair it with an in-person tour before deciding.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 3 of 5 Inspections: 2 of 5 Staffing: 3 of 5 Quality measures: 5 of 5
| Total nurse hours / resident-day | 4.54 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.52 | 0.55–0.75 |
| Weekend hours / resident-day | 4.05 | ≈ weekday level |
| Nursing turnover / year | 33% | median 45% |
| Fines (3-yr window) | none |
Inspection citations (49 in the current record)
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Potential for harm · E April 15, 2026 · found via complaint
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected May 7, 2026 · Resident Assessment and Care Planning
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Potential for harm · E April 15, 2026 · found via complaint
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected May 7, 2026 · Resident Assessment and Care Planning
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Potential for harm · E April 15, 2026 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected May 7, 2026 · Quality of Life and Care
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Potential for harm · D April 15, 2026 · found via complaint
Ensure that residents are free from significant medication errors.
Corrected May 7, 2026 · Pharmacy Service
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Potential for harm · E April 15, 2026 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected May 7, 2026 · Resident Assessment and Care Planning
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Potential for harm · E February 12, 2026
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.
Corrected February 24, 2026 · Resident Rights
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Potential for harm · D February 12, 2026
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected February 24, 2026 · Resident Assessment and Care Planning
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Potential for harm · E February 12, 2026
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected February 24, 2026 · Resident Assessment and Care Planning
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Potential for harm · D February 12, 2026
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected February 24, 2026 · Quality of Life and Care
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Potential for harm · D February 12, 2026
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected February 24, 2026 · Pharmacy Service
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Potential for harm · D February 12, 2026
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.
Corrected February 24, 2026 · Pharmacy Service
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Potential for harm · E February 12, 2026
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected February 24, 2026 · Nutrition and Dietary
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Potential for harm · D February 12, 2026
Provide and implement an infection prevention and control program.
Corrected February 24, 2026 · Infection Control
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Potential for harm · E February 12, 2026
Keep all essential equipment working safely.
Corrected February 24, 2026 · Environmental
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Potential for harm · D May 16, 2025
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected June 17, 2025 · Resident Rights
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Potential for harm · D May 16, 2025
Reasonably accommodate the needs and preferences of each resident.
Corrected June 17, 2025 · Resident Rights
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Potential for harm · F May 16, 2025
Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.
Corrected June 17, 2025 · Resident Rights
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Potential for harm · D May 16, 2025
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.
Corrected June 17, 2025 · Resident Rights
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Potential for harm · D May 16, 2025
Ensure each resident receives an accurate assessment.
Corrected June 17, 2025 · Resident Assessment and Care Planning
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Potential for harm · E May 16, 2025
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected June 17, 2025 · Resident Assessment and Care Planning
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Potential for harm · D May 16, 2025
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected June 17, 2025 · Quality of Life and Care
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Potential for harm · E May 16, 2025
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Corrected June 17, 2025 · Quality of Life and Care
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Potential for harm · D May 16, 2025
Provide enough food/fluids to maintain a resident's health.
Corrected June 17, 2025 · Quality of Life and Care
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Potential for harm · D May 16, 2025
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Corrected June 17, 2025 · Quality of Life and Care
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Potential for harm · D May 16, 2025
Ensure medication error rates are not 5 percent or greater.
Corrected June 17, 2025 · Pharmacy Service
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Family & resident reviews — a separate signal, never mixed into the score
No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 555595 · certified since April 15, 1994. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.