Nursing home report card · Sacramento, CA
Pioneer House
415 P Street, Sacramento, CA 95814
Call this home: (916) 442-4906
View this home on Medicare.gov ↗
Quick summary
Medicare shows an abuse warning
Medicare’s Care Compare site shows an abuse icon here. That is one of the strongest public warnings CMS publishes — dig into the inspection history and talk with an attorney if a loved one was hurt.
Our summary of public Medicare records. It does not establish that this home harmed a particular resident. About this summary.
How recent is this information?
- Medicare file prepared
- Aug 1, 2026
- Our record last updated
- Oct 15, 2026
- Last routine health inspection
- Dec 4, 2025
These dates mean different things. A new file can include older inspections and staffing figures. Read about the dates.
Medicare ratings
One star is the lowest rating. Five stars is the highest. Ratings are a starting point—read the inspection findings too.
Combines inspection, staffing, and care measures.
About average for U.S. nursing homes
Based on problems found during health inspections.
Below-average Medicare rating
Based on staffing levels and related measures.
Above average
Based on reported health and care results.
Among the highest Medicare ratings
What do the ratings and warnings mean?
- Medicare ratings
- One star is the lowest rating. Five stars is the highest. These are government ratings, not family reviews.
- Inspection problems
- Inspectors found that a home did not meet a care or safety rule. The official term is “deficiency.”
- Abuse warning
- Medicare has flagged the home because of abuse-related inspection findings. Read the findings and dates.
- Nursing staff time
- Average staff hours for each resident per day. This does not mean each resident gets that much one-to-one care.
At a glance
These numbers come from the records we have. Inspection problems are rules the home did not meet. The dates covered can differ.
Care, safety, and resident-rights issues on recent inspections
Building, alarms, exits, and related safety citations
Total fine amounts in the imported penalty records
Medicare home ID: 555542
Inspection findings to read first
Start with these past findings. We show the most serious first, then the most recent. They do not describe the home’s condition today.
Caused actual harm · isolated case
Nov 24, 2025 · Inspection rule 0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Could have caused harm · isolated case
Jun 3, 2026 · Inspection rule 0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Could have caused harm · isolated case
Feb 10, 2026 · Inspection rule 0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nursing staff time
These are average staff hours for each resident per day. They are not one-to-one bedside care. The file does not give the reporting period for each figure.
about 39 minutes per resident per day
about 4 hr 8 min per resident per day
about 23 minutes per resident per day
Latest inspection summary
A summary of the most recent routine inspections. You can open the dated findings below.
We do not have a routine inspection summary for this home. Check the dated findings below and the Medicare.gov record.
How this home compares
Compared with state and national averages. The numbers may cover different periods.
- Overall CMS rating: 3 stars
- Health inspection rating: 2 stars
- Staffing rating: 4 stars
- Registered nurse time per resident: 0.64 hours/day
- Total nurse time per resident: 4.13 hours/day
See the dates used for these averages
Medicare file dates: this home Aug 1, 2026; California averages Unavailable; U.S. averages Oct 1, 2026.
Other concerns in the records
These points may be worth asking about. They do not establish what happened to a particular resident. See our Terms of Use.
- Medicare shows an abuse warning icon for this home
- Health inspection rating is 2 stars or lower
- Recent citations include infection-control problems
- Inspectors have listed an unusually high number of problems
How serious were the problems?
Inspectors rate each problem by how much harm it caused or could cause. We group the CMS letter codes into plain language.
- Caused actual harm1 citation
- Could have caused harm59 citations
Why inspectors showed up
Routine checks happen on a schedule. Complaint visits happen when someone reports a concern.
- Complaints
- 0
- Routine
- 60
- Fire safety
- 0
- Other
- 0
Who owns it
Names CMS lists as owners or managers · reported as For profit - Limited Liability company.
- We do not have individual owner names for this home.
Other homes in this group: All Cypress Healthcare Group nursing homes
Inspection history
Open a date to read what inspectors found. The harm labels explain how serious the problem was at the time.
June 3, 20261 finding
- Quality of Life and Care problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0686 · code D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
February 10, 20261 finding
- Quality of Life and Care problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0689 · code D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
December 9, 20251 finding
- Resident Rights problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0627 · code D
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
December 4, 20258 findings
- Quality of Life and Care problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0692 · code E
Provide enough food/fluids to maintain a resident's health.
- Pharmacy Service problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0761 · code E
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.
- Nutrition and Dietary problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0812 · code E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Infection Control problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0880 · code E
Provide and implement an infection prevention and control program.
- Pharmacy Service problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0755 · code D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Environmental problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0925 · code E
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- Resident Assessment and Care Planning problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0658 · code E
Ensure services provided by the nursing facility meet professional standards of quality.
- Quality of Life and Care problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0677 · code E
Provide care and assistance to perform activities of daily living for any resident who is unable.
November 24, 20251 finding
- Quality of Life and Care problemsCaused actual harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0689 · code G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
September 5, 20251 finding
- Freedom from Abuse, Neglect, and Exploitation problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0600 · code D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
February 18, 20251 finding
- Nutrition and Dietary problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0808 · code D
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
January 24, 20251 finding
- Resident Rights problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0624 · code D
Prepare residents for a safe transfer or discharge from the nursing home.
December 26, 20241 finding
- Resident Rights problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0557 · code D
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
December 19, 20241 finding
- Freedom from Abuse, Neglect, and Exploitation problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0600 · code E
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
November 29, 20242 findings
- Resident Assessment and Care Planning problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0658 · code D
Ensure services provided by the nursing facility meet professional standards of quality.
- Quality of Life and Care problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0677 · code D
Provide care and assistance to perform activities of daily living for any resident who is unable.
November 15, 20246 findings
- Freedom from Abuse, Neglect, and Exploitation problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0609 · code D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Pharmacy Service problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0761 · code E
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.
- Resident Rights problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0557 · code D
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
- Nutrition and Dietary problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0812 · code E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Infection Control problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag 0880 · code E
Provide and implement an infection prevention and control program.
- Quality of Life and Care problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag 0675 · code D
Honor each resident's preferences, choices, values and beliefs.
Fines & penalties
These fines appear in Medicare’s records. A listed amount does not tell us whether it has been paid.
- No fines or penalties appear in the records we have.
Other homes in this chain
Cypress Healthcare Group · other locations in California
- Fair Oaks Healthcare Center · Fair Oaks3 of 5 · 55 problems
- Greenhaven Healthcare Center · Sacramento3 of 5 · 72 problems
- Grass Valley Healthcare Center · Grass Valley3 of 5 · 23 problems
- College Oak Nursing and Rehabilitation Center · Sacramento3 of 5 · 25 problems
- Asbury Park Nursing and Rehabilitation Center · Sacramento3 of 5 · 50 problems
- Gold Country Health Center · Placerville4 of 5 · 51 problems
- Oak Ridge Healthcare Center · Roseville4 of 5 · 27 problems
- Saylor Lane Healthcare Center · Sacramento4 of 5 · 41 problems
Related topics
Questions about Pioneer House
What is Pioneer House's Medicare star rating?
Has Pioneer House been fined?
Does Pioneer House have a Medicare abuse warning?
How does Pioneer House compare with other nursing homes in California?
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