Anberry Post Acute
1000 West Yosemite Avenue, Merced, CA 95341 · Merced County · 120 certified beds · avg 93 residents/day · certified since Dec 9, 2016
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 3/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
All citations in the current public record (38)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Jun 19, 2026 | E · Potential for harm, repeated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Jun 19, 2026 | E · Potential for harm, repeated | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| Jun 19, 2026 | E · Potential for harm, repeated | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Jun 19, 2026 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Jun 19, 2026 | D · Potential for harm, one-off | The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable. |
| Jun 19, 2026 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Jun 19, 2026 | D · Potential for harm, one-off | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. |
| Jun 19, 2026 | D · Potential for harm, one-off | The facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. |
| Jun 19, 2026 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Jun 19, 2026 | D · Potential for harm, one-off | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. |
| Jun 19, 2026 | D · Potential for harm, one-off | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Jun 19, 2026 | D · Potential for harm, one-off | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. |
| Jun 19, 2026 | D · Potential for harm, one-off | The facility did not educate residents and staff about COVID-19 vaccination, offer the vaccine to those eligible after that education, or properly document everyone's vaccination status. |
| Jun 19, 2026 | D · Potential for harm, one-off | The facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors. |
| Mar 19, 2025 | D · Potential for harm, one-off | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint |
| Dec 13, 2024 | F · Potential for harm, facility-wide | The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. |
| Dec 13, 2024 | F · Potential for harm, facility-wide | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Dec 13, 2024 | F · Potential for harm, facility-wide | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. |
| Dec 13, 2024 | F · Potential for harm, facility-wide | The facility did not post its nurse staffing information every day. Nursing homes must publicly display how many nurses and aides are on duty each day. |
| Dec 13, 2024 | F · Potential for harm, facility-wide | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. |
| Dec 13, 2024 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Dec 13, 2024 | E · Potential for harm, repeated | The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal. |
| Dec 13, 2024 | E · Potential for harm, repeated | The facility did not give the resident or their representative written notice of how long it would hold the resident's bed during a hospital stay or approved leave. |
| Dec 13, 2024 | E · Potential for harm, repeated | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Dec 13, 2024 | E · Potential for harm, repeated | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Dec 13, 2024 | E · Potential for harm, repeated | The facility's menus did not meet residents' nutritional needs, or were not prepared in advance, followed as written, kept up to date, or reviewed by a dietician. |
| Dec 13, 2024 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Dec 13, 2024 | D · Potential for harm, one-off | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Dec 13, 2024 | D · Potential for harm, one-off | The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. |
| Dec 13, 2024 | D · Potential for harm, one-off | The facility did not provide food that accounts for each resident's allergies, intolerances, and personal preferences, or did not offer appealing alternatives. |
| Dec 13, 2024 | D · Potential for harm, one-off | The facility did not provide residents with enough to drink, or with drinks matching their needs and preferences, to keep them properly hydrated. |
| Dec 13, 2024 | D · Potential for harm, one-off | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. |
| Nov 2, 2023 | F · Potential for harm, facility-wide | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Nov 2, 2023 | D · Potential for harm, one-off | The facility did not allow residents to take their own medications when a clinical review showed they could do so safely. Residents have this right if their care team determines it's appropriate. |
| Nov 2, 2023 | D · Potential for harm, one-off | The facility did not properly complete the required screening (called PASARR) that identifies whether a person entering a nursing home has a mental illness or intellectual disability and needs specialized services. |
| Nov 2, 2023 | D · Potential for harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Nov 2, 2023 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Nov 2, 2023 | D · Potential for harm, one-off | The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (17 → 14).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 6 | 0 | F |
| 2024 | 17 | 0 | F |
| 2025 | 1 | 0 | D |
| 2026 | 14 | 0 | E |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
No fines or payment denials in the published 3-year window.
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | California avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 3.03 | 4.31 | 3.95 | bottom 1% in California; bottom 15% in the U.S. |
| Registered Nurse hours | 0.29 | 0.61 | 0.69 | bottom 11% in California; bottom 9% in the U.S. |
| Weekend total nurse staffing | 2.57 | 3.90 | 3.50 | bottom 1% in California; bottom 11% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.15 | 0.51 | 0.48 | bottom 2% in California; bottom 5% in the U.S. |
| Total nursing staff turnover (%) | 41.3 | 36.7 | 45.8 | bottom 34% in California; top 40% in the U.S. |
| RN turnover (%) | 50.0 | 38.1 | 42.9 | bottom 29% in California; bottom 39% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 2.92, RN 0.28, weekend 2.48. Staffing rating: 1/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 5/5 · long-stay residents: 5/5 · short-stay residents: 4/5
Who owns this facility
For profit - Partnership
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| DG 2016 Holdings Trust Dated September 14, 2016 | Organization | 5% or Greater Indirect Ownership Interest | 25% | 12/31/2018 |
| DH 2016 Holdings Trust Dated November 28, 2016 | Organization | 5% or Greater Indirect Ownership Interest | 25% | 12/31/2018 |
| Don and Nancy Gormly Family Trust Dated February 25, 2002 | Organization | 5% or Greater Indirect Ownership Interest | — | 12/31/2018 |
| Gormly, Donald | Individual | 5% or Greater Direct Ownership Interest | 50% | 12/31/2018 |
| Gormly, Nancy | Individual | 5% or Greater Indirect Ownership Interest | — | 12/31/2018 |
| Holloway, Debra | Individual | 5% or Greater Indirect Ownership Interest | — | 12/31/2018 |
| Holloway, Jerry | Individual | 5% or Greater Indirect Ownership Interest | — | 12/31/2018 |
| Jerry and Debbie Holloway Revocable Trust Dated February 25, 2002 | Organization | 5% or Greater Indirect Ownership Interest | — | 12/31/2018 |
| JH 2016 Holdings Trust Dated November 28, 2016 | Organization | 5% or Greater Indirect Ownership Interest | 25% | 12/31/2018 |
| NG 2016 Holdings Trust Dated September 14, 2016 | Organization | 5% or Greater Indirect Ownership Interest | 25% | 12/31/2018 |
| Gormly, Donald | Individual | Corporate Director | NOT APPLICABLE | 12/31/2018 |
| Gormly, Donald | Individual | Corporate Officer | NOT APPLICABLE | 12/31/2018 |
| Gormly, Donald | Individual | Operational/Managerial Control | NOT APPLICABLE | 11/20/2015 |
| Gormly, Nancy | Individual | Corporate Director | NOT APPLICABLE | 12/31/2018 |
| Holloway, Debra | Individual | Corporate Director | NOT APPLICABLE | 12/31/2018 |
| Holloway, Jerry | Individual | Corporate Director | NOT APPLICABLE | 12/31/2018 |
| Holloway, Jerry | Individual | Corporate Officer | NOT APPLICABLE | 12/31/2018 |
| Holloway, Jerry | Individual | Operational/Managerial Control | NOT APPLICABLE | 12/31/2018 |
| Kuhls, David | Individual | W-2 Managing Employee | NOT APPLICABLE | 12/16/2016 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
- "Can you show me how medications are stored and secured on the units, including controlled drugs?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "What does the care plan for a brand-new resident cover in the first 48 hours, and who writes it?"
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
- "How do you decide when a feeding tube is truly needed, and how do staff care for residents who have one?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Merced Behavioral Center | 2.5 mi | Merced, CA | ★★★★★ | 5/5 | |
| La Sierra Care Center | 3.0 mi | Merced, CA | ★★★☆☆ | 3/5 | |
| Merced Nursing & Rehabilitation Ctr | 3.0 mi | Merced, CA | ★★★★☆ | 3/5 | |
| Golden Merced Care Center | 3.2 mi | Merced, CA | ★★★☆☆ | 3/5 | |
| Franciscan Post-Acute Care Center | 3.7 mi | Merced, CA | ★★★★☆ | 4/5 | |
| Anberry Nursing and Rehabilitation Center | 7.1 mi | Atwater, CA | ★★★★★ | 4/5 | |
| Grace Home INC. | 14.0 mi | Livingston, CA | ★★★★★ | 5/5 | |
| Palms Care Center | 16.9 mi | Chowchilla, CA | ★★★★☆ | 4/5 | |
| Chowchilla Memorial Healthcare District | 16.9 mi | Chowchilla, CA | ★★★★☆ | 4/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 555901.