Pacific Gardens Nursing and Rehabilitation Center topped the list as Fresno County’s largest nursing home in the first quarter of 2026, based on data from the Centers for Medicare and Medicaid Services (CMS).
The facility had 188 available beds, exceeding the Fresno County average by 95 beds during the first quarter of 2026. The nursing home cared for an average of 154 residents throughout this period.
The CMS gave Pacific Gardens Nursing and Rehabilitation Center an overall rating of 3 out of 5, which falls short of California’s average rating of 3.2 for nursing homes.
Horizon Health & Subacute Center was next in size in the county with 180 beds, followed by Willow Creek Healthcare Center, which held 159 beds.
Pacific Gardens Nursing and Rehabilitation Center incurred $30,654 in fines and had one penalty listed for the first quarter of 2026.
Across Fresno County, there were 24 for-profit nursing homes during this reporting period.
U.S. Census Bureau estimates show the continued growth of the nation’s older population even as numbers of children decline. Between 2020 and 2024, the U.S. saw a 13% increase in residents age 65 and older, while the number of individuals under 18 declined 1.7%. The country’s older population has increased substantially over the past century, rising from 4.9 million in 1920 to more than 61 million in 2024.
A study released in 2021 estimated that almost half of people in this age group, about 28 million, will require long-term care services or support. The report also projects that more than one-third could eventually need nursing facility care.
“Living a long life is something that many of us want and could get,” said Jesse Slome, executive director of the American Association for Long-Term Care Insurance. “But when we live a long life, the chances of us needing long-term care increase exponentially. But when you need that type of care, there are limited options.”
| Rank | Nursing Home | Overall Rating |
|---|---|---|
| 1 | Pacific Gardens Nursing and Rehabilitation Center | 3 |
| 2 | Horizon Health & Subacute Center | 2 |
| 3 | Willow Creek Healthcare Center | 3 |
| 4 | Healthcare Centre of Fresno | 1 |
| 5 | Covenant Post Acute | 3 |
| 6 | Veterans Home of California – Fresno | 5 |
| 6 | Palm Village Retirement Community | 4 |
| 6 | California Home for the Aged | 5 |
| 9 | Community Subacute and Transitional Care Center | 5 |
| 10 | Oakwood Gardens Care Center | 5 |
| 11 | Orchard Post Acute | 3 |
| 11 | Grace Healthcare Center | 1 |
| 11 | Sierra Vista Healthcare | 3 |
| 11 | Coalinga Regional Medical Center DP/SNF | 1 |
| 11 | Cornerstone Care Center | 2 |
| 11 | North Point Healthcare & Wellness Centre LP | 5 |
| 17 | Kingsburg Center | 1 |
| 18 | Fresno Postacute Care | 1 |
| 19 | Keystone Post-Acute | 2 |
| 20 | Sierra View Homes | 3 |
| 20 | Countryside Care Center | 1 |
| 20 | Bethel Lutheran Home | 2 |
| 20 | Manning Gardens Care Center, Inc. | 4 |
| 24 | Morning Star Post Acute | 3 |
| 25 | Vineyard Care Center | 4 |
| 26 | The Terraces at San Joaquin Gardens Village | 5 |
| 27 | Vineyards at Fowler | 2 |
| 27 | Evergreen Care Center | 3 |
| 29 | Fowler Care Center | 4 |
| 30 | Rolling Hills Care Center | 3 |
Information in this article was obtained from the Centers for Medicare and Medicaid Services. The source data can be found here.
