CCN 555918 · Fresno County, California
Fowler Care Center
8448 East Adams Avenue, Fowler, CA 93625
Fowler Care Center is a 46-bed for-profit nursing home in Fowler, California, first certified for Medicare or Medicaid in 2019. CMS rates it 5 out of 5 stars overall in its September 2026 data, and it averaged 43.2 residents a day, about 94% of its certified beds. It has an active FHA-insured Section 232 loan: $3.1 million originally, at 5.77%, with $3 million outstanding as of September 30, 2026 and maturity in October 2050.
Facility facts
- Certified beds
- 46
- Average residents per day
- 43.2 (93.9% of beds)
- Ownership type
- For profit - Corporation
- Certification
- Medicare and Medicaid
- Legal business name
- Fowler Care Center LLC
- Certified since
- Nov 9, 2019
- Chain or affiliated group
- Ajc Healthcare (14 facilities, chain average 2.3 stars)
- Location
- Urban
Ratings and staffing
Star ratings run from 1 to 5. Staffing is nurse hours per resident per day from CMS Payroll Based Journal data; turnover is the CMS annual nursing staff turnover rate. Occupancy is CMS's average daily census divided by certified beds.
| Measure | This facility | California median | US median |
|---|---|---|---|
| Overall rating | 5 of 5 | State spread: 186 at 1, 213 at 2, 244 at 3, 240 at 4, 270 at 5 | |
| Health inspections | 4 of 5 | ||
| Quality measures | 5 of 5 | ||
| Staffing | 2 of 5 | ||
| Total nurse hours per resident per day | 4.19 | 4.24 | 3.68 |
| RN hours per resident per day | 0.19 | 0.50 | 0.58 |
| Weekend nurse hours per resident per day | 3.96 | ||
| Nursing staff turnover | 50.8% | 36.4% | 44.9% |
| Occupancy (residents / beds) | 93.9% | 92.0% | 85.7% |
| Fines reported by CMS | None | ||
| Health deficiencies, latest standard survey | 8 (Jul 2, 2026) | ||
HUD 223(f) Express Lane: the CMS part
HUD gives 223(f) applications queue priority when the facility has CMS overall and health inspection ratings of at least 2 stars and no abuse icon, among other tests (ORCF criteria of March 31, 2026). Fowler Care Center meets that part today: 5 stars overall, 4 on health inspections, no abuse icon. The loan-to-value, coverage and operator tests depend on the deal. All the criteria.
Who owns and operates it
These are the owners and operators the facility reported to CMS: anyone with a 5% or greater direct or indirect stake, and any organization with operational or managerial control.
| Name | Role | Share | Since |
|---|---|---|---|
| Fowler Care Center Holdings LLCOrganization | Indirect Ownership Interest | n/a | 05/17/2019 |
| Swc Ca Opco, LLCOrganization | Indirect Ownership Interest | n/a | 02/01/2021 |
| Chesley, AaronIndividual | Indirect Ownership Interest | n/a | 02/01/2021 |
| Fowler Care Center Holdings LLCOrganization | Operational / Managerial Control | n/a | 05/17/2019 |
Changes of ownership
No change of ownership for this facility appears in the CMS change-of-ownership file, which starts in January 2016.
HUD Section 232 loans
HUD's Office of Healthcare Programs lists these FHA-insured loans for a project we matched to this facility by name, city and bed count. Status, rate and balance come from HUD's insured-mortgage files as of September 30, 2026. Check the FHA number against the loan documents before relying on the match.
| Endorsed | Program | Original amount | Status | FHA number |
|---|---|---|---|---|
| Sep 25, 2024 | 223(f) refinance or purchaseHUD project name: Fowler Care Center, 46 beds. Lender at endorsement: Greystone Funding Company LLC | $3,124,800 | Active: 5.77%, $3,019,655 balanceMatures Oct 1, 2050. Servicer: Greystone Servicing Company | 12122262 |
Sources and dates
Facility, rating, staffing and ownership data: CMS Provider Information and CMS Ownership, processing date September 2026. Private equity, REIT and mortgage-interest flags and changes of ownership: CMS Skilled Nursing Facility All Owners and Change of Ownership files (2026-10-01). FHA-insured loans: HUD Office of Healthcare Programs endorsement database, data run July 8, 2026. How we join them, and what the join can get wrong: methodology.
SNF Register is independent. It is not affiliated with or endorsed by CMS, HUD or FHA. Spotted an error? Write to hello@hudskillednursing.loan.