Attorney General Bonta Holds Skilled Nursing Facility Chain Accountable for Misrepresenting its Quality of Care and Putting Patients at Risk

OAKLAND – California Attorney General Rob Bonta filed a lawsuit against Sweetwater Care (Sweetwater), a San Diego-based operator of skilled nursing facilities (SNFs). The lawsuit, which pertains to Sweetwater’s 19 California skilled nursing facilities, alleges that Sweetwater violated California law, specifically the Unfair Competition Law, due to their failure to meet statutory minimum staffing levels and to protect California residents under its care. This failure led to delayed care and critical oversights, resulting in severe harm to patients who depended on timely medical attention. The lawsuit also highlights that while Sweetwater received significant payments from Medi-Cal, the chain engaged in a pattern of violations of California law and regulations related to minimum skilled nursing facility staffing.  

“Sweetwater and its skilled nursing facilities violated the law and betrayed the trust of communities by failing to safeguard the health and safety of its residents. This is simply unacceptable,” said Attorney General Bonta. “The California Department of Justice will step in whenever the well-being of patients is at stake. With today’s lawsuit, we are holding Sweetwater accountable for breaking the law by understaffing its facilities and leaving residents vulnerable to serious neglect and injuries. No one is above the law, and our vulnerable patients deserve nothing less than dignity, safety, and high-quality care.” 

The California Department of Justice (DOJ)’s Division of Medi-Cal Fraud and Elder Abuse (DMFEA)’s investigation found that Sweetwater was engaging in a pattern of unlawful conduct leading to associated patient harm, preventable neglect, abuse, and injuries. From 2020 through 2024, Sweetwater SNFs were staffed below California minimum staffing levels in over 14,126 instances. This unlawful level of understaffing led to patients at Sweetwater’s SNFs being exposed to preventable neglect, abuse, and injuries including fractured bones that went days without assessment or medical care, patients with head trauma leaving the facility unbeknownst to staff, unwitnessed falls, pressure injuries so severe that a patient’s hip bone was visible, medical emergencies that were not timely assessed or responded to, and patients being left for hours and overnight in soiled diapers because staff were too few or unwilling to provide care. The investigation also revealed that Sweetwater extracted over $31 million as “profit” or “management fees” instead of using those dollars to provide the legally required staffing to meet minimum nursing staff levels.

The California Department of Justice is alleging Sweetwater violated California’s Unfair Competition Law in its lawsuit. The DOJ is also seeking remedies including civil monetary penalties, injunctive relief to prevent violations of California laws and regulations, the installation of a receiver or compliance monitor, and costs of suit.  

Pursuant to California’s Unfair Competition Law, Defendants are potentially liable for a civil penalty of up to $2,500 for each violation. That penalty may be doubled for each violation perpetrated against a senior citizen or disabled person. 

DMFEA works to protect Californians by investigating and prosecuting those responsible for abuse, neglect, and fraud committed against elderly and dependent adults in the state, and those who perpetrate fraud on the Medi-Cal program.

The Division of Medi-Cal Fraud and Elder Abuse receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $69,244,976 for Federal fiscal year (FY) 2025. The remaining 25 percent is funded by the State of California. FY 2025 is from October 1, 2024, through September 30, 2025. 

A link to a copy of the complaint as filed with the court will be provided once available.