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Twilight Haven
Nursing Home, Assisted Living & Skilled Nursing · Fresno, CA
Exterior view of a senior living facility with gardens Staff member posing in front of a bookshelf An elderly man standing in a library setting A man in a suit standing in front of a bookshelf

Twilight Haven

Nursing Home, Assisted Living & Skilled Nursing · Fresno, CA
1717 S Winery Ave, Fresno, CA 93727 View map
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Twilight Haven accepts Medicare, Medicaid, and private pay.
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Twilight Haven accepts Medicare, Medicaid, and private pay.

Overview of Twilight Haven

Organized around assisted living, nursing, home care, and skilled nursing, Twilight Haven operates in Fresno, CA. For assisted living residents, bathing, dressing, and medication are handled with staff help. Skilled nursing adds licensed nursing care, and the range fits someone whose needs run from daily help to ongoing nursing.

If a short skilled stay follows a hospital discharge, Medicaid is the payer. If a long stay outlasts a family’s savings, Medicaid applies, and private pay covers the rest. There are 166 beds at Twilight Haven in all.

Facility Direct Line (610) 927-1466
By The Numbers

Community insights.

Bed count Info A mid-sized community that may balance personal attention with shared amenities and social activities. 166 Rank #122 / 345Bed count — State benchmarked This nursing home is ranked 122nd out of 345 nursing homes we track in California for bed count. Shows this facility's certified or reported bed count compared to other California facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in California that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.

Medium-capacity home · Offers a balance of services and community atmosphere.

Walk Score Info Car-dependent. Most errands require a car, with limited nearby walkable options. Rank #339 / 343Walk Score — State benchmarked This nursing home is ranked 339th out of 343 nursing homes we track in California for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across California facilities. Higher scores benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in California that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
2 / 100
Avg. Length of Stay Info Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
156 days

About This Community

Ownership & Operating Entity

Profit StatusNonprofit

Contact Twilight Haven

ALM Inspection Grade Unavailable

Not published

We don't have enough verified data to publish an inspection grade for this facility — a missing grade reflects what we've been able to verify, not the facility's quality.

ALM Inspection Grade unavailable: limited inspection data.
Enforcement

Penalties and fines About penalties and fines Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.

Source: CMS Penalties Database · Data as of Oct 2026

No penalties in the past 3 years

No civil money penalties or payment denials on record since Oct 2023.

Clean record
Total fines
$0 CA avg $57KCalifornia average: $56,949. Average among the 478 California facilities with a penalty on record.US avg $66KUS average: $66,281, among the 6,725 US facilities with a penalty on record.
Number of fines
0 CA avg 1.85California average: 1.85. Average among the 478 California facilities with a penalty on record.US avg 1.88US average: 1.88, among the 6,725 US facilities with a penalty on record.
Payment denials What is a payment denial? Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0 CA avg 0.59California average: 0.59. Average among the 478 California facilities with a penalty on record.US avg 0.35US average: 0.35, among the 6,725 US facilities with a penalty on record.
Financials

Money and staffing.

Twilight Haven’s finances from its CMS cost report for the fiscal year ending December 2022. Includes all financial data for this property, which could include management/ownership changes.

FY Dec 2022

Latest cost report is for the fiscal year ending December 2022, older than most California homes. Rankings are not shown because peers report different years.

Is it financially stable?

Losing money on care, and more than last year

−31.4% operating margin

−12.5 pts vs prior year

An operating loss in 7 of the last 8 reported years. Other income ($0.0M) trims the net loss to −$1.9M. Watch for cost-cutting that reaches staffing.

Does it invest in staff?

Spends more on payroll than most California homes

75.9% payroll share of revenue

CA average 61.6%

Payroll rose $0.4M while revenue rose $0.3M. Check hours per resident in the staffing section to confirm it reaches the floor.

This home is owned by Raymond Goertzen

Certified by the Centers for Medicare & Medicaid Services authority — CMS Certification Number: 055658

Show certification details

Who this home usually serves

Residents split by who pays for their care: Medicare, Medicaid, or private pay and other sources.
Over a year: CMS SNF Cost Report, FY2022
Arriving
100 admissions · FY2022 Residents admitted during the year.
Medicare 35 · 35%
Medicaid 30 · 30%
Private pay & other 35 · 35%
Shows care patterns over time; not used to rate this facility.

Mix of rehab and long-term care

This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.

Typical stay

Medicare 1 - 2 months Medicaid 10 - 11 months Private pay & other 2 - 3 months

Places of interest near Twilight Haven

Address 3.2 miles from city center Info Estimated distance in miles from Fresno's city center to Twilight Haven's address, calculated via Google Maps.

Calculate Travel Distance to Twilight Haven

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Address

Compare Nursing Homes around Fresno

Info below is compiled from CMS reports & the CA Dept. of Social Services (CDSS), senior community websites & trusted data sources such as Walk Score & BBB.

Communities are listed from highest-ranked to lowest-ranked based on our methodology.

The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
Care Types in This Table AL (Assisted Living): Housing with help for daily activities like bathing, dressing, and medication, without 24-hour skilled nursing. NH (Nursing Home): 24/7 skilled nursing care for residents with complex, ongoing medical needs. SNF (Skilled Nursing Facility): Round-the-clock nursing care, often for recovery after surgery, injury, or illness. MC (Memory Care): Secured, specialized care for people living with Alzheimer's or dementia. RC (Respite Care): Short-term temporary care that gives family caregivers a break. IL (Independent Living): Community living with dining, activities, and transportation for active seniors who need little personal care. HOS (Hospice Care): Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The California average is: 61.6% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
CMS Certification Number: the unique federal identifier for this skilled nursing provider.
North Pointe Care Center ★ ★ ★ ★ ★
NH
MC
RC
SNF
Fresno
99
Facility 99
CA AVG 179
Rank #197 / 345
91.6%
Facility 91.6%
CA AVG 82.3%
Rank #107 / 303
+11%
3.54
Facility 3.54
CA AVG 4.36
Rank #261 / 291
 ★ ★ ★ ★ ★ ★ ★ ★ ☆ ☆ ★ ★ ★ ★ ☆ +18%-19%
$0
Facility $0
CA AVG $60.0k
Rank #1 / 296
20
Facility 20
CA AVG 49.7
Rank #35 / 294
5.0
Facility 5.0
CA AVG 4.8
Rank #188 / 294
-91-
80
Facility 80
CA AVG 60
Rank #71 / 343
North Point Wellness Gp LLC
$13.8MFiscal year ending 04/2025
Facility $13.8MFiscal year ending 04/2025
CA AVG $17.3M
Rank #168 / 289
$8.0MFiscal year ending 04/2025
Facility $8.0MFiscal year ending 04/2025
CA AVG $9.8M
Rank #168 / 289
57.9%Fiscal year ending 04/2025
Facility 57.9%Fiscal year ending 04/2025
CA AVG 61.6%
Rank #93 / 289
555179
The Terraces at San Joaquin Gardens a CCRC ★ ★ ★ ★ ★
NH
AL
IL
MC
SNF
Fresno
706
Facility 706
CA AVG 179
Rank #9 / 345
57.2%
Facility 57.2%
CA AVG 82.3%
Rank #271 / 303
-30%
5.34
Facility 5.34
CA AVG 4.36
Rank #29 / 291
 ★ ★ ★ ☆ ☆ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ +12%+23%
$0
Facility $0
CA AVG $60.0k
Rank #1 / 296
31
Facility 31
CA AVG 49.7
Rank #102 / 294
5.2
Facility 5.2
CA AVG 4.8
Rank #202 / 294
1373A+
57
Facility 57
CA AVG 60
Rank #210 / 343
Humangood & Humangood Norcal & Humangood Fresno
$37.7MFiscal year ending 12/2024
Facility $37.7MFiscal year ending 12/2024
CA AVG $17.3M
Rank #10 / 289
$14.4MFiscal year ending 12/2024
Facility $14.4MFiscal year ending 12/2024
CA AVG $9.8M
Rank #42 / 289
38.3%Fiscal year ending 12/2024
Facility 38.3%Fiscal year ending 12/2024
CA AVG 61.6%
Rank #279 / 289
055846
Evergreen Life Care Homes ★ ★ ★ ☆ ☆
NH
HOS
MC
RC
SNF
Fresno (Roosevelt)
49
Facility 49
CA AVG 179
Rank #317 / 345
93.3%
Facility 93.3%
CA AVG 82.3%
Rank #80 / 303
+13%
3.73
Facility 3.73
CA AVG 4.36
Rank #220 / 291
 ★ ★ ★ ☆ ☆ ★ ★ ★ ☆ ☆ ★ ★ ★ ☆ ☆ -32%-14%
$0
Facility $0
CA AVG $60.0k
Rank #1 / 296
34
Facility 34
CA AVG 49.7
Rank #114 / 294
2.8
Facility 2.8
CA AVG 4.8
Rank #37 / 294
246A+
37
Facility 37
CA AVG 60
Rank #279 / 343
Evergreen Care Center Holdings LLC
$7.2MFiscal year ending 12/2024
Facility $7.2MFiscal year ending 12/2024
CA AVG $17.3M
Rank #273 / 289
$3.5MFiscal year ending 12/2024
Facility $3.5MFiscal year ending 12/2024
CA AVG $9.8M
Rank #281 / 289
48.7%Fiscal year ending 12/2024
Facility 48.7%Fiscal year ending 12/2024
CA AVG 61.6%
Rank #215 / 289
555920
Horizon Health & Subacute Center ★ ★ ★ ☆ ☆
NH
SNF
Fresno
180
Facility 180
CA AVG 179
Rank #104 / 345
85.2%
Facility 85.2%
CA AVG 82.3%
Rank #176 / 303
+4%
4.59
Facility 4.59
CA AVG 4.36
Rank #83 / 291
 ★ ★ ☆ ☆ ☆ ★ ★ ★ ★ ☆ ★ ★ ★ ★ ★ -38%+5%
$22.9k
Facility $22.9k
CA AVG $60.0k
Rank #230 / 296
53
Facility 53
CA AVG 49.7
Rank #206 / 294
3.8
Facility 3.8
CA AVG 4.8
Rank #115 / 294
1153-
58
Facility 58
CA AVG 60
Rank #207 / 343
Chad Galley
$24.6MFiscal year ending 12/2024
Facility $24.6MFiscal year ending 12/2024
CA AVG $17.3M
Rank #59 / 289
$16.0MFiscal year ending 12/2024
Facility $16.0MFiscal year ending 12/2024
CA AVG $9.8M
Rank #26 / 289
65.1%Fiscal year ending 12/2024
Facility 65.1%Fiscal year ending 12/2024
CA AVG 61.6%
Rank #47 / 289
055199
Twilight Haven -
NH
AL
SNF
Fresno
166
Facility 166
CA AVG 179
Rank #122 / 345
--------------
2
Facility 2
CA AVG 60
Rank #339 / 343
Raymond Goertzen$6.3M*Fiscal year ending 12/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind.$4.8M*Fiscal year ending 12/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind.75.9%*Fiscal year ending 12/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind.055658

Rank badges are statewide and care-type specific: each nursing home is ranked against every other CA nursing home we track that reports that metric, not just the 5 on this page. See how we rank facilities

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Financial assistance

Programs that may help with care and living costs in California

Twilight Haven is in FRESNO, California. These programs may support different care settings or living expenses. A listing does not confirm this community participates; our concierge team can help confirm.

Get financial aid guidance
Cash support for qualifying nonmedical residential care

SSI/SSP Nonmedical Out-of-Home Care Support

California SSI/SSP — Nonmedical Out-of-Home Care (NMOHC)

Who it is for
SSI/SSP-eligible Californians 65+, or blind or disabled, living in licensed nonmedical residential care
Income limit
Countable income and living arrangement affect eligibility and payment; SSA makes the determination.
Asset limit
Countable-resource limits are $2,000 for an individual and $3,000 for a couple.

Eligibility

General
Cash support for California residents age 65+ or blind or disabled who meet SSA eligibility rules and have a qualifying nonmedical residential living arrangement.
CA specifics
The nonmedical out-of-home-care category must be verified.

What it provides

  • Combined federal SSI and California SSP cash support. From January 1; 2026; the individual licensed-facility NMOHC maximum payment standard is $1,626.07/month before countable-income reductions. This is not an extra payment on top of regular SSI/SSP or a guarantee of full facility fees.
Cash support for qualifying immigrants, including residential care

Cash Assistance Program for Immigrants

California Cash Assistance Program for Immigrants (CAPI)

Who it is for
Immigrants 65+, or blind or disabled, in California who cannot get SSI because of immigration status
Income limit
Income must meet the CAPI payment standard for the person’s living arrangement; the county determines the individual award.
Asset limit
Countable-resource limits are $2,000 for an individual and $3,000 for a couple.

Eligibility

General
Cash support for California residents age 65+ or blind or disabled who meet CAPI immigration rules and cannot receive SSI/SSP solely because of immigration status.
CA specifics
County staff review proof of SSI/SSP ineligibility. A residential payment category requires its own determination.

What it provides

  • State-funded monthly cash assistance with payment standards equivalent to SSI/SSP; including a qualifying nonmedical out-of-home-care category. Actual payments vary; Medi-Cal and IHSS require separate applications.
In-home & community support

Multipurpose Senior Services Program

MSSP (Medi-Cal Waiver)

Who it is for
Medi-Cal members 60+ who meet nursing-facility level of care and can be served at home
Asset limit
For affected non-MAGI Medi-Cal categories, the 2026 countable-asset limit is $130,000 for one person plus $65,000 for each additional eligible family member (up to ten people). Exclusions and spousal protections apply.

Eligibility

General
Adults age 60+ with a qualifying Medi-Cal aid code who meet nursing-facility level-of-care criteria and can be served in the community.
CA specifics
Enrollment and a team-developed plan are required. The current program age is 60, not 65.

What it provides

  • Care management and authorized support such as adult day care; respite; personal care; meals; transportation and minor home modifications.
In-home support

In-Home Supportive Services (IHSS)

California IHSS

Who it is for
Californians who are aged, blind or disabled and need help to stay safely at home
Asset limit
For affected non-MAGI Medi-Cal categories, the 2026 countable-asset limit is $130,000 for one person plus $65,000 for each additional eligible family member (up to ten people). Exclusions and spousal protections apply.

Eligibility

General
California residents who are aged, blind or disabled (including eligible children) and need assistance to remain safely in their own home; Medi-Cal eligibility and health certification are required.
CA specifics
A county social worker assesses tasks and authorized hours; the recipient generally hires and supervises a provider.

What it provides

  • Authorized in-home assistance with daily needs; the approved hours depend on the county assessment and applicable program limits.
Homeowner tax relief

Property Tax Postponement Program (PTP)

CA PTP

Who it is for
California homeowners 62+, or blind or disabled, with limited income who want to defer property taxes
Income limit
2026 · For the 2026–2027 application cycle, 2025 total household income must not exceed $57,002.
Asset limit
At least 40% equity in the home is required; a reverse mortgage disqualifies participation.

Eligibility

General
California homeowner age 62+ or blind or disabled who occupies the property as a principal residence and meets all program conditions.
CA specifics
Applications for the 2026–2027 cycle run October 1 2026 through February 10 2027; limited funding is first come, first served.

What it provides

  • Deferral of eligible property taxes secured by a lien; 5% simple annual interest accrues and repayment is triggered by specified events. This is a loan-like deferral; not a grant.
Energy assistance

Low-Income Home Energy Assistance Program (LIHEAP)

CA LIHEAP

Who it is for
Income-eligible California households responsible for home energy costs
Income limit
2026 · Published 2026 monthly limits: $3,331.66 for one person; $4,356.83 for two; $5,382 for three; larger households use the CSD table.

Eligibility

General
California households meeting local LIHEAP eligibility and prioritization rules; energy costs and household vulnerability are considered.
CA specifics
Apply through the local provider. Funds are limited and assistance is prioritized under program rules.

What it provides

  • One-time energy-bill help; eligible crisis assistance and weatherization; award amounts depend on program rules and available funds.
Know before you visit

Frequently Asked Questions about Twilight Haven

Quick answers from public records and the community's own listing.
01 Is Twilight Haven in a walkable area?
Twilight Haven has a walk score of 2. Car-dependent. Most errands require a car, with limited nearby walkable options.
02 Are pets allowed at Twilight Haven?
No, Twilight Haven has a no-pet policy.
03 What is the best email address for Twilight Haven?
The team at Twilight Haven can be reached at williamsb@twilighthaven.com.
04 Does Twilight Haven operate as a for-profit or non-profit?
Twilight Haven is registered as a non-profit.
05 How many beds does Twilight Haven have?
Twilight Haven has 166 beds.
06 Are there photos of Twilight Haven?
Yes — there are 4 photos of Twilight Haven in the photo gallery on this page.
07 What levels of care does Twilight Haven provide?
Twilight Haven offers Nursing Home, Assisted Living & Skilled Nursing.
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