Fresno area hospitals and healthcare facilities racked up tens of thousands of dollars in penalties for putting patients in harm’s way or contributing to their deaths.
California issued 43 “immediate jeopardy” penalties to hospitals and healthcare facilities statewide, for $2,850,000 in penalties, according to the California Department of Public Health’s Center for Health Care Quality state enforcement actions dashboard. The U.S. Centers for Medicare & Medicaid Services define immediate jeopardy as noncompliance that “has placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death.” It is the most serious type of deficiency or violation. In California, citations for these violations can result in administrative fines between $25,000 to $125,000.
Sixteen, or 37%, of these citations were issued to Valley based healthcare institutions in Fresno, Kern, Madera, Merced, Tulare, Stanislaus counties.
From erroneous insertions of feeding tubes to abuse at a behavior health center to a “preventable death” post-pregnancy, Fresno area institutions were cited tens of thousands of dollars in 2025 for putting patients in harm’s way.
Bruce Spurlock, executive director of Cal Healthcare Compare said administrative penalties like immediate jeopardies should not be used to analyze the overall quality of a hospital. His organization provides free an unbiased, one-stop snapshot of how local facilities measure up against each other and to statewide averages on a variety of quality metrics. Each year, they produce a patient safety honor roll of California hospitals.
Spurlock said in an interview that immediate jeopardy citations usually issued for incidents that happened in the past and can “often miss the systems-issues lying underneath.”
The citations typically focus on only one safety issue, which might not even be the most important one. Enforcement and analysis can vary from surveyor to surveyor, and also depend on hospital self-reporting, too, he said. Immediate jeopardy and administrative penalty data should be “a tool for quality improvement, not a tool for quality measurement,” he said.
Immediate jeopardy citations in Fresno area in 2025
Several San Joaquin Valley hospitals were cited by the California Department of Public Health for patient safety violations in 2025.
Immediate Jeopardy citations are relatively rare
All hospitals incur violation deficiencies during the course of regular operations, which are noted instances of failing to comply with state or federal requirements.
Not all deficiencies are serious. Some can be issued for something as mundane as inadequate signage and doors that don’t close properly. The most serious violations can escalate to what state and federal inspectors call “immediate jeopardy” situations, ones that can cause or have caused serious patient injury, harm or even death.
This rare designation can result from one violation or a series of them in a short period of time. “Any incident of Immediate Jeopardy … is a serious violation and CDPH must go on site within 24 to 48 hours to ensure patient safety,” the CDPH Office of Communications told The Bee in 2023.
A 2021 analysis of hospital deficiencies reported by Centers for Medicare and Medicaid Services (CMS) over a 10-year period found that only 2%, or 730 of 30,808, were elevated to immediate jeopardy designations. The analysis was published in the Journal of Patient Safety.