Attorney General Bonta Conditionally Approves Sale of St. Elizabeth Care Center in North Hollywood, Requiring Protections for Residents and Continued Access to Care

OAKLAND - California Attorney General Rob Bonta today conditionally approved the sale of St. Elizabeth Care Center (St. Elizabeth), a 52-bed nonprofit skilled nursing facility in North Hollywood. The facility will be transferred from Providence Health System - Southern California to affiliates of The Ensign Group, Inc. (Ensign), a publicly traded, for-profit healthcare company. St. Elizabeth has served the community since 1964 and provides care to elderly residents, with Medi-Cal and Medicare beneficiaries accounting for a significant share of its residents. The approval includes conditions designed to protect current residents and help ensure continued access to care. Under California law, any transaction involving the sale, or transfer of control and governance of a nonprofit health facility, must secure the advance approval of the Attorney General's Office.

"St. Elizabeth Care Center has been part of the North Hollywood community for more than 60 years, and we want to see it continue serving residents for years to come," said Attorney General Bonta. "The conditions we are requiring will help protect current residents, preserve access to care, and provide meaningful oversight of the facility's operations."

Ensign has been operating St. Elizabeth since June 1, 2025, after receiving approval from the California Department of Public Health to take over management. The proposed transaction is part of a broader acquisition by Ensign including other Providence facilities in Alaska, Oregon, and Washington. St. Elizabeth is the only California facility included in the deal.

The conditions include protections tailored to this transaction, along with safeguards Attorney General Bonta has required in other healthcare transactions. They range from seven to 10 years in duration. Among the key requirements are:

• Maintain Medicare and Medi-Cal participation, while reserving at least 30% of skilled nursing beds for Medi-Cal beneficiaries.
• Maintain sufficient direct-care staffing to meet residents' needs, consistent with resident acuity and state and federal requirements.
• Employ a full-time licensed nursing home administrator to provide consistent day-to-day oversight of the facility.
• Ensure residents have safe transfers and discharges and adequate living space.
• Limit rent increases, payments to affiliated entities, and debt that could threaten the facility's financial stability or reduce direct-care staffing, including requiring Attorney General approval for rent increases above 2.5%.
• Maintain an Attorney General-appointed monitor to oversee compliance with the conditions.

The California Department of Justice's Healthcare Rights and Access Section (HRA) works proactively to increase and protect the affordability, accessibility, and quality of healthcare in California. HRA's attorneys monitor and contribute to various areas of the Attorney General's healthcare work, including nonprofit health care facility transactions; consumer rights; anticompetitive consolidation and conduct in the healthcare market; anticompetitive drug pricing; privacy issues; civil rights, such as reproductive rights and LGBTQ healthcare-related rights; and public health work on tobacco, e-cigarettes, and other products.