California Attorney General Rob Bonta has conditionally approved the sale of St. Elizabeth Care Center, a 52-bed nonprofit skilled nursing facility in North Hollywood that has cared for elderly residents since 1964, clearing the way for its transfer from Providence Health System — Southern California to affiliates of the publicly traded, for-profit Ensign Group Inc. The approval comes with a lengthy list of conditions designed to protect current residents and preserve their access to care.
The facility sits at 10425 Magnolia Blvd. and holds 52 licensed skilled nursing beds, though state regulatory filings show it currently operates 48 active beds, according to the California Attorney General's Office. Under the deal, ownership passes from Providence to buyer entities Toluca Way Health Holdings LLC, West Star Healthcare LLC, and corporate affiliates of Delaware-registered The Ensign Group — the same filings show. As reported by MyNewsLA, Bonta said St. Elizabeth Care Center has been part of the North Hollywood community for more than 60 years, and that the required conditions will protect current residents and preserve access to care.
Why State Approval Was Required
California law requires nonprofit healthcare operators to give advance written notice and receive consent from the Attorney General before selling or transferring governance control of health facility assets to for-profit corporations, under Corporations Code Section 5914. That statutory authority is what gave Bonta's office jurisdiction to review the St. Elizabeth transaction in the first place.
Before granting conditional approval, the AG's Healthcare Rights and Access Section held a required public hearing at the St. Elizabeth facility in July to take testimony on how the ownership change would affect local healthcare access. The office has also appointed a monitor to oversee compliance with the conditions going forward, per the MyNewsLA report.
Rent Caps, Staffing Rules and a Decade-Long Watch
The conditions attached to the sale are extensive. New owners must maintain participation in Medicare and Medi-Cal, reserve at least 30% of skilled nursing beds for Medi-Cal beneficiaries, maintain sufficient direct-care staffing to meet residents' needs, and employ a full-time licensed nursing home administrator. The rules also require safe transfers and discharges and adequate living space for residents, and they remain in effect for seven to 10 years.
Financially, the conditions cap rent increases above 2.5% unless the Attorney General approves them, and they restrict cash transfers to corporate-affiliated entities meant to prevent debt accumulation that could undermine resident care staffing. The same MyNewsLA account notes that any debt threatening the facility's financial stability or reducing direct-care staffing is similarly limited under the agreement.
Ensign Has Already Been Running the Facility for Over a Year
Ensign isn't new to St. Elizabeth. The company received initial management authorization from the California Department of Public Health and assumed day-to-day operational control of the facility on June 1, 2025, more than a year before the Attorney General's final sign-off on the ownership transfer, according to the Attorney General's Office. That arrangement let Ensign manage daily operations under state licensing while the broader ownership review proceeded separately.
St. Elizabeth is the only California facility included in a broader multi-state transaction that also involves Providence facilities in Alaska, Oregon and Washington. That wider deal is part of a 10-facility portfolio divestiture Providence announced in December 2024, with the Alaska, Washington and Oregon transfers closing in March 2025 while California's sale required the separate, lengthier Attorney General review spelled out under Corporations Code Section 5914.
A Nonprofit's Broader Retreat From Skilled Nursing
The Renton, Washington-based health system's divestiture of non-acute long-term care centers supports its $2 billion strategic turnaround plan for 2030, which aims to stabilize operating finances by shedding non-core assets and refocusing capital on hospital operations, according to Becker's Hospital Review. On the buying side, Ensign Group, headquartered in San Juan Capistrano, expanded its national portfolio to 418 healthcare operations and 189 real estate properties across 18 states following acquisitions completed this month, per Investing.com.
The rent caps and staffing safeguards placed on St. Elizabeth echo concerns Bonta has raised at the state and federal level. In February, Bonta co-led an 18-state coalition of attorneys general opposing federal attempts to roll back minimum nursing home staffing rules for Medicare- and Medicaid-certified facilities nationwide. The North Hollywood conditions, requiring sufficient direct-care staffing and a full-time licensed administrator, reflect that same push to keep for-profit acquisitions from eroding resident care.
