Before Kenneth Bryan Holcomb shot and killed a homeless man in San Mateo County in 1992, he had been in prison for burglary and drug dealing. While he was serving a 22-years-to-life sentence for the murder, he fractured his spine during a fight, which left him a quadriplegic, unable to walk, dress or bathe himself.

Holcomb speaks with some difficulty, although he is able to see and hear, Patrick Sparks, his lawyer, said during a medical parole hearing last September. Yet Sparks said that his client retained “the capacity in his mind for dangerousness,” a transcript shows. “Not to say that he’s the Godfather or anything, but he’s a pretty dangerous guy,” he said.

Even so, the California Board of Parole Hearings found that because of Holcomb’s disabilities “the conditions under which the inmate would be released will not pose a reasonable threat to public safety.”

Today Holcomb lives in the Idylwood Care Center, a private 172-bed nursing home in a leafy suburban neighborhood in Sunnyvale, near a park and a private school. He and three other medical parolees from the California Department of Corrections and Rehabilitation — murderers, drug dealers and burglars, ranging in age from 40s to 70s — are watched by medical staff instead of by prison guards.

The four are among the first 29 prisoners to be granted medical parole under a 2010 California law intended to save the state tens of millions of dollars in medical and guarding costs for permanently, medically incapacitated prisoners. Some of the parolees are bedridden, while others can be moved by wheelchair, and officials said that the parolees posed no threat to others.

Yet the medical parole program is raising concerns among the state’s long-term care ombudsmen, who investigate complaints from residents of nursing homes.

“There are worries involved in putting prisoners in with the regular population of frail seniors, but there is a lot of risk involved in putting them in with psych patients,” said Wanda Hale, who visited the Idylwood Care Center as the program manager for the long-term care ombudsman program at Catholic Charities in Santa Clara County. “My concern is that there is a lot of potential for problems. They just haven’t happened yet.”

The nursing facility in Sunnyvale received its first medical parolee from the Department of Corrections in August. They are all forbidden from leaving the Idylwood premises, except in a medical emergency, and they are confined to a 22-bed locked unit that they share with seven psychiatric patients.

“These medical parolees are both physically and mentally incapacitated,” said Larry Kamer, a spokesman for the nursing home, which is operated by Crestwood Behavioral Health of Sacramento. “In fact, in all but one case, they’re not even alert.”

One parolee’s interactions with staff have raised concerns, however. Peter Post, a medical parolee at another facility, “allegedly made indecent gestures to female nurses at a San Diego area long-term care facility” soon after arriving there in November, according to the state’s Department of Corrections and Rehabilitation. The Board of Parole hearings determined that Post was still eligible for medical parole.

Facilities that care for medical parolees are not required to inform other patients or their families about the parolees. The ombudsmen receive no formal notification when medical parolees are transferred to facilities in their region.

Other homes in California that accept medical parolees include Magnolia Special Care Center in El Cajon in the San Diego area and San Fernando Post Acute Hospital in Sylmar in Los Angeles, parole hearing transcripts show.