Pacific Gardens Nursing and Rehabilitation Center
- Reviewed By
Anthony C. Lanzone, Founding Partner
Table of Contents:
Overall Ratings & Reviews for Pacific Gardens Nursing and Rehabilitation Center in Fresno
Pacific Gardens has a three-star overall rating from the U.S. Centers for Medicare and Medicaid Services. However, the overall score is based on the following ratings:
- Two stars for health inspections
- Two stars for staffing
- Five stars for quality measures
Residents at the facility receive an average of 4 hours and 7 minutes of nursing staff time per day, which is below the California average. Licensed practical and vocational nurses provide only 41 minutes of daily care per resident, compared with the statewide average of 72 minutes.
The facility also falls below the national average for successful discharges. Only 46% of residents reached or exceeded the expected ability to care for themselves and move around at discharge, compared with 57% nationwide.
Pacific Gardens has earned a 3.4-star Yelp rating. The facility has received 21 one-star reviews, some alleging that staff failed to properly monitor residents, contributing to preventable infections and falls. Residents and loved ones also reported poor communication, restricted family access, and staff ignoring residents’ requests for help.
Documented Care Deficiencies at Pacific Gardens Nursing and Rehabilitation Center
Pacific Gardens has received 21 health citations in the last 3 years, more than double the national average. Some of the most egregious deficiencies involved failures to prevent pressure ulcers, to provide necessary follow-up treatment after physical therapy, and to maintain sanitary conditions. Some of these violations either resulted in actual harm to residents or placed vulnerable residents at risk.
February 2025 Inspection Findings
Following a February 2025 inspection, Pacific Gardens was fined $30,654 for serious care failures. During the inspection, surveyors reportedly found that staff failed to provide the required range-of-motion treatment to a resident for nearly 11 months after physical therapy ended.
During that period, the resident reportedly developed a hand contracture. Four fingers became increasingly bent, leaving her unable to straighten them. Inspectors concluded that the missing treatment may have contributed to the contracture and classified the deficiency as causing actual harm.
October 2024 Inspection Findings
An October 2024 complaint inspection of Pacific Gardens Nursing and Rehabilitation Center found that the facility failed to maintain sanitary kitchen conditions and an effective pest control program. Surveyors reportedly observed food debris, dirty buildup, scattered trash, and dead cockroaches in multiple areas of the kitchen. According to the report, these conditions may have put vulnerable residents at risk of foodborne illness.
March 2024 Inspection Findings
During a March 2024 complaint inspection, inspectors noted that the facility failed to conduct required skin assessments for a resident who was virtually bedridden. This deficiency resulted in actual harm to the resident.
Despite the resident’s moderate risk of developing pressure ulcers, staff reportedly did not complete the resident’s twice-daily or weekly skin assessments for nearly two weeks. Consequently, the resident developed a preventable stage 3 pressure ulcer on the sacrum. The facility’s director of nursing acknowledged that its failure to follow skin integrity policies contributed to the ulcer.
What To Consider When Choosing a Nursing Home for Your Loved One
While every elder care facility promises high-quality services, a closer look can reveal important differences in the level of care residents actually receive. A good place to start is by reviewing ratings for specific areas of care and recent inspection reports on Medicare’s website. Pay attention to serious citations and repeated problems within the facility.
Request a tour during daytime hours so you can observe how staff interact with residents in common areas and note residents’ overall demeanor. You’ll also want to observe the kitchen and living spaces for signs of unsanitary conditions.
The following questions can also provide further insight:
- How many nursing staff members work during each shift?
- How do staff prevent falls and pressure ulcers?
- What security measures are in place to protect residents from wandering or unauthorized visitors?
- How does the facility handle complaints?
- How will the facility notify me about changes in my loved one’s condition?
Compare several centers before deciding, and trust your instincts if something feels wrong.
Get Trusted Help With Your Family’s Nursing Home Abuse Claim
If your loved one has suffered harm at Pacific Gardens Nursing and Rehabilitation Center, you deserve answers and accountability. Lanzone Morgan, LLP, can help you understand your legal options and stand up to the facility on your family’s behalf.
Fighting for vulnerable adults is all we do. With over 75 years of combined experience, our team has recovered over $250 million for people affected by nursing home abuse and neglect. Our sole focus on these types of cases means we know how to investigate care failures and hold powerful nursing home corporations accountable.
Your family has been through enough stress. Let our Fresno nursing home abuse lawyers handle all the details so your family can focus on healing and moving forward. Contact us online or call 888-887-9777 for a free consultation.
Disclaimer: The inspection information provided above comes from public sources. Lanzone Morgan, LLP cannot ensure that this page reflects the most current data or complete findings. For the latest information, visit https://projects.propublica.org/ or medicare.gov. Deficiencies listed may have been corrected since the inspection date and the time of publication. This page is a legal advertisement and information resource. It is not endorsed by the named facility or any government agency. Lanzone Morgan, LLP, is not affiliated with the facility discussed.
- Fact-Checked
This content has been legally reviewed and approved by nursing home abuse attorney, Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.
VIEW SOURCES
- 356 Redondo Avenue, Long Beach, CA 90814
- 888-887-9777
- Fact-Checked
This content has been legally reviewed and approved by nursing home abuse attorney, Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.
VIEW SOURCES
Pacific Gardens Nursing and Rehabilitation Center. (n.d.). Medicare.gov. https://www.medicare.gov/care-compare/details/nursing-home/056207/view-all?state=CA
Pacific Gardens Nursing And Rehabilitation Center in California. (n.d.). ProPublica. https://projects.propublica.org/nursing-homes/homes/h-056207/