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Nursing HomeMedicaid Investigative

Fulton Gardens Post Acute, LLC

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

537 E. Fulton Street, Pacific · Stockton, CA 95204116 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Google rating
3.9/5

based on 47 Google reviews

5
4
3
2
1
Fulton Gardens Post Acute, LLC Nursing Home in Stockton, CA — Street View
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3/ 10
moderate Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low overall rating (2/5 stars)
  • Above-median deficiencies (19 vs median 13.0)

Below average in CA · Below recommended RN staffing · No penalties on record

Source: Medicare data

What this means for your family

This facility is a strong candidate for rehabilitation and dementia care due to its highly praised therapy teams and clean environment. However, families must be extremely vigilant regarding medical oversight, specifically monitoring for signs of infection and ensuring that pain medications are being administered as prescribed, as multiple reviewers have noted failures in these areas.

Google Reviews

Google Reviews

47 reviews on Google
Families often praise the facility for its exceptional rehabilitation programs and the compassionate nature of the nursing and therapy staff, particularly during end-of-life care or post-stroke recovery. However, there are serious, recurring allegations regarding medical oversight, including failure to manage infections and delays in administering pain medication. While many find the facility clean and well-maintained, some reviewers report significant issues with communication and responsiveness from the night shift.

Quality Themes

Tap a score for details
FoodN/AStaff6.0Clean9.0Activities5.0Meds2.0Memory8.0Comms4.0ValueN/A

Strengths

  • Effective rehabilitation and physical therapy programs
  • Compassionate and attentive nursing staff
  • Clean and well-maintained facility
  • Positive environment for dementia care

Concerns

  • Medical oversight and failure to detect infections (mentioned by 2 reviewers)
  • Inadequate responsiveness from night shift/unanswered phones (mentioned by 2 reviewers)
  • Inconsistent medication management and pain control (mentioned by 2 reviewers)
  • Staffing shortages or lack of adequate knowledge (mentioned by 2 reviewers)

Rating Trends

Tap a year to see what changed

234'16(1)'18(1)'21(1)'23(3)'25(4)'26(28)

Distribution · 49 analyzed

5
30
4
6
3
2
2
1
1
10

How They Respond to Reviews

0%response rate

Questions for Your Tour

  • 1We've heard wonderful things about your physical therapy and rehab programs; how do you tailor those sessions to a resident's specific recovery goals?
  • 2What specific protocols do you have in place to ensure medication is administered accurately and that pain levels are monitored closely?
  • 3How does the nursing team handle medical monitoring and infection detection, especially during the overnight hours?
  • 4With the focus on dementia care being a strength here, what kind of daily social activities or sensory programs do you offer to keep residents engaged?
  • 5How do you ensure consistent communication between the nursing staff and family members regarding any changes in a resident's health?
  • 6What is your process for ensuring that all staff members, including those on the night shift, are fully responsive to call lights and resident needs?

Personalized based on this facility's data


Key Review Excerpts

The rehabilitation program was great and the rehab staff were fantastic. The staff at Fulton gardens ( especially the RNs and CNAs kept me informed of everything going on with him in a timely manner

Long-term resident's family · 2026★★★★★

I was so scared to put my 75 yr old mom here because nursing homes have such bad reputations, but the nurses and their CNAs were so attentive to my mom for the past 4 months. She had an open wound and there was a treatment nurse who saw her regularly and it improved dramatically.

Rehab patient's family · 2025★★★★★

If I could give this place a zero I would!! During the day is good, my uncles CNA William was absolutely amazing and attentive, the night shift crew and staff are HORRIBLE!! No one ever answers the phone!!

Rehab patient's family · 2025☆☆☆☆
Source: 47 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.63hrs
84%
Registered nurses for medical care
Total Nursing
3.94hrs
96%
All nurses + aides combined
Staff Turnover
37%
Lower is better (< 30% = good)
RN Turnover
23%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
4/ 5
Better Than Avg

16

measures

Mixed Results

1

measures

Long-Stay Residents
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility4.8%
Better than Avg
Here
4.8%
US
19.4%
CA
10.7%
San joaquin
12.6%
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility2.1%
Better than Avg
Here
2.1%
US
15.4%
CA
11.6%
San joaquin
11.0%
😔

Residents with depression symptoms

↓ Lower is better
This Facility1.2%
Better than Avg
Here
1.2%
US
12.1%
CA
7.0%
San joaquin
2.8%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

🛏️

Residents needing more daily help over time

↓ Lower is better
This Facility3.9%
Better than Avg
Here
3.9%
US
14.4%
CA
10.4%
San joaquin
7.7%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility6.1%
Better than Avg
Here
6.1%
US
15.3%
CA
10.5%
San joaquin
13.2%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
93.4%
CA
98.6%
San joaquin
98.2%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
79.7%
CA
93.2%
San joaquin
93.1%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
81.8%
CA
94.2%
San joaquin
92.8%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility0.5%
Better than Avg
Here
0.5%
US
1.6%
CA
1.5%
San joaquin
1.5%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

19deficiencies
Above state avg (15.4)
9 complaint-triggered

This facility shows significant concerns with families filing multiple complaints that triggered investigations, revealing issues with accident prevention, abuse protection, and maintaining a safe environment. The most recurring problems involve medication management, accident hazard prevention, and nutrition services, with safety violations appearing repeatedly across surveys from 2022 to 2025. While the facility reports correcting each deficiency, the persistent pattern of similar issues—particularly around resident safety and medication errors—suggests ongoing quality control challenges that families should carefully evaluate before choosing this facility.

Nov 18, 2025Complaint
3
0584Potential for harm · PatternCorrected

Resident Rights Deficiencies

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

0600Potential for harm · PatternCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

0689Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Feb 18, 2025Complaint
1
0684Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Jan 10, 2025Routine
23
0803Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

0805Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

0812Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0880Potential for harm · PatternCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0881Potential for harm · PatternCorrected

Infection Control Deficiencies

Implement a program that monitors antibiotic use.

0363Potential for harm · PatternCorrected

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

0550Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0554Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Allow residents to self-administer drugs if determined clinically appropriate.

0656Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

0688Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

0689Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0755Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

0757Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure each resident’s drug regimen must be free from unnecessary drugs.

0761Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

0814Potential for harm · IsolatedCorrected

Nutrition and Dietary Deficiencies

Dispose of garbage and refuse properly.

0842Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

0849Potential for harm · IsolatedCorrected

Administration Deficiencies

Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.

0161Potential for harm · IsolatedCorrected

Construction Deficiencies

Use approved construction type or materials.

0325Potential for harm · IsolatedCorrected

Smoke Deficiencies

Have properly installed hallway dispensers for alcohol-based hand rub.

0918Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have generator or other power source capable of supplying service within 10 seconds.

0919Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Meet requirements for the use of electrical equipment.

0920Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

0923Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have proper medical gas storage and administration areas.

Nov 15, 2024Complaint
1
0658Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure services provided by the nursing facility meet professional standards of quality.

Jul 2, 2024Complaint
1
0677Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

Dec 15, 2023Routine
23
0689Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0800Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.

0353Potential for harm · PatternCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0920Potential for harm · PatternCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

0550Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0558Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

0578Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

0646Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

0755Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

0757Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure each resident’s drug regimen must be free from unnecessary drugs.

0758Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

0759Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure medication error rates are not 5 percent or greater.

0761Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

0812Potential for harm · IsolatedCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0031Potential for harm · IsolatedCorrected

Emergency Preparedness Deficiencies

Provide emergency officials' contact information.

0161Potential for harm · IsolatedCorrected

Construction Deficiencies

Use approved construction type or materials.

0345Potential for harm · IsolatedCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0363Potential for harm · IsolatedCorrected

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

0741Potential for harm · IsolatedCorrected

Miscellaneous Deficiencies

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

0919Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Meet requirements for the use of electrical equipment.

0926Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk.

Ownership & Operations

Who Operates This Facility

Owner / Operator

Fulton Gardens Post Acute, LLC

Organization Type

for profit

Ownership & Management

Owners

Abby Gl LLC

Owner · Organization

92%

Gans, Barry

Owner

6%

Sims, James

Owner

Lynch, Jose

Owner (parent company)

92%

Key personnel

Lotia, MariamManagerLynch, JoseManagerMillan, ElizabethManagerEretz Stockton Properties LLCAdp of the SnfPursue Health LLCAdp of the Snf
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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