Pacific Gardens Nursing and Rehabilitation Center
Meets baseline Medicare standards with room for improvement. A tour and talking to current residents' families is the best next step.
based on 40 Google reviews
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What this means for your family
The facility excels in providing emotionally supportive and kind bedside care from its nursing and CNA teams. However, families must remain vigilant regarding medical monitoring and staffing levels, as some reviewers have reported issues with neglected medical needs and slow response times.
Google Reviews
Google Reviews
40 reviews on Google“Families can expect highly compassionate and dedicated nursing and CNA staff, with many reviewers praising specific individuals for their kindness and professionalism. However, there are serious concerns regarding understaffing, inconsistent rehabilitation therapy, and instances of inadequate medical monitoring.”
Quality Themes
Strengths
- Compassionate and attentive nursing/CNA staff
- Clean and well-maintained environment
- Professional wound care services
- Friendly and helpful housekeeping
Concerns
- Understaffing leading to slow response times (mentioned by 2 reviewers)
- Inconsistency in rehabilitation therapy staff and scheduling
- Lack of communication with families
Rating Trends
Tap a year to see what changed
Distribution · 43 analyzed
How They Respond to Reviews
The owner provides personalized responses that specifically mention the names of staff members and the specific care qualities highlighted by the reviewer. The tone is consistently warm, professional, and appreciative.
Questions for Your Tour
- 1I noticed some families have shared how much they appreciate the compassionate nursing and housekeeping staff; how do you ensure that level of care remains consistent for every resident?
- 2With the recent state inspections, what specific steps is the facility taking to address the identified deficiencies and improve overall care quality?
- 3How does the facility manage medication administration to ensure there are no errors or delays in the daily routine?
- 4Can you tell me more about how the nursing and therapy teams communicate with families regarding a resident's progress or any changes in their condition?
- 5What is the protocol for handling medical emergencies or urgent care needs during the night or over the weekend?
- 6What kind of daily activities or social engagement programs are available to help residents stay active and connected with others?
Personalized based on this facility's data
Key Review Excerpts
“My father spent about 3 months at this facility after breaking his hip/femur. Overall, the staff did a good job providing care even when he was disoriented and not particularly cooperative; someone was always watching at the nurses' station when he couldn't stay in his bed alone.”
“I was a state surveyor for over 20+ years and I have NEVER seen such stellar work, esp. on the MEDICARE SIDE where I’ve been a patient after brain surgery.”
“My mother was at this facility for several weeks. As others have stated, this place is understaffed. They don't appear to care very much about patients. My mother's blood sugar was extremely elevated, and not being addressed; which resulted in health conditions that she did not previously have.”
Staffing
Staffing Hours
per resident/day · Medicare 2026RN hours are below the national benchmark. RNs handle complex medical needs and medication, so ask about coverage during your visit.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 17 measures
11
measures
6
measures
Residents whose bladder or bowel control got worse
Residents on anti-anxiety or sleep medication
Residents on antipsychotic medication
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents needing more daily help over time
Residents vaccinated for pneumonia
Short-stay residents vaccinated for the flu
Short-stay residents vaccinated for pneumonia
Short-stay residents newly given antipsychotics
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
This facility shows concerning patterns with families filing 7 complaints over recent years about serious issues including pressure ulcer care, food safety, and pest control. The main recurring problems are in resident rights, fire safety systems, and care planning, with many deficiencies appearing repeatedly across multiple surveys, suggesting ongoing challenges with maintaining standards. While all violations have correction plans, the frequency of complaints and repeat deficiencies should prompt careful evaluation during any visit.
Aug 27, 2025Complaint1
Resident Rights Deficiencies
Treat residents equally regarding transfer, discharge, and provision of services for all residents, regardless of payment source
Feb 7, 2025Routine23
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.
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
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.
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.
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.
Nutrition and Dietary Deficiencies
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Environmental Deficiencies
Put firmly secured handrails on each side of hallways.
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
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.
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Quality of Life and Care Deficiencies
Provide appropriate foot care.
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
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.
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Nov 26, 2024Complaint2
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Oct 4, 2024Complaint2
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Environmental Deficiencies
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Mar 15, 2024Complaint1
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Nov 30, 2023Routine13
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
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.
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Smoke Deficiencies
Provide properly protected cooking facilities.
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Miscellaneous Deficiencies
Have restrictions on the use of portable space heaters.
Gas, Vacuum, and Electrical Systems Deficiencies
Meet requirements for the use of electrical equipment.
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Federal Penalties
Fine
Feb 7, 2025
$30,654
Ownership & Operations
Who Operates This Facility
Pacific Gardens Nursing and Rehabilitation Center
for profit
Chain Affiliation
Covenant Care
19 facilities nationwide
Chain avg rating: 2.8/5 · Rank 12 of 24
Ownership & Management
Owners
Covenant Care California, LLC
Owner · Organization
Covenant Care, LLC
Owner · Organization
Centre Capital Investors V, Lp
Owner (parent company) · Organization
Centre Covenant Purchaser (b), LLC
Owner (parent company) · Organization
Centre Covenant Purchaser (q), LLC
Owner (parent company) · Organization
Centre Covenant Purchaser (s), LLC
Owner (parent company) · Organization
Centre V Secondary Fund, L.p.
Owner (parent company) · Organization
Covenant Holdco, LLC
Owner (parent company) · Organization
Covenant Subco, LLC
Owner (parent company) · Organization
State Treasurer of Mich Custodian of Public School Empl Rtmnt Systems
Owner (parent company) · Organization
Stockwell Fund II Lp
Owner (parent company) · Organization
Evans, Mary
Owner (parent company)
Levin, Robert
Owner (parent company)
Sims, Christine
Owner (parent company)
Torok, Andrew
Owner (parent company)
Key personnel
Contact
Get in Touch
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References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
40 reviews from families & visitors
Medicare data downloads
Original nursing home datasets
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