Health inspection·July 31, 2025

F 0825 Provide or get specialized rehabilitative services as required for a resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to provide physical therapy services for one of three sample residents (Resident 1) as ordered by the physician and as outlined in the plan of care when Resident 1 was ordered to receive physical therapy five times per week beginning on 7/4/25 but documentation showed multiple missed therapy sessions.This failure placed Resident 1 at risk for decline in functional abilities and unmet care plan goals.Findings:A Review of Resident 1's admission RECORD, indicated, Resident 1 was admitted to the facility on [DATE] with primary diagnoses of urinary tract infection (UTI, an infection in the urinary system), diabetes type 2 (the body's inability to regulate sugar levels), acute kidney failure (sudden onset usually due to a medical issue), stage 3 chronic kidney disease (a condition where the kidneys are moderately damaged and unable to filter waste products effectively), and muscle wasting atrophy (a condition where muscles lose mass and strength due to prolonged inactivity or immobilization).Review of Resident 1's Brief Interview for Mental Status (BIMS, an assessment tool), dated 7/7/25, indicated Resident 1 scored 15 out of 15 points total. A score of 15 indicated Resident 1 had no cognitive impairment. During an interview with Resident 1 on 7/31/25 at 9:25 a.m., Resident 1 stated that she was informed she would receive physical therapy (PT) and occupational therapy (OT) every Monday, Wednesday and Friday. Resident 1 also reported that just recently, another therapist came in on Saturdays and Sundays to provide therapy. Resident 1 stated that if she does not have therapy, she remained in bed and performed her own exercises with a resistance band (elastic bands of varying resistance used to add tension to strength training exercises, promoting muscle growth), leg lifts, and Kegel exercises (exercises to strengthen the muscles in the pelvis region). Resident 1 stated her last therapy session consisted of sitting on the edge of the bed with her legs hanging down, performing leg exercises, squeezing a ball with her hand, and lifting a weight over her head. Resident 1 expressed that PT/OT services were not helping her improve.A review of Resident 1's physician order, dated 7/4/25, indicated, .PT to address .thera ex [therapeutic exercise], thera ac [therapeutic activity], neuro reeducation [a therapeutic technique used to retrain the brain and body to restore normal coordinated movement patterns], w/c [wheelchair] mgt [management] training, and pt [patient]/care giver training for 5x [times]/week for 6 weeks [stop date of 8/15/25] .During an interview with the Occupational Therapist (OT) on 7/31/25 at 1:46 p.m., the OT stated that the physical therapist was not in the building, and she was unsure if the therapist may be reached via phone. The OT confirmed that Resident 1 was scheduled to receive rehabilitation services five times per week. A review of Resident 1's physician progress note dated 7/4/25, indicated, .[Resident 1] has a chronic left upper extremity weakness, she wears a brace for prevention of contractures [a permanent tightening and shortening of muscles, tendons, skin, or ligaments]. [Resident 1] has generalized weakness, patient will be participating in physical therapy .she is at high risk for decline .A review of Resident1's Care Plan Report initiated on 7/4/25 indicated, .Focus: Physical Therapy Care Plan.Goal: Residents Affected - Some (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 555105 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 555105 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Noble Care Center 2740 North California Street Stockton, CA 95204 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)