Cedarwood Rehab: Repeated Food Safety Failures - PA
The finding, recorded during a January 10, 2025 inspection of Cedarwood Rehabilitation & Healthcare Center, cuts to a specific failure: not just that food safety conditions were unsanitary, but that the facility's own internal oversight system, the committee responsible for catching and correcting exactly these kinds of problems, let the same violation happen a third time.
The first citation came in February 2024. Inspectors documented that Cedarwood had failed to prepare, store, and serve food under sanitary conditions. The facility responded the way facilities are expected to respond. It developed a plan of correction. That plan included completing audits of kitchen practices and bringing the results of those audits back to the Quality Assurance and Performance Improvement committee, known as QAPI, for review.
The QAPI committee is, in theory, the internal mechanism that keeps a nursing home from repeating its mistakes. It exists to catch patterns, to close gaps, to make sure a correction actually corrects something.
By December 2024, inspectors were back. They cited the same violation. Unsanitary food conditions, again. Cedarwood wrote another plan of correction. Audits, again. Reporting to QAPI, again.
Three weeks into January 2025, inspectors returned once more. The January survey cited the violation again, and this time the inspection report named the QAPI committee directly, finding that it had failed to maintain the facility's compliance with food service standards. The audits the facility had promised to conduct, and to bring before that committee, had not produced the result the plans of correction described.
What the inspection record shows is a loop. A problem is found. A fix is promised. The fix is not fixed. The problem is found again.
Unsanitary food service conditions in a nursing home carry real consequences for the people eating that food. Residents in long-term care facilities are, by definition, a population with compromised immune systems, chronic illness, and limited ability to recover from foodborne illness. Contaminated food or improper storage temperatures can cause infections that in a younger, healthier person might mean a miserable day and in a nursing home resident can mean hospitalization or worse.
The inspection report does not describe what specific conditions inspectors observed in the kitchen, what foods were improperly stored, or whether any resident became ill. What it records is the pattern: cited in February, cited in December, cited again in January.
Cedarwood Rehabilitation & Healthcare Center is a skilled nursing facility in Tyrone, a small city in Blair County in central Pennsylvania. The January inspection was a standard health survey.
The QAPI finding is its own category of concern. A single citation for a food safety lapse can reflect a bad day in a kitchen, a staff member who didn't follow procedure, a problem that was genuinely corrected after the inspector left. A QAPI citation, layered on top of two prior citations for the identical deficiency, reflects something different. It reflects a facility that told regulators it had a system in place to prevent recurrence and then, when inspectors checked, could not show that the system had worked.
The plans of correction Cedarwood submitted after February 2024 and December 2024 both described the same mechanism: audits, committee review. The January 2025 inspection found that mechanism had not produced compliance.
The residents eating meals at Cedarwood on any given day are unlikely to know that the kitchen serving their food has been cited for unsanitary conditions three times in under a year, or that the committee charged with making sure that stopped happening was itself found deficient. They are unlikely to know that the facility promised, twice, to fix this, and that inspectors came back and found it wasn't fixed.
They are just eating lunch.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Cedarwood Rehabilitation & Healthcare Center from 2025-01-10 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: August 9, 2026 · Our methodology
CEDARWOOD REHABILITATION & HEALTHCARE CENTER in TYRONE, PA was cited for violations during a health inspection on January 10, 2025.
The first citation came in February 2024.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.