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Complaint Investigation

Buena Park Nursing Center

January 30, 2026 · Buena Park, CA · 8520 Western Avenue
Citations 2
CMS Rating 2/5
Beds 143
Provider ID 055571
Healthcare Facility
Buena Park Nursing Center
Buena Park, CA  ·  View full profile →
Inspection Summary

BUENA PARK NURSING CENTER in BUENA PARK, CA — inspection on January 30, 2026.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0656
Resident Assessment and Care Planning Deficiencies

Review of the facility's P&P titled Physical Restraints revised 1/2017 showed if the restraints are utilized, the opportunity for motion and exercise should be provided for a period of not less than 10 minutes during two hour period in which restraints are utilized.

Medical record review for Resident 6 was initiated on 1/28/26. Resident 6 was admitted to the facility on [DATE].

Review of Resident 6's Order Summary Report showed a physician's order dated 3/10/25, to apply left hand mitten necessity due to persistent pulling out of GT.

Review of Resident 6's care plan for usage of the left hand mittens or persistent pulling out of GT initiated 3/10/25 and revised 11/9/25, showed interventions including the application of the left hand mitten to prevent pulling out the tube and release every two hours for circulation and comfort for 15 minutes.

Review of Resident 6's MAR for March 2025 showed the left hand mitten placement was monitored every shift on 3/10 - 3/31/25.

Review of Resident 6's medical record failed to show documented evidence Resident 6's left hand mitten restraint was released every two hours for skin integrity and circulation. On 1/30/26 at 1100 hours, an interview and concurrent medical record review for Resident 6 was conducted with RN 1. RN 1 stated the facility protocol for the use of hand mitten restraint was to remove the hand mitten every two hours and check for circulation and skin condition. RN 1 verified Resident 6 did not have an order to monitor circulation and skin condition every 2 hours. RN 1 further verified there was no documentation to show whether Resident 6's hand mittens were released every two hours to monitor for circulation and comfort. On 1/30/26 at 1315 hours, an interview was conducted with the Administrator.

The Administrator was informed and acknowledged the above findings.

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 TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE

055571 01/30/2026

Buena Park Nursing Center 8520 Western Avenue Buena Park, CA 90620

Review of Resident 1's H&P examination dated 3/15/25, showed Resident 1 had no capacity to understand and make decisions.

Review of Resident 1's Order Summary Report showed the following physician's orders:- dated 3/29/25, to administer Refresh Plus ophthalmic solution one drop in both eyes every two hours for dry eyes, ocular surface irritation;- dated 6/27/25, to administer Timoptic Ophthalmic solution (timolol) one drop in both eyes two times a day for uncontrolled primary open angle glaucoma; and- dated 7/30/25, to administer Lumify ophthalmic solution (brimonidine tartrate) one drop in both eyes two times a day for ocular hyperemia (red eye).

Review of Resident 1's MAR showed the following medications were not administered on the following dates:- dated 3/29/25, Refresh Plus administration was coded 5 (indicating hold/see progress notes) at 1600 hours and coded 4 (indicating the vitals were outside of the parameters for administration) at 2000 hours.

However, the administration progress note failed to show the reason why the medication was not administered and what parameters of administration.- dated 6/1/25, Refresh Plus was not administered 12 times from 0000 to 2200 hours.

Further review of the MAR progress note showed awaiting medication from pharmacy. In addition, review of the nursing progress note dated 6/1/25, showed that pharmacy was contacted and requested for refill; however, there was no documentation if the physician was informed regarding multiple missed doses.- dated 6/2/25, Refresh Plus was not administered nine times from 0000 to 1600 hours.

Further review of the MAR progress note showed awaiting medication from pharmacy.- dated 8/11/25, Timoptic ophthalmic solution administration for 1700 hours was coded 9 (indicating to see the progress note).

However, reviewed of the administration progress note failed to show a reason why the medication was not administered - dated 9/3/25, Timoptic ophthalmic solution administration for 1700 hours was coded 9 (indicating to see the progress note).

Review of the administration progress note showed awaiting for delivery.- dated 10/15/25, Lumify ophthalmic solution administration for 0900 hours was coded 9 (indicating to see progress note).

Review of the nursing progress note showed three nursing documentation indicating that follow up phone calls were made with the pharmacy; however, pharmacy does not have stock of Lumify medication. On 1/27/26 at 1500 hours, an interview and concurrent medical record review was conducted with RN 1. RN 1 acknowledged the above findings and stated it was the responsibility of the charge nurse to submit a request for refill five days before the medication runs out. RN 1 further stated the physician should have also been notified when the medication was not administered as ordered. On 1/30/26 at 1315 hours, an interview was conducted with the DON and Administrator.

The DON and Administrator were informed and acknowledged the findings.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in BUENA PARK, CA, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from BUENA PARK NURSING CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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