Skip to main content
Advertisement
Complaint Investigation

The Ellison John Transitional Care Center

Inspection Date: December 26, 2025
Total Violations 1
Facility ID 555904
Location LANCASTER, CA
Advertisement

Inspection Findings

F-Tag F0755

Pharmacy Service Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

12/26/2025 of Resident 1's December MAR with the Infection Control Preventionist (IP), the IP reviewed Resident 1's December MAR and stated Resident 1's 9 a.m. medications are not signed off. It appears the medications were not given. The IP stated there should be some documentation about why Resident 1 did not take his medication. The IP stated Resident 1 not getting his medications, as prescribed can increase Resident 1's blood pressure and if blood thinners, it can result in developing a blood clot. The IP stated if Resident 1 is having a difficult time swallowing the medication or is refusing medications, the doctor must be notified. If the doctor is not notified it can be a potential delay in care. The IP reviewed Resident 1's MAR and stated for amlodipine parameters it indicates to hold if the SBP is less than 120 or if the DBP is less than 60 or if the HR is less than 60. The IP stated on 12/15/2025 Resident 1's BP was 108/62 and heart rate was 78. The IP stated the nurse administered the medication outside of the parameters. The IP stated if the medication is given outside of the parameters the resident can become hypotensive. During a review of the Facility Policy and Procedure (P&P) titled, Medication Administration-General Guidelines, last reviewed on 12/10/2025, the P&P indicated medications are administered as prescribed in accordance with good nursing principles and practices.B. Administration 2. Medications are administered in accordance with

the written orders of the attending physician.10. Medications are administered within 60 minutes of scheduled time (1 hour before and 1 hour after), except before or after meal orders, which are administered based on mealtimes. Unless otherwise specified by the prescriber, routine medication are administered according to the established medication administration schedule for the facility.

Event ID:

Facility ID:

If continuation sheet

📋 Inspection Summary

THE ELLISON JOHN TRANSITIONAL CARE CENTER in LANCASTER, CA inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

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

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 LANCASTER, 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 THE ELLISON JOHN TRANSITIONAL CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
« Back to Facility Page
Advertisement
Advertisement