Alexandria Care Center
Inspection Findings
F-Tag F0656
F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
1 received azithromycin on 11/30/2025.During a review of Resident 1's MAR, dated 12/2025, the MAR indicated Resident 1 received azithromycin on 12/1/2025 and 12/2/2025.During a concurrent interview, and
record review on 12/24/2025, at 8:39 a.m., with RN 1, Resident 1's care plans were reviewed. RN 1 stated Resident 1 was on azithromycin from 11/29/2025 to 12/2/2025. RN 1 stated care plan for azithromycin was not developed until 12/3/2025. RN 1 stated care plan informs the nurses on what intervention to perform to achieve resident's goals.During an interview on 12/24/2025, at 9:12 a.m., with the Director of Nursing (DON), the DON stated the facility was late in developing the care plan for use of antibiotic azithromycin and legionnaires disease. The DON stated the care plans for use of antibiotic azithromycin and legionnaires disease should have been developed on 11/29/2025. The DON stated care plan guides the nurses on what to do to address Resident 1's problems. The DON stated not timely development of a care plan could possibly result in nurses not performing the interventions to provide care to Resident 1.During an interview
on 12/24/2025 at 1:20 p.m., with the Infection Preventionist (IP), the IP stated care plans help nurses care for the residents. The IP stated delay in developing care plans could potentially delay Resident 1's care.During a review of facility's policy and procedures (P&P), titled, Care Plan Comprehensive, dated 8/25/2021,and last reviewed on 1/22/2025, the P&P indicated, An individualized comprehensive care plan that includes measurable objectives and timetables to meet the resident's medical, physical, mental and psychosocial (interrelation of social factors and individual thought and behavior) needs shall be developed for each resident.Each resident ' s comprehensive care plan is designed to:a. Incorporate identified problem areas.f. Reflect treatment goals, timetables, and objectives in measurable outcomes.j. Reflect currently recognized professional standards of practice for problem areas and conditions.2. The comprehensive care plan includes the following:a. The services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being.7. Assessments of residents are ongoing, and care plans are reviewed and revised as information about the resident and the resident 's condition change.
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 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
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
12/30/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Alexandria Care Center
1515 N Alexandria Ave.
Los Angeles, CA 90027
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)
F-Tag F0755
F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
indicated Resident 1 received dextromethorphan-guaifenesin on 11/20/2025 at 8 a.m.During a concurrent interview, and record review on 12/24/2025, at 7:45 a.m., with LVN 1, Resident 1's Physician Orders, and MAR, dated 11/2025 were reviewed. LVN 1 stated guaifenesin and dextromethorphan- guaifenesin were
the same medication. LVN 1 stated the order was to be given every six hours. LVN 1 stated on 11/20/2025, Resident 1 received guaifenesin at 4:56 a.m. and Resident 1 received dextromethorphan- guaifenesin at 8 a.m. LVN 1 stated that it was only three hours and not six hours in between the two medications. LVN 1 stated Resident 1 could experience overdose (taking too much of a substance such as medicine) of the cough medicine.During an interview on 12/24/2025, at 8:29 a.m., with the DSD, the DSD stated guaifenesin and dextromethorphan- guaifenesin were the same. The DSD stated the nurses did not clarify and did not follow the order. The DSD stated Resident 1 could have upset stomach.During an interview on 12/24/2025, at 8:39 a.m., with Registered Nurse 1 (RN 1), RN 1 stated Resident 1 could experience nausea, vomiting and other negative side effects from receiving two doses of famotidine. RN 1 stated Resident 1 could also experience increase heart rate and can get drowsy from cough medicine when given too close from the last dose.During an interview on 12/24/2025, at 9:12 a.m., with the Director of Nursing (DON), the DON stated nurses should have clarified the famotidine order on which one to follow, the daily or the before breakfast.
The DON stated Resident 1 could overdose with the famotidine. The DON stated guaifenesin and dextromethorphan- guaifenesin were the same medication and nurses should follow the order to give the cough medicine with a six-hour gap. The DON stated Resident 1 could possibly get drowsy and can have low blood pressure from taking the cough medication less than six hours. The DON stated nurses did not follow the physician order for the cough medicine.During a review of facility's policy and procedure (P&P) titled, Administering Medications, dated 4/2019 and last reviewed on 1/22/2025, the P&P indicated, Medications are administered in a safe and timely manner, and as prescribed.4. Medications are administered in accordance with prescriber orders, including any required time frame. 8. If a dosage is believed to be inappropriate or excessive for a resident, or a medication has been identified as having potential adverse consequences (negative, unfavorable, or harmful results that happen) for the resident or is suspected of being associated with adverse consequences, the person preparing or administering the medication will contact the prescriber, the resident's Attending Physician or the facility's Medical Director to discuss the concerns.10. The individual administering the medication checks the label three (3) times to verify the right resident, right medication, right dosage, right time and right method (route) of administration
before giving the medication.
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 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
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
12/30/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Alexandria Care Center
1515 N Alexandria Ave.
Los Angeles, CA 90027
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)
F-Tag F0842
F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
(DON), the DON stated it is important to document accurately in Resident 1's medical record to show what was the intervention provided to the resident when resident had low oxygen saturation. The DON stated using face mask with 15 liters of oxygen will not be effective in delivering oxygen and could potentially cause continued low saturation.During a review of facility's policy and procedure (P&P), titled, Nursing Documentation, dated [DATE REDACTED], and last reviewed on [DATE REDACTED], the P&P indicated, To communicate patient's status and provide complete, comprehensive, and accessible accounting of care and monitoring provided.
Nursing documentation will follow the guidelines of good communication and be concise, clear, pertinent, and accurate based on the resident's/patient's condition, situation, and complexity. Documentation includes information about the patient's status, nursing assessment and interventions, expected outcomes, evaluation of the patients' outcomes, and responses to nursing care.
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 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
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
12/30/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Alexandria Care Center
1515 N Alexandria Ave.
Los Angeles, CA 90027
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)
F-Tag F0880
F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
Medical Services Healthcare Personnel, who have direct patient contact or work in Patient-Care Areas in Licensed Healthcare Facilities subject to this Order and the prehospital care setting ( any setting in which medical care is provided prior to the patient's arrival at a hospital).Masking Requirement for Skilled Nursing Facilities. All persons who meet the definition of Healthcare Personnel within Skilled Nursing Facilities must wear a Respiratory Mask, regardless of vaccination status, while in contact with patients or working in patient-Care Areas during the respiratory virus seasons (11/1 to 3/31).
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 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
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
12/30/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Alexandria Care Center
1515 N Alexandria Ave.
Los Angeles, CA 90027
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)
F-Tag F0881
F 0881 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
titled, Infection Prevention and Control Program dated 9/18/2024, and last reviewed on 1/22/2025, the P&P indicated, Antibiotic StewardshipCulture reports (identifies microorganisms causing an infection), sensitivity (the ability of a test to correctly identify patients with a disease) data, and antibiotic usage reviews are included in surveillance activities.Medical criteria and standardized definitions of infections are used to help recognize and manage infections.Antibiotic usage is evaluated, and practitioners are provided feedback on reviews.11. Prevention of Infection. (2) instituting measures to avoid complications or dissemination.During
a review of facility's P&P, titled, Antibiotic Stewardship-Review and Surveillance of Antibiotic Use and Outcomes, dated 9/18/2023, and last reviewed on 1/22/2025, indicated, Antibiotic usage and outcome data will be collected and documented using a facility-approved antibiotic surveillance tracking form. The data will be used to guide decisions for improvement of individual resident antibiotic prescribing practices and facility-wide antibiotic stewardship.1. As part of the facility antibiotic stewardship program, all clinical infections treated with antibiotics will undergo review by the infection preventionist, or designee.2. The IP, or designee, will review antibiotic utilization as part of the antibiotic stewardship program and identify specific situations that are not consistent with the appropriate use of antibiotics.3. At the conclusion of the review,
the provider will be notified of the review findings.4. All resident antibiotic regimens will be documented on
the facility-approved antibiotic surveillance tracking log.
Event ID:
Facility ID:
If continuation sheet
ALEXANDRIA CARE CENTER in LOS ANGELES, CA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 LOS ANGELES, 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 ALEXANDRIA CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.