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Complaint Investigation

Cedar Pine Post Acute

August 15, 2025 · Pasadena, CA · 1640 N. Fair Oaks Avenue
Citations 1
CMS Rating 2/5
Beds 99
Provider ID 555213
Healthcare Facility
Cedar Pine Post Acute
Pasadena, CA  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

Cedar Pine Post Acute in PASADENA, CA — inspection on August 15, 2025.

Found 1 citation. 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.

Inspection Findings

FF0689
Quality of Life and Care Deficiencies

During an interview on 8/15/2025 at 12:26 PM with the MDS Nurse, the MDS Functional Abilities section dated 5/8/2025 was reviewed.

The Functional Abilities section indicated Resident 1 was wheelchair bound, was dependent on chair to bed, sit lying, tub/shower transfer.

The MDS Nurse stated that according to the assessment, Resident 1 needed staff to assist with Activities of Daily Living (ADLs-tasks a person does to take care of the body and overall well-being) all the time.

The MDS nurse stated that if Resident 1 was not assisted, it could lead to possible falls that could possibly cause harm and injury to the resident.

The MDS nurse stated Resident 1 was assessed as having memory problems and with episodes of confusion.

The MDS nurse stated Resident 1 should not have been left unattended or unsupervised on 5/10/2025.

The MDS nurse stated that with supervision from staff, the falls could have been prevented.

During a review of the facility's Policy and Procedures (P&P) titled, Fall Risk Assessment, revised 3/2024, the P&P indicated: The nursing staff, in conjunction with the Attending MD, consultant pharmacist, therapy staff and others, will seek to identify and document resident risk factors for falls and establish a resident-centered fall prevention plan based on relevant assessment information.During a review of the facility's P&P, titled Fall Risk Intervention and Monitoring, revised 12/2024, the P&P indicated: If falling recurs despite initial interventions, staff will implement additional or different interventions or indicate why the current approach remains relevant. If underlying causes cannot be readily identified or corrected, staff will try various interventions, based on assessment of the nature or category of falling, until falling is reduced or stopped, or until the reason for the continuation of falling is identified as unavoidable.

For monitoring subsequent falls and fall risk, the staff will monitor and periodically document the resident's response to interventions intended to reduce falling or the risks of falling. If the resident continues to fall, staff will re-evaluate the situation and whether it is appropriate to continue or change current interventions.

The MD may help the staff reconsider possible causes that may not previously have been identified.

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 PASADENA, 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 Cedar Pine Post Acute or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.