Cedar Pine Post Acute
Inspection Findings
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
enlargement of the prostate gland in older men), GERD, and chronic venous hypertension (high blood pressure in leg veins, caused by faulty valves that cannot return blood to the heart).During a review of Resident 2's MDS, dated [DATE REDACTED], the MDS indicated the resident was independent in cognitive skills for daily decision making. The MDS also indicated the resident required substantial/maximal assistance with oral hygiene, upper body dressing, and personal hygiene but was dependent on toileting hygiene, shower/bathe self, lower body dressing and putting on/taking off footwear. During a review of Resident 2's Physician Orders, dated 1/31/2025, the Physician Orders indicated the following but not limited to:1.
Finasteride (is used to treat men who have symptoms of benign prostatic hyperplasia [BPH]) oral tablet 5 mg. Give 1 tablet by mouth one time a day for BPH.2. Multiple Vitamin-Minerals (a supplement containing a combination of vitamins) oral tablet. Give 1 tablet by mouth one time a day for supplement. During a review of Resident 2's Physician Orders, dated 4/5/2025, the Physician Orders indicated Vitamin C (a vital water-soluble nutrient and antioxidant that the body needs daily for growth, tissue repair, collagen formation) oral tablet 500 mg (Ascorbic Acid) Give 1 Tablet by mouth one time a day for supplement. During
a review of Resident 2's Physician Orders, dated 10/29/2025, the Physician Orders indicated Pro-Stat (a medical liquid protein supplement) oral liquid Give 30 milliliters (ml - unit of measure) by mouth one time a day for supplement. During a review of Resident 2's MAR, dated 12/2025, the MAR indicated the following medications are due at 9AM:1. Finasteride 5 mg2. Multiple Vitamins-Minerals 1 tab3. Pro-stat Oral Liquid 30 milliliters (ml - unit of measure)4. Vitamin C 500 mgDuring a concurrent observation and interview on 12/23/2025 at 11:30 AM in Resident 2's room, four (4) medications were observed on top of Resident 2's bedside table unattended. The medications observed were one (1) unidentified blue tablet, 1 unidentified white tablet and 1 unidentified orange tablet were observed in a medication cup along with 30ml of brown, honey like consistency fluid in another medication cup. Resident 2 stated the nurse left his medication with him and the resident was observed taking the medication at 11:45AM. During an interview on 12/23/2025 at 11:49AM, Licensed Vocational Nurse 1 (LVN 1) stated Resident 2 was given his 9AM medications at 10:30AM and they were left at his bedside table. LVN 1 also stated the medication was given late and she should not have left the medications on the resident's bedside table without observing the resident taking his medication. LVN 1 stated the resident can throw it away or another resident can take it. During an
interview on 12/23/2025 at 12PM, the Director of Nursing (DON) stated medications should be given at least an hour before or 1 hour after the prescribed time. The DON also stated medication cannot be left at
the bedside and the nurses should observe the resident taking the medication.During an interview on 12/23/2025 at 1:30PM, the Policy and Procedure (P&P) titled, Policy and Procedure in Medication Administration, dated revised 7/2013, was reviewed. The DON stated the policy indicated meds should not be left unattended. The DON also stated the policy should but does not indicate that medications are not to be left at bedside and the nurse should observe the resident taking the medication. The DON stated the facility does not have any residents who can self-administer medication. During a review of the facility's P&P titled, Policy and Procedure in Medication Administration, revised 7/2013, the P&P indicated medications must not be prepared in advance and/or left unattended. The P&P also indicated medications must be administered within one hour before or after administration time per physician's order.
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Cedar Pine Post Acute in PASADENA, 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 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.