Golden Rose Care Center
GOLDEN ROSE CARE CENTER in PASADENA, CA — inspection on April 29, 2026.
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
During a review of the Minimum Data Set (MDS, a standardized assessment and care-screening tool), dated 4/11/2026, the MDS indicated Resident 1's cognitive skill (mental action or process of acquiring knowledge and understanding) for daily decision-making was impaired.
The MDS indicated that Resident 1 was dependent (helper does all of the effort, resident does none of the effort to complete the activity) for toileting hygiene, shower/bathe self, and lower body dressing.
During an interview with Registered Nurse Supervisor (RN Sup) on 4/28/2026 at 1:11 PM, RN sup stated Resident 1 was transferred to the general acute care hospital (GACH) on 4/14/2026 at 5PM due to chest pain.
During an interview on 4/28/2026 at 2:41 PM with Licensed Vocational Nurse 2 (LVN 2), LVN 2 stated the POLST was not available in Resident 1's medical record upon the EMS (Emergency Medical Services, a system providing rapid, pre-hospital care and transport for injuries or illnesses, by calling 911) arrival on 4/14/2026. LVN 2 stated it was important to have the POLST in the resident's chart to know what the resident's wishes were.
During a concurrent record review and interview on 4/28/2026 at 4:28 PM with the Administrator (ADM), the ADM stated that Resident 1 had a POLST, dated 4/9/2026 but was not in the resident's medical records.
The ADM stated it was important to have the POLST in the chart to provide actionable medical orders and to ensure the resident's care preference was honored during emergency.
During a concurrent record review and interview on 4/29/2026 at 10:23 AM with the Nurse Practitioner (NP), the NP stated, On 4/14/2026, I called the daughter because the POLST was not available in the resident's (Resident 1) medical chart. A new POLST was created and signed by me.
The NP also stated it was important to have the POLST readily available in the medical chart so that all appropriate and desired care could be provided to the resident.
During a review of the facility's Policy and Procedure (P&P) titled, Physician Orders for Life Sustaining Treatment (POLST) dated, 6/1/2017, the P&P indicated the current original POLST will be placed along with a copy of the resident's advanced directive (if he or she has one) in the front section of the resident's medical record. It also indicated that a fully executed, dated copy of the POLST that has been marked COPY, will be retained in the resident's medical record in the advance directive legal section. If the facility has electronic health records, the POLST form will be scanned and placed in the appropriate section of the health care record per facility policy.
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
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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.