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Complaint Investigation

Pasadena Nursing Center

March 28, 2025 · Pasadena, CA · 1570 North Fair Oaks Ave
Citations 2
CMS Rating 2/5
Beds 52
Provider ID 555893
Healthcare Facility
Pasadena Nursing Center
Pasadena, CA  ·  View full profile →
Inspection Summary

PASADENA NURSING CENTER in PASADENA, CA — inspection on March 28, 2025.

Found 2 citations. 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.

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Inspection Findings

FF607
Minimal harm or assistance (helper sets up or cleans up; resident completes activity. Helper assists only prior to or following Few dressing, partial/moderate assistance (helper does less than half the effort to lift, hold, or support trunk or affected

During a review of Resident 1's Minimum Data Set: (MDS- resident assessment tool), dated 1/7/2025, the MDS indicated Resident 1 had moderate cognitive impairment (ability to think, reason, and make decisions) skills for daily decision making.

The MDS indicated Resident 1 was independent (resident completes the activity by themself with so assistance from a helper) to eat, perform oral and personal hygiene, for toileting, showering, upper and lower body dressing, putting on and taking off footwear, rolling left and right, sit to lying, sit to stand, and chair/bed transfer.

During a review of Resident 1's Change of Condition, dated 3/26/2025, indicated Resident 1 had been found with scratches on the right side of his face and had stated someone else had done it.

During a review of Resident 1's Orders, dated 3/26/2025, indicated, Resident 1 had a new order to treat scratches on Resident 1's face with normal saline (a sterile solution of 0.9% of sodium chloride in water used for hydration and wound cleaning/ flushing solution), and antibiotic ointment.

2.During a review of Resident 2's Admission Record, indicated Resident 2 was admitted to the facility on [DATE] with diagnosis of exposure to disaster, war and other hostilities, schizoaffective disorder (a mental illness that can affect thoughts, mood, and behavior), and pulmonary edema (a condition where fluid accumulates in the lungs, making it difficult to breathe).

During a review of Resident 2's Care Plan (CP), dated 11/22/2024, indicated Resident 2 had struck another resident in the face, and interventions included monitor closely for aggressive behavior, separate resident from others, and remove resident from situation.

The CP, initiated on 3/28/2024, indicated Resident 2 had aggressive behavior directed towards others and staff was to monitor closely for aggressive behavior and separate resident from others when behavior present.

555893

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 555893 B.

Wing 03/28/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Pasadena Nursing Center 1570 North Fair Oaks Ave Pasadena, CA 91103

During a review of Resident 1's Minimum Data Set: (MDS- resident assessment tool), dated 1/7/2025, the MDS indicated Resident 1 had moderate cognitive impairment (ability to think, reason, and make decisions) skills for daily decision making.

The MDS indicated Resident 1 was independent (resident completes the activity by themself with so assistance from a helper) to eat, perform oral and personal hygiene, for toileting, showering, upper and lower body dressing, putting on and taking off footwear, rolling left and right, sit to lying, sit to stand, and chair/bed transfer.

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

555893

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 555893 B.

Wing 03/28/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Pasadena Nursing Center 1570 North Fair Oaks Ave Pasadena, CA 91103

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 PASADENA NURSING CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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