Inspection Reports for Cedar Health and Rehabilitation

411 West 1325 North, UT, 84721

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Deficiencies per Year

8 6 4 2 0
2023
2025
Unclassified
Inspection Report Routine Deficiencies: 2 Jun 26, 2025
Visit Reason
The inspection was an unannounced routine inspection conducted to review compliance with state regulations for Cedar Health and Rehabilitation nursing care facility.
Findings
The facility was found compliant with most rules, with some non-compliances noted including deficiencies in developing comprehensive care plans within required timeframes and ensuring dietary needs are met. The inspection covered a wide range of regulatory requirements including resident rights, care plans, medication management, staffing, and facility maintenance.
Deficiencies (2)
Description
The licensee failed to develop a comprehensive care plan within seven days after completion of the comprehensive assessment and to periodically review and revise the care plan as the resident's condition changes.
The licensee failed to provide each resident with a safe, palatable, well-balanced diet that meets the daily nutritional and special dietary needs.
Report Facts
Inspection duration: 4 Number of rule noncompliances: Not explicitly stated
Employees Mentioned
NameTitleContext
Spencer EatonProviderNamed as individual informed of the inspection
Jessica BolanderLicensorConducted the inspection
Amy WilliamsLicensorConducted the inspection
Nicole KololliLicensorConducted the inspection
Catherine BristowLicensorConducted the inspection
Tiffany StoneLicensorConducted the inspection
JessicaReferenced in resident rights section (F561)
CathieReferenced in comprehensive care plan section (F656)
NicoleReferenced in comprehensive care plan and medication error monitoring sections (F656, F759)
AmyReferenced in comprehensive care plan section (F656)
Inspection Report Complaint Investigation Deficiencies: 7 Jul 13, 2023
Visit Reason
The inspection was conducted in response to allegations of abuse, neglect, exploitation, or mistreatment involving multiple residents at Cedar Health and Rehabilitation.
Findings
The facility failed to ensure that all alleged violations involving abuse, neglect, exploitation, or mistreatment were reported immediately and thoroughly investigated. Multiple resident incidents involving falls and injuries were not reported to the State Survey Agency within required timeframes. The facility also failed to coordinate assessments for residents with serious mental illness and did not properly label and store drugs and biologicals.
Complaint Details
The complaint investigation was substantiated as the facility failed to report multiple abuse allegations timely and did not thoroughly investigate incidents involving resident falls and injuries. Resident identifiers included 9, 15, 23, 43, 46, and 124. The facility also failed to coordinate PASARR assessments and maintain proper medication and food safety procedures.
Deficiencies (7)
Description
Failure to report alleged violations involving abuse, neglect, exploitation, or mistreatment immediately and thoroughly investigate all allegations.
Failure to report multiple falls with fractures to the State Survey Agency within required timeframes.
Failure to coordinate assessments with the PASARR program for residents with serious mental illness.
Failure to properly label and store drugs and biologicals, including insulin pens without expiration dates.
Failure to maintain food safety standards including unclean dish machine and food storage areas.
Failure to provide adequate assistance with activities of daily living for dependent residents.
Failure to maintain proper documentation and investigation of resident falls and injuries.
Report Facts
Sample residents reviewed: 30 Residents with falls not reported timely: 6 Insulin pens found without expiration date: 4 Residents reviewed for PASARR coordination: 30
Employees Mentioned
NameTitleContext
Amy WilliamsAccepted Plan of Correction on 08/07/2023
Cole JulianTeam CoordinatorListed on survey tracking form
Director of NursingDONInterviewed regarding resident falls and investigations
Registered Nurse 1RN 1Interviewed regarding medication cart and insulin pens
Unit ManagerUM 1Interviewed regarding resident care and nail care
Certified Nursing Assistant 1CNA 1Interviewed regarding nail care documentation
Certified Nursing Assistant 2CNA 2Interviewed regarding nail care documentation
Certified Nursing Assistant 3CNA 3Interviewed regarding nail care documentation
Certified Nursing Assistant 4CNA 4Interviewed regarding nail care documentation
Dietary ManagerDMInterviewed regarding food safety and dish machine cleaning
Plant Operations DirectorPODInterviewed regarding dish machine condition
Resident AdvocateRAInterviewed regarding PASARR referral process

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