Stay Ahead of Compliance with Monthly Citation Updates


In your State Survey window and need a snapshot of your risks?

Survey Preparedness Report

One Time Fee
$79
  • Last 12 months of citation data in one tailored report
  • Pinpoint the tags driving penalties in facilities like yours
  • Jump to regulations and pathways used by surveyors
  • Access to your report within 2 hours of purchase
  • Easily share it with your team - no registration needed
Get Your Report Now →

Monthly citation updates straight to your inbox for ongoing preparation?

Monthly Citation Reports

$18.90 per month
  • Latest citation updates delivered monthly to your email
  • Citations organized by compliance areas
  • Shared automatically with your team, by area
  • Customizable for your state(s) of interest
  • Direct links to CMS documentation relevant parts
Learn more →

Save Hours of Work with AI-Powered Plan of Correction Writer


One-Time Fee

$49 per Plan of Correction
Volume discounts available – save up to 20%
  • Quickly search for approved POC from other facilities
  • Instant access
  • Intuitive interface
  • No recurring fees
  • Save hours of work
F0684
D

Failure to Administer Medications and Notify Physician per Standards

Hudson, Florida Survey Completed on 09-26-2025

Penalty

Fine: $90,650
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to administer insulin and cardiovascular medications according to professional standards of practice for multiple residents. For one resident with a history of diabetes, chronic kidney disease, and heart disease, insulin was not administered as ordered on two occasions, and there was no documentation of physician notification when the medication was held or when the resident experienced hypoglycemia. The nurse involved stated uncertainty about the reason for holding the insulin and did not notify the physician, despite the absence of parameters to hold the medication. Facility policy required physician notification when medications are held due to abnormal vital signs or test results, but this was not followed. Another resident with hypertension had their prescribed Lisinopril withheld on multiple occasions due to low blood pressure or hypotension, as documented in the medication administration record. Nursing staff reported using their own judgment to hold the medication and did not consistently notify the physician, sometimes leaving notes for the charge nurse or physician instead. The Director of Nursing acknowledged that nurses should notify the physician when medications are held, but there was inconsistency in how and when this was done, and the facility's policy required notification in such cases. A third resident with diabetes had insulin and metformin held on certain days, sometimes without following the specific parameters in the physician's orders. In one instance, insulin was held despite the blood sugar being above the threshold for administration, and the nurse attributed this to confusion with another order. The Director of Nursing and the physician confirmed that nurses should follow parameters and document accurately, but there was a lack of consistent communication and documentation when medications were withheld. Facility policies required accurate documentation and physician notification when medications were held, but these procedures were not consistently followed.

See complete original report
An unhandled error has occurred. Reload 🗙