Failure to Provide Medication Administration Records During Survey
Penalty
Summary
The facility failed to provide requested medical records, specifically the July 2025 Medication Administration Records (MARs) for two residents, which were needed to assist the survey process. The MARs reviewed in the Electronic Health Records did not document the actual time medications were administered. When the surveyor requested MARs with documented and timestamped medication administration times, the Director of Nursing (DON) stated he was instructed by the Chief Operating Officer not to provide these records or allow the surveyor to view them, citing an ongoing internal Quality Assurance investigation. The internal investigation had been initiated after the two residents reported that their medications were being administered outside of the ordered time ranges.