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F0641
D

Inaccurate MDS Coding for High Risk Drug Class Medications

Greenville, North Carolina Survey Completed on 06-11-2025

Penalty

Fine: $81,485
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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 accurately code the Minimum Data Set (MDS) assessment for a resident in the area of high risk drug class medications. Specifically, the MDS assessment indicated that the resident received anticoagulant medication during the look-back period, despite a review of the Medication Administration Record (MAR) showing no physician's order or administration of anticoagulant medication to the resident since admission. The resident had received heparin, an anticoagulant, in the hospital prior to admission, but not during the facility stay or the look-back period covered by the MDS. Interviews with the MDS nurse, Director of Nursing, and Administrator revealed a misunderstanding regarding the correct coding of the MDS. Staff believed that anticoagulant medication administered in the hospital prior to admission should be included in the MDS assessment's look-back period, even though the medication was not given in the facility. This misunderstanding led to inaccurate coding of the resident's MDS assessment.

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