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F0658
D

Failure to Follow Professional Standards for Medication Administration

Hillsboro, North Dakota Survey Completed on 06-26-2025

Penalty

No penalty information released
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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

A medication aide prepared a cup of medications and applesauce for a resident and placed them in the medication cart drawer. Later, the aide handed these prepared medications to a nurse, who confirmed the resident's name and then administered the medications to the resident. The aide acknowledged that she had prepared the medications earlier that morning and had attempted to administer them twice before handing them to the nurse. The facility's policy and professional nursing standards both require that staff only administer medications they have personally prepared, and not those prepared by another individual. Review of the resident's electronic medication administration record showed that the medications were documented as administered by the medication aide, despite the nurse actually giving them. An administrative staff member confirmed that the facility's expectation is for medication aides and nurses to administer only those medications they have personally prepared. This sequence of actions did not follow the facility's policy or professional standards for medication administration.

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