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F0635
D

Failure to Address Resident's Medication Needs Upon Admission

Rural Retreat, Virginia Survey Completed on 04-08-2025

Penalty

Fine: $135,372
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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

Facility staff failed to ensure that a resident's medication needs were addressed as part of the admission orders. Upon admission from the hospital, the resident's discharge summary included instructions to continue several medications and supplements, including enoxaparin, Epipen, Baqsimi nasal spray, ergocalciferol, olopatadine eye drops, and various vitamins and supplements. However, the facility's medical provider did not order enoxaparin until two days after admission, and there was no documentation explaining the omission for the intervening day. Additionally, orders for Epipen and Baqsimi nasal spray were not obtained until prompted by a surveyor, and several other medications and supplements listed in the hospital discharge summary were not addressed in the admission orders at all. The resident was documented as alert, oriented, with adequate vision and grossly intact hearing at the time of admission. The facility's own policy required that a physician or other qualified provider give orders for the resident's immediate care and needs upon admission, including medication orders if indicated. Despite this, the admission provider failed to address all medications and supplements specified in the hospital discharge summary, and the facility's standing orders did not cover all of the resident's needs, such as the Baqsimi nasal spray for low blood sugar.

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