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F0760
D

Failure to Administer Prescribed Antibiotic and Notify Physician

Novato, California Survey Completed on 08-08-2025

Penalty

Fine: $26,680
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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 deficiency occurred when the facility failed to ensure that a resident received a prescribed antibiotic, Ceflozane Sulfate Tazobactram Sodium (CSTS), as ordered by the physician following admission from the hospital. The resident, who had a complicated medical history including a recent spinal infection and abscess treated for lumbosacral-spine-osteomyelitis, was admitted with orders for CSTS to be administered intravenously every eight hours until a specified date. Despite these orders, the medication was not acquired or administered as scheduled, with the medication administration record showing missed doses on the day of admission and the following morning and afternoon. Interviews and record reviews confirmed that staff were aware of the medication order and the delay in pharmacy delivery, but there was no documentation that the physician was notified about the inability to administer the antibiotic as prescribed. The Director of Nursing confirmed that it was expected for the physician to be notified in such situations, and the facility's policy required medications to be administered as ordered to ensure compliance with dosing guidelines. The lack of timely acquisition and administration of the antibiotic, as well as the failure to notify the physician, led to the identified deficiency.

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