Stay Ahead of Compliance with Monthly Citation Updates


In your State Survey window and need a snapshot of your risks?

Survey Preparedness Report

One Time Fee
$79
  • Last 12 months of citation data in one tailored report
  • Pinpoint the tags driving penalties in facilities like yours
  • Jump to regulations and pathways used by surveyors
  • Access to your report within 2 hours of purchase
  • Easily share it with your team - no registration needed
Get Your Report Now →

Monthly citation updates straight to your inbox for ongoing preparation?

Monthly Citation Reports

$18.90 per month
  • Latest citation updates delivered monthly to your email
  • Citations organized by compliance areas
  • Shared automatically with your team, by area
  • Customizable for your state(s) of interest
  • Direct links to CMS documentation relevant parts
Learn more →

Save Hours of Work with AI-Powered Plan of Correction Writer


One-Time Fee

$49 per Plan of Correction
Volume discounts available – save up to 20%
  • Quickly search for approved POC from other facilities
  • Instant access
  • Intuitive interface
  • No recurring fees
  • Save hours of work
F0658
D

Failure to Administer Medications as Prescribed

Iowa City, Iowa Survey Completed on 12-15-2025

Penalty

No penalty information released
tooltip icon
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 administer medications as prescribed by physicians for two residents. For one resident with chronic pain, COPD, and diabetes, there was a lapse in the administration of scheduled Hydromorphone for pain management. The resident reported not receiving the medication for approximately 20 hours, receiving only an alternative medication that was not effective. Documentation showed multiple missed doses, and staff interviews confirmed that the medication was not ordered in time, compounded by delayed delivery due to bad weather. The medication administration record indicated missed doses, and progress notes reflected that staff had to contact hospice for a new supply after the medication ran out. For another resident with asthma, COPD, and other chronic lung disease, a provider ordered new medications, including an antibiotic, corticosteroid, and inhaler, due to ongoing respiratory symptoms. However, these medications were not started over the weekend as ordered, and administration only began several days later. Staff interviews confirmed that the delay was due to a failure to order the medications in a timely manner. Facility policy requires medications to be administered safely, timely, and as prescribed, but this was not followed in these cases.

An unhandled error has occurred. Reload 🗙