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F0842
D

Incomplete and Inaccurate Documentation of IV Antibiotic Administration

Warwick, Rhode Island Survey Completed on 02-18-2026

Penalty

Fine: $115,500
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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 deficiency involves the facility’s failure to maintain complete and accurate medical records related to IV medication administration for a resident admitted with a diagnosis that included a urinary tract infection (UTI). The physician ordered Meropenem 1 gm IV three times a day in 50 mL of normal saline for a complicated UTI, to continue until 2/10/2026. Record review showed that the facility received a complete IV E-kit on 2/4/2026, and the PharMerica Genesis Master E-Kit Contents List indicated that Meropenem 1 gm vials and 100 mL normal saline were available in the IV kit. However, review of the IV E-kit utilization form did not show that Meropenem or normal saline had been removed from the E-kit for administration. Further record review and pharmacy documentation revealed that Meropenem and 50 mL normal saline were not delivered by the pharmacy until the evening of 2/5/2026 at 8:54 PM, and the resident missed three ordered doses of Meropenem IV 1 gm. Despite this, the February 2026 Medication Administration Record (MAR) showed Meropenem IV 1 gm as signed out and documented as administered on 2/4/2025 at 10:00 PM and on 2/5/2025 at 6:00 AM, when it had not actually been given. During an interview, the Director of Nursing Services acknowledged that Meropenem and 100 mL normal saline were available in the E-kit, that the medication was not administered until it was delivered by the pharmacy on 2/5/2026, and that she could not provide evidence that the MAR accurately reflected the three missed doses.

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