Choctaw Residential Center: Medication Error - MS
The resident, identified in inspection records as Resident 90, was admitted with a diagnosis of end-stage renal disease, a condition in which the kidneys have lost nearly all function. The nurse, identified as LPN 4, administered Aspirin EC 81 mg rather than the correct form of the medication.
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See the Derila PillowShe then signed the medication administration record indicating the dose had been given correctly.
During an interview with inspectors on March 5, LPN 4 said she administered the aspirin and only later realized it was not the right medication. She said she reviewed the medication record afterward and confirmed she had given the incorrect form. She also acknowledged she had not checked the six rights of medication administration before giving the dose.
The six rights, a foundational framework nurses learn in training, require confirming the right patient, right drug, right dose, right route, right time, and right documentation before administering any medication. LPN 4 told inspectors that if she had followed those steps, she likely would not have made the error.
She did not dispute any of this. She said it plainly.
The distinction between aspirin formulations is not a minor technical point, particularly for a patient with end-stage renal disease. Enteric-coated aspirin, the EC form that LPN 4 administered, is designed to pass through the stomach before dissolving, a formulation that affects how the drug is absorbed. For patients with severely compromised kidney function, how medications are absorbed and cleared from the body carries real consequences. The inspection report classified the level of harm as minimal harm or potential for actual harm.
What the record also shows is that after giving the wrong medication, LPN 4 documented it as correctly administered. The error was not caught at the point of administration. It was not flagged in the moment. It surfaced later, when LPN 4 reviewed the record herself, and it came to light fully only when inspectors asked.
That sequence matters. A medication error that gets corrected and documented honestly is a different institutional problem than one that gets signed off as correct and discovered later. The inspection report does not describe any notation in the medication record indicating an error had occurred, only that the wrong form had been signed off as administered.
Choctaw Residential Center is located at 135 Residential Center Road in Choctaw, Mississippi. The inspection was conducted by the Centers for Medicare and Medicaid Services and carries the facility identification number 255339.
The deficiency was cited at the minimal harm level, the lowest tier in CMS's harm classification system. That classification reflects the agency's assessment of what actually happened to this particular resident during this particular incident. It does not speak to what could happen the next time a nurse skips the verification steps and the patient's condition is less forgiving, or the medication more dangerous than aspirin.
LPN 4 told inspectors she knew what she should have done. She said she didn't do it. She said the error followed directly from that.
Resident 90, whose kidneys no longer function adequately on their own, received a medication that was not what their care plan called for. The nurse who gave it signed the record to say otherwise. By the time inspectors arrived, the nurse had already worked out, on her own review, that she had made a mistake. What she had not done, and what the record does not reflect, is correct the documentation at the time.
The plan of correction, if one was filed, was not included in the inspection materials reviewed for this report.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Choctaw Residential Center from 2025-03-06 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
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Last verified: November 12, 2026 · Our methodology
Choctaw Residential Center in CHOCTAW, MS was cited for violations during a health inspection on March 6, 2025.
The nurse, identified as LPN 4, administered Aspirin EC 81 mg rather than the correct form of the medication.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.