Waters of Rushville: Medication Authorization Failures - IN
The citation, which federal regulators tagged as carrying potential for harm, identified a chain of failures that each represented a separate point where a resident's safety could slip through the cracks. Staff were not consistently documenting that a licensed nurse had been contacted before medication was administered. They were not recording the time of that contact. And when permission was granted, the licensed nurse was not consistently cosigning the resident's record before the end of her shift, or, if she was on call, before the end of her next tour of duty.
The requirement to obtain permission each time symptoms occur, not just once for a recurring condition, was also cited as something the facility failed to ensure.
Inspectors tied the citation to two separate complaint intakes, case numbers 1656340 and 2564836, meaning the problems that led to this finding did not come to regulators through a routine survey. Someone reported concerns. The facility did not catch the problem on its own before that happened.
The violations fell under F0726, a federal tag that addresses nurse staffing competency and the systems facilities use to ensure care is carried out under proper licensed oversight. Regulators classified the level of harm as minimal harm or potential for actual harm, meaning no documented injury was confirmed, but the conditions inspectors found created real risk.
What the citation describes is a gap between what happens at the bedside and what a licensed nurse actually knows about and has sanctioned. When a resident shows symptoms and a staff member reaches for medication, the licensed nurse is supposed to be the checkpoint, the person who hears what is happening, weighs it, and says yes or no. Documentation of that exchange is not paperwork for its own sake. It is the record that a nurse actually made that call, at that time, with that information in front of her. Without it, there is no way to know whether anyone with a license reviewed what was happening to a resident before a medication was given.
The cosignature requirement carries the same logic. A nurse who gives verbal permission over the phone and never signs the record has authorized something that, on paper, looks like it happened without her. If something goes wrong later, if a resident reacts badly, if a dosage question comes up, if a family member asks what happened and when, the record is supposed to answer those questions. A missing cosignature means it cannot.
Inspectors noted that few residents were affected, which limits the scope but does not change the nature of what was found. The facility's plan of correction was not included in the inspection report. For information on how Waters of Rushville intends to address the deficiencies, CMS directed inquirers to contact the facility or the state survey agency directly.
What the record does show is that two people cared enough about what was happening at this facility to file complaints, and that when inspectors arrived, they found something worth citing. The residents who needed medication and got it without a nurse's documented approval did not know, in the moment, whether anyone with a license had reviewed their symptoms. They had no way to know.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Waters of Rushville Skilled Nursing Facility, The from 2025-08-22 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.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: October 8, 2026 · Our methodology
WATERS OF RUSHVILLE SKILLED NURSING FACILITY, THE in RUSHVILLE, IN was cited for violations during a health inspection on August 22, 2025.
Staff were not consistently documenting that a licensed nurse had been contacted before medication was administered.
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.