Life Care Center: Unnecessary Drug Violations - FL
She gave it anyway. So did three other nurses, on three other occasions, over the course of eleven days.
Inspectors from the Centers for Medicare and Medicaid Services documented the pattern during a February 12, 2026 survey of the facility at 3325 W. Jerwayne Lane. What they found was not a single lapse but a recurring failure across multiple shifts and multiple licensed nurses, each of whom later acknowledged, when asked directly, that they had known the parameters and administered the medication regardless.
Resident 17 carries a serious list of diagnoses: cognitive communication deficit, dysarthria and anarthria, protein calorie malnutrition, major depressive disorder, chronic Hepatitis C, and lymphedema. His physician ordered Metoprolol Tartrate, a blood pressure drug, twice daily, with a specific instruction to hold the dose if his heart rate dropped below 60 or his systolic blood pressure fell to 110 or below.
His medication records for February 2026 tell a different story. On February 1 at 8:00 AM, his heart rate was 52. A nurse identified in the report as Staff K signed off on the medication. That same evening, his heart rate was 58, still below the threshold. Staff J, another LPN, gave the dose. On February 7 at 8:00 AM, his heart rate was again 58. Staff Q administered the medication. On February 11 at 8:00 PM, his blood pressure had dropped to 108/49 and his heart rate was 56. Staff P gave the drug.
Not one of them called the physician.
When inspectors interviewed Staff K, she did not dispute what the records showed. "I do see in the MAR on 2/1/2026 at 8 AM that I signed and the HR was 52," she said. "The order stated hold if HR is less than 60 so I agree that the vitals are out of parameters. I should have notified the MD and at that time discussed the next protocol for the resident. I should have held the medication and made a progress note."
Staff J was similarly direct. "I did give his blood pressure medications out of parameter on 2/1/2026 at 8 PM, but I didn't look at any other months. I should have notified the MD that his pulse was under 60 and then the MD would have advised me further on the next step."
The problems extended to a second resident. Resident 35 has high blood pressure, and her physician had prescribed medication with specific parameters governing when it should be given. Inspectors found that a nurse, identified as Staff D, had documented check marks on the medication administration record indicating the drug had been given on days when it was unclear whether it actually had been.
Staff D told inspectors: "A check mark documented on the medication record normally means that the medication was given. I don't remember, it's been some time. If I marked it off, I probably gave the medication."
Another nurse who had cared for Resident 35 acknowledged the stakes plainly. "I want to talk to the provider about that order because she has high blood pressure," the nurse said. "If the medication is not given to her, her blood pressure goes up." She added that staff had grown so accustomed to the resident's routine that vigilance had slipped. "We get so used to the residents," she said.
The advanced practice registered nurse overseeing Resident 35's care told inspectors she had never received a call from staff about the medication not being given within parameters. The Director of Nursing, interviewed on the morning of February 12, said only that nurses are expected to follow parameters and nursing orders.
Resident 35, for her part, had remained stable without being hospitalized, according to the APRN. Her blood pressure had been elevated. Nobody had called.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Life Care Center of Citrus County from 2026-02-12 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: August 4, 2026 · Our methodology
LIFE CARE CENTER OF CITRUS COUNTY in LECANTO, FL was cited for violations during a health inspection on February 12, 2026.
So did three other nurses, on three other occasions, over the course of eleven days.
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.