LPN #301 pulled the midline IVs from Resident #22 and Resident #49 on October 20th after receiving direction from corporate officials who admitted they didn't know the Ohio regulations governing what LPNs can legally do with IV equipment.
The violations came to light during a complaint investigation at Country Lane Gardens Rehab & Nursing Center. State inspectors found that facility staff had no IV training and that corporate leadership had issued medical directives without understanding basic state nursing law.
Regional Director of Clinical Services #500 told inspectors she received a phone call on October 20th about LPNs and midline IVs. She then sent LPN #309 an article from the Ohio Board of Nursing titled "LPN IV Therapy Updates and FAQs" and told staff that "no one should have any questions about what the LPNs could do with central lines."
But the corporate official hadn't read the regulations carefully. Ohio Administrative Code explicitly states that LPNs "shall not perform any of the following intravenous therapy procedures: initiate or discontinue a PICC or any catheter that is longer that three inches."
The facility's own policy defines peripheral IV catheters as those "less than three inches in length." Midline catheters exceed that limit, putting them squarely outside an LPN's legal scope of practice.
When inspectors interviewed the regional director on October 27th, she admitted the mistake. "RDCS #500 stated she didn't know the OAC rules regarding the intravenous therapy procedures for the LPN or she would not have directed them to remove the catheter."
She confirmed that LPN #301 "was not qualified to remove the midline IV catheter for Resident #22 and Resident #49."
The corporate official had been at the facility for only three weeks when she issued the directive. During that time, she told inspectors, "no IV training had been completed by any of the staff prior to her arrival or after her arrival."
LPN #301 told the regional director during their October 20th conversation that "she felt comfortable with IVs and she had been working with IVs for years." But comfort and experience don't override state licensing restrictions.
Resident #49 confirmed to inspectors that LPN #301 had removed her midline IV catheter the previous week. The resident reported no arm discomfort or complications from the procedure.
RN #324, working on the second floor, told inspectors she was initially asked about removing midline IVs but was then told "someone from corporate had stated that LPNs can remove midline IV catheters." The registered nurse said she "was not aware that LPNs could change the midline IV dressings or remove the midline IV catheter" and confirmed she did not remove the catheters from either resident.
The facility maintains separate policies for different types of IV equipment. The policy for removing peripheral IVs, dated September 2011, clearly defines them as catheters "less than three inches in length." The policy for central line and midline catheter removal, from January 2019, instructs staff to "verify the state nurse practice act for RN/LPN scope of practice and function."
That verification never happened. The Ohio Board of Nursing article that corporate officials cited actually supports the state regulations restricting LPN practice. It states that LPNs "are authorized to perform limited adult IV therapy" but references the same Ohio Administrative Code rules that prohibit them from handling catheters longer than three inches.
The administrative code, effective since February 2020, leaves no room for interpretation. LPNs cannot "initiate or discontinue a peripherally inserted central catheter, or any catheter that is longer that three inches."
Both residents received their midline IV catheters at the facility, meaning staff should have been familiar with the equipment and the regulations governing who could handle it. Instead, corporate leadership issued medical directives based on incomplete understanding of state nursing law, and facility staff followed those directives without independent verification.
The violation occurred despite the facility having written policies that could have prevented it. The January 2019 policy specifically instructs staff to verify state practice acts before removing central lines and midlines, but that step was skipped entirely.
Resident #49 reported no complications from the improper procedure, but the regulatory violation represents a breakdown in basic oversight of nursing practice and patient safety protocols at the facility.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Country Lane Gardens Rehab & Nursing Ctr from 2025-10-28 including all violations, facility responses, and corrective action plans.
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