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Complaint Investigation

Haven Of Saguaro Valley

Inspection Date: December 23, 2025
Total Violations 1
Facility ID 035085
Location TUCSON, AZ
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Inspection Findings

F-Tag F0658

Resident Assessment and Care Planning Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0658 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

reviewed the December 2025 MAR administration of the Midodrine on December 10, 2025, and stated that

it was marked administered at 2:00 pm with a systolic blood pressure of 150; however, in reviewing the progress notes, she revealed that it was noted this was above parameters and held. The DON further reviewed the December 21, 2025, 2:00 p.m. administration of Midodrine and stated it was marked as administered, but review of the progress notes showed that the nurse had indicated it was held due to the systolic blood pressure being above 140. The DON goes on to reveal that possibly the nurses had removed

the medication from its packaging in preparation for administering and realized the blood pressure was too high, and withheld the medication, and that is why they added the supplementary progress note then disposed of the medication but never changed the administration of the medication in the MAR. The DON then reviewed the December 12, 2025, administration of the Midodrine at 10:00 p.m. and revealed that it was marked administered, and further review could not find a follow-up medication administration note in

the progress notes. The DON stated that this indicates the medication was given, and the nurse was not following the physician's order and giving the medication outside of parameters. The DON stated the concern with giving this medication outside of parameters is that it causes the blood pressure to be uncontrolled. A policy and procedure titled, Medications: Administering Medications, dated January 1, 2024, revealed that it is the policy of the facility that medications are administered in accordance with prescriber orders, including any required time frames. The policy also revealed that the individual administering the medication documents in the electronic medical administration record after giving each medication and

before administering the next one.

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📋 Inspection Summary

HAVEN OF SAGUARO VALLEY in TUCSON, AZ inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in TUCSON, AZ, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from HAVEN OF SAGUARO VALLEY or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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