New London Specialty Care
Inspection Findings
F-Tag F0602
F 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
Staff A reported she got in trouble for taping/wasting narcotics. The DON explained this information wasn't communicated to the DON until Saturday. On Saturday, Staff F called the DON because he had a taped med. Staff F looked at the pill, punched it out, it looked a lot like Oxycodone, and it was not Oxycodone. Per
the DON, Staff F looked it up, and it was Amlodipine. This was for Resident #1. The DON further explained
it was identified there was a problem, and the DON interviewed multiple staff who worked Friday and overnight who denied taping medications.The DON explained the ADON had previously talked to Staff A about taping medications. Per the DON, there was only one other person who had been on that cart, which was Staff A. The DON further explained Staff A was suspended related to being suspect in drug diversion, and was terminated due to results of investigation, where in house investigation was founded for drug diversion. The Facility Policy titled Investigating Incident of Theft and/or Misappropriation of Resident Property revised April 2021 revealed, Residents have the right to be free from exploitation, theft and/or misappropriation of personal property.
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Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
10/14/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
New London Specialty Care
100 Care Circle Street New London, IA 52645
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0755
F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
resident scored 15 out of 15 on a BIMS exam, which indicated intact cognition. Per this assessment, the resident took opioid medication. The Physician Order dated 8/18/25 revealed Oxycodone Hcl Oral Tablet 5mg with directions to give one tablet by mouth three times a day for pain. The Physician Order dated 8/20/25 revealed Oxycodone Hcl Oral Tablet 5 mg with directions to give one tablet orally every 12 hours as needed for pain May take PRN with the scheduled dose. Review of the Investigation Drug Diversion 9-13-25 provided by the facility revealed Resident #6's Oxycodone dated 9/9/25 at 3:25 PM was not documented on the resident's MAR.Review of Narcotic Log (Page 51) revealed Staff A removed a tablet of
the medication on 9/9/25 at 3:25 PM, and removed another tablet of the medication on 9/9/25 at 7:20 PM.
Resident #6's MAR dated 9/6/25 revealed Staff A documented she administered only the resident's scheduled HS (evening) Oxycodone 5mg dose that day, with no PRN doses given by Staff A.4. Review of
the Narcotic Log Page 28 for Resident #7's Hydrocodone/APAP (Acetaminophen) 5/325 mg revealed on the last line of the narcotic record, dated 9/10/25 at 8:45 PM, Staff A had removed one pill, which dropped the medication count to 26 pills remaining. Review of the Narcotic Log Page 64 revealed for the first line on the new log, Staff A again charted the same date and time (9/10/25 at 8:45 PM), and dropped the medication count by one pill, which brought the amount remaining to 25 pills. The Narcotic Log Page 28 and Page 64 revealed two pills had been removed for one date and time. Continued review of Narcotic Log Page 64 revealed the following occurred on 9/11/25: Staff A signed out one dose of the medication at 2:45 PM (count lowered to 24), removed another pill at 9:00 PM (count lowered to 23), then charted removed a dose
on 9/11/25 at 3:00 PM (count lowered to 22).5. Review of the MDS assessment for Resident #9 dated 7/10/25 revealed the resident scored 15 out of 15 on a BIMS exam, which indicated intact cognition. Per
this assessment, the resident took opioid medication. The Physician Order dated 6/23/25 revealed Resident #9 was ordered Hydrocodone Acetaminophen 5-325 mg with directions to administer one tablet by mouth three times a day (scheduled). The resident was also prescribed Hydrocodone Acetaminophen 5-325 with directions to administer one tab by mouth as needed for pain, and could take two times a day as needed for breakthrough pain. Review of the Narcotic Log (Page 50) for Resident #9's Hydrocodone Acetaminophen revealed on 9/6/25, Staff A removed a dose of the resident's medication at 6:40 AM (lowered count to 57), 12:45 PM (lowered count to 56), and 2:20 PM (lowered count to 55). A dosage of the medication was removed at 5:45 PM (lowered count to 55), with no nurse signature present on the log. A different nurse removed a dosage of the medication at 7:15 PM (lowered count to 53). Five doses of the resident's medication were removed from the resident's medication supply on 9/6/25.Review of Resident #9's September 2025 MAR revealed on 9/6/25, Staff A signed out two scheduled doses of the medication, on MAR for AM and Mid, and another nurse signed out the resident's scheduled evening dose. The MAR revealed one PRN dose administered on 9/6/25, administered at 5:41 PM. The MAR revealed on 9/6/25 four doses of the medication were administered to Resident #9. Review of a Policy document from the pharmacy dated 2/2023 revealed, Each schedule II medication at the facilty shall be recorded on two forms .Controlled Drug Receipt/Proof of Use/Disposition form. The total quantity received from pharmacy and all subsequent doses administered to the resident will be recorded on the Controlled Drug Receipt/Proof of Use/Disposition Form. Every time a dose is given, the Nursing Staff/CMA (Certified Medication Aide) will enter the date and time, dose given, the Nursing Staff/CMA's signature/initial, and the balance remaining in
the container .Document in the eMAR (electronic medication administration record) or paper MAR (so your MAR form and Controlled Drug Receipt/Proof of Use/Disposition form show the same information).
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New London Specialty Care in New London, IA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 New London, IA, (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 New London Specialty Care or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.