Riverview Village
Inspection Findings
F-Tag F0842
F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Based on interview and record review, the facility failed to ensure residents' (Resident C and Resident F) medication administration accurately reflected the administration of narcotic pain medication for 2 of 3 residents reviewed for medical records. Findings include:1.The clinical record for Resident C was reviewed
on 11/20/25 at 11:40 a.m. The resident's diagnoses included, but were not limited to, restless leg syndrome, depression and osteoarthritis. The physician's order, dated 5/19/25, indicated the resident was to receive Tramadol (narcotic pain medication) 50 mg (milligrams) every 6 hours for pain at 8:00 a.m., 2:00 p.m., 8:00 p.m. and 2:00 a.m. Review of the October 2025 and November 2025 controlled substance record indicated
the resident received the medication on the following dates and times: 10/03/25 at 8:00 p.m., 10/30/25 at 2:00 a.m., 11/01/25 at 2:00 a.m., 11/05/25 at 8:00 p.m., 11/07/25 at 8:00 p.m., and 11/11/25 at 8:00 a.m.
The October 2025 and November 2025 medication administration record lacked documentation that the pain medication was administered. During an interview, on 11/20/25 at 4:12 p.m., Licensed Practical Nurse (LPN) 5 indicated when a narcotic pain medication was administered, the nurse should sign the medication as administered on the controlled substance record and the medication administration record. 2. The clinical record for Resident F was reviewed on 11/20/25 at 1:59 p.m. The resident's diagnoses included, but were not limited to, diabetes and hypertension. The physician's order, dated 10/1/25, indicated the resident was to receive Tramadol 50 mg three times a day for pain at 8:00 a.m., 2:00 p.m. and 8:00 p.m. Review of
the October 2025 and November 2025 controlled substance records and medication administration records indicated the following: -On 10/01/25 at 8:00 p.m., the medication was signed out as administered on the controlled substance record but not on the MAR.-On 10/10/25 at 8:00 a.m., the medication was signed out as administered on the controlled substance record but not on the MAR.-On 10/11/25 at 2:00 p.m., the medication was signed out as administered on the MAR but not on the controlled substance record.-On 11/07/25 at 2:00 p.m., the medication was signed out as administered on the MAR but not on the controlled substance record.-On 11/10/25 at 2:00 p.m., the medication was signed out as administered on the MAR but not on the controlled substance record. On 11/20/25 at 4:30 p.m., the Director of Nursing provided a current copy of the document titled Controlled Substances: Storage, Documentation, Inventory and Destruction (Includes Fentanyl Patch Removal and Destruction) dated November 2024. It included, but was not limited to, Policy.It is the policy of this facility that all controlled substances will be.recorded.Documentation.When a controlled substance is administered to a resident, it must be recorded
in the residents Medication Administration Record. 3.1-50(a)(2)
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
RIVERVIEW VILLAGE in CLARKSVILLE, IN 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 CLARKSVILLE, IN, (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 RIVERVIEW VILLAGE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.