Aperion Care Marion Llc
Inspection Findings
F-Tag F0684
F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
On 9/9/25 at 7:00 a.m., the resident's heart rate was 54. The resident received amlodipine besylate 10 mg.
The resident's heart rate was not within the ordered parameters. During an interview, on 9/9/25 at 3:41 p.m., RN 3 indicated when a medication had blood pressure and heart rate parameters, she obtained the blood pressure and heart rate. She administered the medication if the blood pressure and heart rate met
the parameters. If the medication order was unclear, she would call the physician to get further instructions.
- 2. Resident B's clinical record was reviewed on 9/9/25 at 12:20 p.m. Diagnoses included atherosclerotic
heart disease of native coronary artery with unstable angina pectoris, unspecified combined systolic (congestive) and diastolic (congestive) heart failure, and essential (primary) hypertension. Physician orders included midodrine 5 mg every eight hours as needed (PRN) for hypotension (low blood pressure) administer for systolic blood pressure (SBP) less than 90 (started 3/17/25) and blood pressure monitoring three times a day for hypotension - administer PRN midodrine 5 mg for SBP less than 90. An annual Minimum Data Set (MDS) assessment, dated 8/2/25, indicated the resident was moderately cognitively impaired. No behaviors were marked. A care plan for coronary artery disease was initiated on 1/28/24.
Interventions included give medications for hypertension and document response to medication and any side effects (1/28/24) and monitor blood pressure and notify physician of any abnormal readings (1/28/24).
A medication administration record (MAR) for July 2025 indicated the following: On 7/1/25 at 3:00 p.m., the resident's blood pressure was 88/54. The MAR lacked an entry for the administration of midodrine on 7/1/25. On 7/11/25 at 7:00 a.m., the resident's blood pressure was 83/49. The MAR lacked an entry for the administration of midodrine on 7/11/25. On 7/19/25 at 7:00 a.m., the resident's blood pressure was 88/61.
The MAR lacked an entry for the administration of midodrine on 7/19/25. On 7/24/25 at 7:00 a.m., the resident's blood pressure was 73/41. On 7/24/25 at 3:00 p.m., the resident's blood pressure was 86/54. The MAR lacked an entry for the administration of midodrine on 7/24/25. On 8/1/25 at 7:00 a.m., the resident's blood pressure was 88/57. The MAR lacked an entry for the administration of midodrine on 8/1/25. On 9/8/25 at 7:00 p.m., the resident's blood pressure was 86/54. The MAR lacked an entry for the administration of midodrine on 9/8/25. During an interview on 9/9/25 at 3:47 p.m., LPN 4 indicated when a medication required a blood pressure or heart rate to be a certain number, she obtained the blood pressure and/or heart rate and administered or held the medication as ordered. If she had questions, she notified the nurse practitioner to get more clarification. During an interview on 9/9/25 at 3:59 p.m., LPN 5 indicated, for medications that required blood pressure or heart rate monitoring, she obtained the blood pressure and heart rate and administered the medication if the readings met the ordered parameters. If the readings did not meet the parameters, then she held the medication as ordered. For any discrepancies in the order, she called the physician. It was important to pay attention to the orders. During an interview, on 9/9/25 at 4:11 p.m., the Director of Nursing (DON) indicated the staff should be following the parameters on medication orders. Multiple physicians provided care for Resident D, thus his medications had different parameters.
During an interview, on 9/9/25 at 4:58 p.m., the DON indicated the physician orders should have been followed, and the medications should have been given or held according to the blood pressure and/or heart rate parameters. During an interview, on 9/9/25 at 5:01 p.m., the Administrator indicated the facility did not have a policy on following physician orders. The facility followed Federal and State guidelines. 3.1-37(a)
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Facility ID:
If continuation sheet
APERION CARE MARION LLC in MARION, 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 MARION, 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 APERION CARE MARION LLC or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.