Markle Health & Rehabilitation
Inspection Findings
F-Tag F0684
F 0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Level of Harm - Minimal harm or potential for actual harm
Based on record review and interview, the facility failed to ensure physician orders were followed, related to
the timely administration of prescribed medications to resident. For 1 of 3 residents reviewed. (Resident K) Findings include:Resident K's record review began on 11/19/25 at 10:15 AM, diagnosis included, Hypothyroidism, unspecified.A review of the physicians orders indicated to give Thyroid tablet 60 mg, oral, once a day on Tuesday; at 5:00 AM. Start date of 10/13/25. Thyroid tablet; 90 mg, oral, once a day on Sunday, Monday, Wednesday, Thursday, Friday and Saturday at 5:00 AM. A review of the medication administration record (MAR) indicated Thyroid 60 mg was given on 10/13/25 at 10:00 AM. The reasons/comments section was noted administered late, with a further comment of given. The entry was created by Registered Nurse (RN) 4, and no specific reason was documented for the delay in administration.A review of the progress notes dated 10/13/25 indicated there was no documentation to indicate why the medication was administered late.In an interview, on 11/19/25 at 9:20, Resident K's husband indicated, on 10/13/25 all the medications were given at 10:00 AM and they were late. He indicated he told the facility, but they told him the medication could be given 1 hour before or 1 hour after
the time that the medication was scheduled. The 6AM medication was given at 10:00 AM, the thyroid medication should be given early in the morning. In an interview, on November 19, 2025, at 11:45 AM, the Director of Nursing (DON), indicated Resident K came from home where her husband had been caring for her, giving her medications at specific times, and he wanted that practice continued at the facility. Resident K's husband was informed of the hour before and hour after window during which medication could be administered from the scheduled time. Staff educated RN 4 on ensuring medications are given on time, and
it remains unclear why RN 4 did not make a note explaining the reason for a late administration.Resident K's MAR was reviewed at 9:14 AM on 11/20/25 with the DON. It was noted that a filter button, specifically for what's due, can be used to display a list of residents with pending medication or treatment administrations. The resident profiles utilize a color-coding system to indicate status: Pink signified an administration was late and had not yet been completed or acknowledged. Within the profile, nurses could document the reason for the delay (e.g., resident refusal) and add specific comments. Light blue indicated
an administration was due but not yet late. [NAME] denoted all required administrations for the resident had been completed. A current facility policy, Medication Administration Times, dated 11/15/24, was provided by
the Administrator on 11/19/25 at 1:11 PM. The policy indicated . Facility should that authorized personnel, as determined by Applicable Law, administer medications according to times of administration as determined by the facility's pharmacy committee and/or Physician/Prescriber .Facility should commence medication administration within sixty (60) minutes before the designated times of administration and should be completed no later than sixty( 60) minutes after the designated times of administration 3.1-37
Residents Affected - Few
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:
MARKLE HEALTH & REHABILITATION in MARKLE, 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 MARKLE, 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 MARKLE HEALTH & REHABILITATION or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.