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Complaint Investigation

Waters Of Princeton, The

Inspection Date: August 28, 2025
Total Violations 1
Facility ID 155275
Location PRINCETON, IN
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Inspection Findings

F-Tag F0755

Pharmacy Service Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Based on observation, interview, and record review, the facility failed to ensure drug records were in order and an account of all drugs were maintained for 2 of 2 nursing units reviewed. The narcotic drug count was not accurate. (East Unit, [NAME] Unit) Finding includes: On 8/27/25 at 10:51 a.m., RN 2 was observed to do a narcotic drug count on the East unit medication cart. The following was observed:hydrocodoneacetaminophen oral tablet 5-325 mg (milligram) -the narcotic count log indicated 23 available, RN 2 indicated 22 were in the drug pack.hydrocodone- acetaminophen Tablet 5-325 mg- the narcotic count log indicated 30 available, RN 2 indicated 29 were in the drug pack. RN 2 indicated she must have been in a hurry and forgot to sign the medications out after giving them, she typically signs the narcotic log as she gives them. On 8/27/25 at 11:04 a.m., QMA 2 was observed to do a narcotic drug count on the [NAME] unit medication cart. The following was observed:clonazepam oral tablet 0.5 mg - the narcotic count log indicated 17 available, QMA 2 indicated 16 were in the drug pack.Ativan tablet 1 mg- the narcotic count log indicated 8 available, QMA 2 indicated 7 were in the drug pack. QMA 2 indicated she was passing medications on 2 halls, was just behind and normally signs the medication out as she gives it. On 8/28/25 at 11:52 a.m., the DON provided the current policy for controlled substance medications with a date of 7/22/23. The policy included but was not limited to : .2) record each dose at the time of administration, 3) confirm that the amount of the controlled drug supply is correct prior to, as well as after, assembling the required dose that is being given-verifying the following: date, time, dosage, signature of nurse administering dosse, number of doses/quantity remaining .This citation relates to Intake 2580774.3.1-25(b)(3)

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:

📋 Inspection Summary

WATERS OF PRINCETON, THE in PRINCETON, IN 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 PRINCETON, 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 WATERS OF PRINCETON, THE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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