Prescott House
Inspection Findings
F-Tag F0755
F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
reason given as to why the medication was not given or what steps Nursing took after they were unable to administer the medication.-01/09/25: 8:00 P.M. No reason given as to why the medication was not given or what steps Nursing took after they were unable to administer the medication.During an interview on 09/23/25 at 3:07 P.M. (which included a review of Resident #1's MAR) Nurse #1 said if a Resident was not given a medication, she would document in the Residents MAR (located in the Point Click Care, EMR-Electronic Medical Record) and would not document in the Residents' Nurses Progress Note. Nurse #1 said if a Resident was not given his/her medication two (2) or three (3) times in a row, the Physician would need to be notified. Nurse #1 said she was assigned to Resident #1 on 01/07/25, 01/08/25, 01/09/25 and 01/11/25, and had administered Resident #1's medications to him/her. Nurse #1 said she had documented code 9, indicates she would have needed to document in Resident #1's Nurses Progress Note
the reason why it had not been given.This Surveyor reviewed Resident #1's MAR with Nurse #1, which indicated Resident #1 had not received the ordered Debrox Otic Solution 6.5% (Carbamide Peroxide (Otic),
on 01/09/25 and 01/11/25 at 6:00 P.M., and for the Diazepam Oral Tablet 5 mg by mouth at bedtime, on 01/07/25, 01/08/25 and 01/09/25 at 8:00 P.M., all of which were documented as code 9 (other see nursing note).However, review of Resident #1's Nurses Progress Notes, indicated there was no documentation to support why Resident #1 did not receive the medication or what steps Nursing took after they were unable to administer the medication, on these dates.Nurse #1 said she could not recall why Resident #1's medications were not given and why she had not documented in Resident #1's Nurses Progress Note.
During an interview on 09/23/25 at 4:20 P.M., the Director of Nurses (DON) said it is her expectation that
the Nurse will document the reason why the medication was not given to a Resident, notify the Residents Physician/Nurse Practitioner regarding the Residents status and document in the Residents Progress Note.
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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
11/17/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Prescott House
140 Prescott Street North Andover, MA 01845
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 F0770
F 0770 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
Orders into the computer system.Nurse #3 said on 01/07/25, she does not know why Resident #1's orders for CBC and BMP were not ordered for 1/09/25.During a telephone interview on 09/24/2025 at 1:29 P.M.,
the Unit Manager said when a new Resident is admitted to the Facility, Nursing will enter the Resident's medication and laboratory orders. The Unit Manager said her practice would be to review the Physicians Orders to ensure they were entered correctly and completely.The Unit Manager said she does the best she can to ensure she checks all new admission Physicians Orders. The Unit Manager said as far as she knew,
the Clinical Staff and the Director of Nurses (DON) would check the Physicians' Orders when she was not at the Facility to ensure they were completed.During an interview on 09/23/2025 at 4:20 P.M., the Director of Nurses (DON) said her expectations of staff are when a Physician Orders laboratory tests for a Resident, that Nursing will order the laboratory tests, ensure the laboratory tests are drawn, and if the Resident is unable to be drawn, the staff will notify the Physician/Nurse Practitioner that is was not completed. The DON said the Unit Manager was responsible for ensuring Resident's Physicians Orders are entered and completed. The DON said she was unable to find any documentation to support Resident #1's CBC and BMP had been ordered by Nursing on 01/07/25, or that test samples were drawn by the Laboratory Staff.
The DON said she was unable to find documentation to support Nursing followed up with Resident #1's Physician/Nurse Practitioner that Resident #1's tests were not completed as ordered.
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PRESCOTT HOUSE in NORTH ANDOVER, MA 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 NORTH ANDOVER, MA, (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 PRESCOTT HOUSE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.