Hamilton Grove Healthcare And Rehabilitation, Llc
Inspection Findings
F-Tag F0760
F 0760 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
family and CNA1 went back to work. CNA1 stated that LPN1 did not ask her to identify the Resident R2 and CNA1 did not witness the administration of the medication.During an interview on 09/30/25 at 9:30 AM, Medical Director (MD) was questioned if he was familiar with Resident R2 and his past history. MD responded that he had taken care of Resident R2 in the hospital. MD stated that Resident R2 was a [AGE] year-old male, with a history of a recent subdural hemorrhage, metabolic encephalopathy, and anemia. MD was questioned if he was notified of the medication error on 07/04/25. MD responded that his team was made aware on 07/05/25 of Resident R2 having nausea and vomiting coffee ground emesis, and he was sent to the hospital. He stated the hospital notified him of a possible medication error. MD was questioned in his opinion, did the medication error have caused
the upper GI bleed and decline in the Resident R2's condition. MD stated that it was merely speculation and that he did not believe the medication errors had caused GI bleed. The MD stated because Resident R2 was not eating, there was a possibility of ulcers, and was on aspirin for coronary artery disease (CAD) and had a diagnosis of adult failure to thrive and poor appetite several months prior to incident. MD added that Resident R2 was discharged to another facility on 07/10/25 from the hospital. He stated Resident R2 was stable, he had an esophagogastroduodenoscopy (EGD), evaluated by GI [gastrointestinal], and was cleared as stable for discharge.During an interview on 09/30/25 at 2:35 PM, Registered Nurse (RN) 1 (also the Unit Manager for
the Smart Unit) was questioned when she was made aware of the medication error. RN1 stated that the Director of Nursing (DON) made her aware on 07/07/25, not sure when DON was made aware. RN1 stated
the initial actions were to contact the Agency where LPN1 was employed and started providing education to nurses concerning the rights of medications, to report medication errors immediately, and monitor the residents. She stated the agency requested facility to develop an orientation packet specific to the facility for their agency nurses.During an interview on 09/30/25 at 5:11 PM, the Assistant Director of Nursing (ADON) was questioned when she had been notified of Resident R2's medication error. ADON responded that the DON notified her when she arrived at the facility on 07/07/25. The facility was unaware of the incident until the morning of 07/07/25, and the DON was notified by the hospital. ADON was asked what the facility did immediately after being informed of incident. ADON responded we started an investigation immediately; there was no documentation from LPN1 for administering the wrong medications. I interviewed the nurse involved who would not state what caused her to administer the wrong medication. We (facility) would've had no idea if facility had not interviewed the nurse.
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HAMILTON GROVE HEALTHCARE AND REHABILITATION, LLC in HAMILTON, NJ 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 HAMILTON, NJ, (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 HAMILTON GROVE HEALTHCARE AND REHABILITATION, LLC or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.