Peace Care St Ann's
Inspection Findings
F-Tag F0658
F 0658 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
Propionate External cream 0.05%. Apply to affected areas topically every day and evening shift for wound care until 8/26/2025 23:59, dated 8/6/2026.A review of Resident #4's August 2025 MAR revealed blank spaces for the above corresponding PO on 8/16/2025 and 8/18/2025 on day shift.A review of Resident #4's August 2025 Progress Notes (PNs) did not reveal documentation that the PO was administered.On 8/21/2025 at 9:22 AM, the surveyor interviewed the Licensed Practical Nurse (LPN) who stated that once a medication was given it was signed out on the MAR. She further stated that if a resident had refused their medications or if it was held, the nurses had to document the reason on the MAR. She further indicated that
the MAR could not be left blank.On 8/21/2025 at 1:16 PM, the surveyor interviewed the Director of Nursing (DON) who stated that the MAR was signed after the nurse administered medications to the resident. She further stated that if a resident refused a medication, the nurse would document a refusal code on the MAR. The DON confirmed that Resident #3 and Resident #4's MARs had blank spaces. She indicated that that the expectation was that there was not supposed to be any blank spaces on the MAR. The DON stated that it was important that the nurses sign out the MAR as it revealed whether the medication was administered or not.A review of the facility's undated policy titled Medication Administration, revealed under Policy, medications are administered by licensed nurses, or other staff who are legally authorized to do so
in this state, as ordered by the physician and in accordance with professional standards of practice. Under Policy Explanation and Compliance Guidelines, 20. Sign MAR after administered. 22. Report and document any adverse side effects or refusals.NJAC 8:39-23.2 (a)
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PEACE CARE ST ANN'S in JERSEY CITY, 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 JERSEY CITY, 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 PEACE CARE ST ANN'S or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.