Hennis Care Centre Of Bolivar
Inspection Findings
F-Tag F0761
F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Based on observation, record review, policy review and staff interview, the facility failed to ensure medications were administered under staff supervision and not left unsupervised at the resident's bedside.
This affected one (Resident #102) of three residents reviewed for medications. Findings include: Based on
observation, record review, policy review and staff interview, the facility failed to ensure medications were administered under staff supervision and not left unsupervised at the resident's bedside. This affected one (Resident #102) of three residents reviewed for medications. Findings include: Review of Resident #102's medical record revealed an admission date of 06/01/23 with diagnoses that included depression, hypothyroidism, hypertension and chronic pain syndrome. Review of Resident #102's medical record revealed a medication self-administration assessment completed on 02/28/24 that indicated the resident was not approved for self-administration of medication or keeping medications at the bedside. Review of the quarterly Minimum Data Set (MDS) 3.0 assessment revealed Resident #102 had an independent and intact cognition level. Review of Resident #102's medication orders revealed the following morning medications ordered by the physician: citalopram (antidepressant) 10 milligram (mg) 1/2 tablet, levothyroxine (thyroid supplement) 100 microgram (mcg), omeprazole (acid reflux) 40 mg, hiprex (urinary antiseptic), vitamin D (supplement) 50 mcg, Coreg (antihypertensive) 6.25 mg, senna (laxative) 8.6 mg two tablets, acetaminophen (analgesic) 500 mg and hydrocodone-acetaminophen (opioid analgesic) 5-325 mg.
Observation on 08/22/25 at 8:25 A.M. revealed nine medications in a pill cup on Resident #102's overbed stand. No staff were observed supervising the resident for medication administration. Interview with Resident #102 on 08/22/25 at 8:25 A.M. revealed staff leave her medicine on her overbed stand so she can take them after she eats breakfast. Resident #102 indicated that the medications were left on her overbed stand by night shift staff who leave at 7:00 A.M.On 06/22/25 at 8:30 A.M. interview with Registered Nurse (RN) #121 verified medications left at Resident #102's bedside and staff did not observe medication administration.Review of the facility policy titled Medication Administration with a revision date of 05/15/25 indicated staff are to remain with resident until medications are swallowed. This deficiency represents non-compliance investigated under Complaint Number 1393128.
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:
HENNIS CARE CENTRE OF BOLIVAR in BOLIVAR, OH 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 BOLIVAR, OH, (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 HENNIS CARE CENTRE OF BOLIVAR or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.