The Laurels Of Heath
Inspection Findings
F-Tag F0760
F 0760 Level of Harm - Actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
since placed a list of medications that should not be crushed on all units accessible to the nurses administering medications. LPN #150 was the one that administered Narcan to Resident #105, after she got the order when calling the provider. She stated within 60 seconds of receiving the Narcan, the resident was talking per his usual. He was alert, drinking, and eating supper. The wife wanted the resident sent to
the ER, despite the resident saying he felt fine. They sent him to the ER as requested by the family and as agreed to by the resident. He returned a short time later with no new orders. On 10/16/25 at 2:10 P.M., an
interview with facility's Director of Nursing (DON) revealed RN #100 was in the building when the medication error involving Resident #105 on 09/30/25 occurred. She was informed there had been a change in Resident #105's condition, which included confusion. When RN #100 was looking into the resident's change in condition, LPN #150 said Oh my God, I crushed his Morphine. RN #100 had reached out to the resident's provider and got an order for Narcan. Resident #105 had positive results to the Narcan and was back to his baseline. His wife wanted him sent out to the ER anyway. He was found to be at baseline when he was evaluated at the hospital. She confirmed she was the one that completed the medication error report the day after the medication error occurred. She spoke with the unit manager (RN #100), pulled the nurse's documentation, reviewed the progress notes, and talked with the PA, as part of her review. She stated they started crushing Resident #105's medications ever since he had thyroid surgery, but not all of his medications. She was not 100% sure if all his medications had been crushed that morning, or if it was just the MS Contin. She confirmed the MS Contin should not be crushed as it was an extended-release tablet and would result in the resident receiving an immediate dose of Morphine 15 mg instead of it being slowly released over a 12 hour period. Review of the facility's Medication Administration policy revised 10/17/23 revealed resident medications were to be administered in an accurate and safe manner. Medications were to be administered in accordance with written orders of the attending physician.
The nurse was to check the Do Not Crush list before crushing medications. If necessary, the nurse was to contact the ordering physician for a change to a different route of administration when the medication could not be crushed. This deficiency represents non-compliance investigated under Complaint Number
- 2637682. Event ID:
Facility ID:
If continuation sheet
THE LAURELS OF HEATH in HEATH, 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 HEATH, 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 THE LAURELS OF HEATH or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.