Fairview Fellowship Home For Senior Citizens, Inc
Inspection Findings
F-Tag F0605
F 0605 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
09/25/25 for hydroxyzine 25 mg TID when the physician reduced the dose after a GDR review on 09/24/25 to hydroxyzine 25 mg BID. The administrator stated the order was put in on 09/25/25 for hydroxyzine 25 mg BID after the GDR request by the physician. The administrator stated LPN #1 called the physician and verified the order as BID but LPN #1 put the order in as TID which was not what the physician had ordered.
The administrator stated LPN #1 was an agency staff and was not allowed to return to the facility due to the error. On 10/09/25 at 4:10 p.m., RN #1 stated there was an order to reduce Resident #8's hydroxyzine 25 mg TID to BID on 09/24/25. RN #1 stated the DON changed Resident #8's orders to hydroxyzine 25 mg BID on 09/25/25. RN #1 stated on 09/29/25, they checked Resident #8's orders and saw LPN #1 changed Resident #8's orders on 09/25/25 around 7:00 p.m., to hydroxyzine 25 mg TID after the DON had changed
the order on 09/25/25 earlier in the day. RN #1 stated they had the medication aide hold the medication and verified with the physician the order for Resident #8's hydroxyzine was not correct and should have been hydroxyzine 25 mg BID. RN #1 stated LPN #1 told them they knew the doctor meant TID and not BID so that was why LPN #1 entered the order as TID. RN #1 stated Resident #8 received 4 additional doses of Hydroxyzine 25 mg from 09/25/25 through 09/29/25 due to LPN #1 putting in the wrong dose order in Resident #8's orders.On 10/13/25 at 3:35 p.m., LPN #1 stated there was a medication review for Resident #8 and the medication aides asked them to change the orders back to TID. LPN #1 stated they changed the order for hydroxyzine 25 mg BID to TID without verifying the order was correct. LPN #1 stated they put the order in as hydroxyzine 25 mg TID when it should have been BID.On 10/14/25 at 1:46 p.m., the DON stated Resident #8's medications were reviewed by the pharmacist on 09/23/25. The DON stated the pharmacist requested a gradual dose reduction of the hydroxyzine 25 mg TID on 09/23/25. The DON stated the primary care physician agreed and requested Resident #8's order for hydroxyzine 25 mg TID to be changed to BID on 09/24/25. The DON stated they entered a new order in Resident #8's chart to reflect hydroxyzine 25 mg BID on 09/25/25. The DON stated on 09/30/25, RN #1 made them aware of the order in Resident #8' health record for hydroxyzine 25 mg TID on 09/30/25. The DON stated LPN #1 changed Resident #8's order for hydroxyzine 25 mg back to TID on 09/25/25 at 7:11 p.m. The DON stated LPN #1 was placed on a do not return from the agency as a result of the medication order error. The DON stated Resident #8 received 4 extra doses of hydroxyzine 25 mg on 09/26/25 through 09/29/25.
Event ID:
Facility ID:
If continuation sheet
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
11/21/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Fairview Fellowship Home for Senior Citizens, Inc
605 East State Road Fairview, OK 73737
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 F0658
F 0658 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
the DON had changed the order on 09/25/25 earlier in the day. RN #1 stated they had the med aide hold
the medication and verified with the physician the order for Resident #8's hydroxyzine was not correct and should have been hydroxyzine 25 mg BID. RN #1 stated LPN #1 told them they knew the doctor meant TID and not BID so that was why LPN #1 entered the order as TID. RN #1 stated Resident #8 received 4 additional doses of Hydroxyzine 25 mg from 09/25/25 through 09/29/25 due to LPN #1 putting in the wrong dose order in Resident #8's orders.On 10/13/25 at 3:35 p.m., LPN #1 stated there was a medication review for Resident #8 and the medication aides asked them to change the orders back to TID. LPN #1 stated they changed the order for hydroxyzine 25 mg BID to TID without verifying the order was correct. LPN #1 stated
they put the order in as hydroxyzine 25 mg TID when it should have been BID.On 10/14/25 at 1:46 p.m., the DON stated Resident #8's medications were reviewed by the pharmacist on 09/23/25. The DON stated the pharmacist requested a gradual dose reduction of the hydroxyzine 25 mg TID on 09/23/25. The DON stated
the primary care physician agreed and requested Resident #8's order for hydroxyzine 25 mg TID to be changed to BID on 09/24/25. The DON stated they entered a new order in Resident #8's chart to reflect hydroxyzine 25 mg BID on 09/25/25. The DON stated on 09/30/25, RN #1 made them aware of the order in Resident #8' health record for hydroxyzine 25 mg TID on 09/30/25. The DON stated LPN #1 changed Resident #8's order for hydroxyzine 25 mg back to TID on 09/25/25 at 7:11 p.m. The DON stated LPN #1 was placed on a do not return from the agency as a result of the medication order error. The DON stated Resident #8 received 4 extra doses of hydroxyzine 25 mg on 09/26/25 through 09/29/25.
Event ID:
Facility ID:
If continuation sheet
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
11/21/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Fairview Fellowship Home for Senior Citizens, Inc
605 East State Road Fairview, OK 73737
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 F0757
F 0757 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
TID after the DON had changed the order on 09/25/25 earlier in the day. RN #1 stated they had the medication aide hold the medication and verified with the physician the order for Resident #8's hydroxyzine was not correct and should have been hydroxyzine 25 mg BID. RN #1 stated LPN #1 told them they knew
the doctor meant TID and not BID so that was why LPN #1 entered the order as TID. RN #1 stated Resident #8 received 4 additional doses of Hydroxyzine 25 mg from 09/25/25 through 09/29/25 due to LPN #1 putting in the wrong dose order in Resident #8's orders.On 10/13/25 at 3:35 p.m., LPN #1 stated there was
a medication review for Resident #8 and the medication aides asked them to change the orders back to TID. LPN #1 stated they changed the order for hydroxyzine 25 mg BID to TID without verifying the order was correct. LPN #1 stated they put the order in as hydroxyzine 25 mg TID when it should have been BID.On 10/14/25 at 1:46 p.m., the DON stated Resident #8's medications were reviewed by the pharmacist
on 09/23/25. The DON stated the pharmacist requested a gradual dose reduction of the hydroxyzine 25 mg TID on 09/23/25. The DON stated the primary care physician agreed and requested Resident #8's order for hydroxyzine 25 mg TID to be changed to BID on 09/24/25. The DON stated they entered a new order in Resident #8's chart to reflect hydroxyzine 25 mg BID on 09/25/25. The DON stated on 09/30/25, RN #1 made them aware of the order in Resident #8' health record for hydroxyzine 25 mg TID on 09/30/25. The DON stated LPN #1 changed Resident #8's order for hydroxyzine 25 mg back to TID on 09/25/25 at 7:11 p.m. The DON stated LPN #1 was placed on a do not return from the agency as a result of the medication order error. The DON stated Resident #8 received four extra doses of hydroxyzine 25 mg on 09/26/25 through 09/29/25.
Event ID:
Facility ID:
If continuation sheet
Fairview Fellowship Home For Senior Citizens, Inc in Fairview, OK 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 Fairview, OK, (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 Fairview Fellowship Home For Senior Citizens, Inc or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.