Based on family interview, staff interview, clinical record review and in the course of a complaint investigation, facility staff failed to ensure medications were available for administration for one of 25 residents in the survey sample, Resident #10 resulting in harm. 1a) Facility staff failed to administer long acting morphine per physician order [REDACTED]. 1b) Resident #10 had a physician order [REDACTED].#10 had not received any doses of the ordered Nystatin. The findings include: 1a) Facility staff failed to administer long acting morphine per physician order [REDACTED]. Resident #10 was originally admitted to the facility on [DATE] and readmitted on [DATE] with [DIAGNOSES REDACTED]. …
F425 citations in Virginia
Pharmacy Service Deficiencies
Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
No F425 citations were recorded in Virginia for 2025. That means none appear in the CMS file for that year — not that the requirement does not apply.
In the surveyor’s words
What Virginia surveyors wrote
F425 findings written in Virginia, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on staff interview, clinical record review, and facility document review, it was determined, the facility staff failed to ensure medications were available for one of 26 residents in the survey sample, Resident #7. The facility staff failed to ensure Resident #7's Nicotine patches (1) were available to be administered on several occasions in October of 2017. The findings include: Resident #7 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Resident #7's most recent MDS (minimum data set) was an admission assessment with an ARD (assessment reference date) of 8/29/17. Resident #7 was coded as being cognitively intact in the ability to make daily decisions scoring 15 out of 15 on the BIMS (Brief Interview for Mental Status) exam. …
Based on observation, staff interview, and facility document review, it was determined that the facility staff failed to ensure that the medication room was free from expired biologicals. The findings included: On 2/16/11 at 2:15 p.m., the medication room was inspected. At this time, 14 containers of "Qucik Care Hand Rinse" were found to have expired on 12/06 (December, 2006); and two containers of "Epi Clense" were found to have expired on 08/09 (August, 2009). These expired biologicals were brought to the attention of LPN (licensed practical nurse) #3, who proceeded to collect them and remove them from the room. On 2/17/11 at 1:00 p.m., the Administrator stated that the pharmacy inspects the medication room and medication carts once a month, and that staff check it at least weekly. …
What else Virginia surveyors cite →
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