Based on record review and staff interview, it has been determined that the facility failed to ensure that the resident's physician completed a medication reconciliation upon admission, failing to identify a medication transcription error, resulting in the resident receiving Dilantin (a medication prescribed to treat seizures) in error on 18 occasions without a diagnosis of a seizure disorder, instead of receiving the intended medication, Diltiazem (a medication prescribed to treat high blood pressure) which was not transcribed. …
F710 citations in Rhode Island
Nursing and Physician Services Deficiencies
Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Rhode Island cites F710 more often than its own record predicts
12.87 times the share F710 takes of citations nationally.
Of every deficiency written in Rhode Island in 2025, this is the portion that was F710.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Rhode Island surveyors wrote
F710 findings written in Rhode Island, 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 record review and staff interview, it has been determined that the facility failed to ensure that the medical care of each resident is supervised by a physician related to anticoagulant therapy for 1 of 4 residents reviewed. Resident ID # 1. Findings are as follows: A Patient's Guide to Taking [MEDICATION(S)], https://www.heart.org/en/health-topics/arrhythmia/prevention--treatment-of-arrhythmia/a-patients-guide-to-taking-[MEDICATION(S)], states in part, .[MEDICATION(S)] (brand names [MEDICATION(S)] and [MEDICATION(S)]) is a prescription medication used to prevent harmful blood clots from forming or growing larger. …
Based on clinical record review and staff interview, the facility failed to ensure the medical care of each resident was supervised by a physician when the ordering provider failed to communicate the discontinuation of a Morphine Sulfate (a narcotic; a controlled medication classified as an opioid, prescribed to treat severe pain) order and the initiation of a new more concentrated Morphine Sulfate order, for 1 of 1 resident reviewed, who was administered 10 times the prescribed dose of Morphine Sulfate and required transfer to the hospital for an evaluation, Resident ID #1. …
The short window
Recent years
| Year | Share of Rhode Island citations | vs expected |
|---|---|---|
| 2023 | 0.95% | 10.29× |
| 2024 | 0.44% | 5.46× |
| 2025 | 0.87% | 12.87× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Rhode Island surveyors cite →
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