Based on facility policy review, observation, and staff interview, it was determined that the facility failed to properly store and label medications on six of 10 nursing units (1C, 1D, 3C, 3D, 3F, 4F) and in the central supply room, to ensure the correct and safe administration of medications for 34 of 43 sampled residents (Residents 9-42). This failure put residents at risk for medication administration errors and resulted in an Immediate Jeopardy situation.Findings include:Review of the facility policy titled, Specific Medication Administration Procedures, last reviewed October 1, 2025, revealed that all medications stored in carts, in medications rooms, or in central supply were to be locked at all times unless in use or under the direct observation of the medication nurse.Review of… …
F761 citations in Pennsylvania
Drug labeling and storage · Pharmacy Service Deficiencies
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.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Pennsylvania cites F761 more often than its own record predicts
1.01 times the share F761 takes of citations nationally.
Of every deficiency written in Pennsylvania in 2025, this is the portion that was F761.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Pennsylvania surveyors wrote
F761 findings written in Pennsylvania, 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 a review of select facility policies and procedures, observation, and staff interview, it was determined that the facility failed to properly store resident medication on one of two nursing units (Main Unit).Findings include: The policy entitled Storage of Medications, last reviewed on March 31, 2026, with no changes, revealed compartments (including, but not limited to, drawers, cabinets, rooms, refrigerators, carts, and boxes) containing drugs and biologicals are locked when not in use. Unlocked medication carts are not left unattended. Observation of the Main nursing unit on September 15, 2026, at 2:57 PM revealed an unattended and unlocked medication cart in front of the nursing station. The first drawer of the medication cart included resident specific medication. …
Based on observations, review of facility policies and clinical records, and staff interviews, it was determined that the facility failed to make certain that multiple (multi) use medications were properly labeled for resident use for two of two medication carts observed during medication pass (3 West Hall and 3 East Hall medication carts). Findings include: The facility policy entitled Storage and Expiration Dating of Medications, Biologicals, Syringes and Needles with a Revision Date of 10/28/2019, revealed that the facility should ensure that all medications and biologicals, including treatment items, are securely stored in a locked cabinet/cart or locked medication room that is inaccessible by residents and visitors. …
The short window
Recent years
| Year | Share of Pennsylvania citations | vs expected |
|---|---|---|
| 2023 | 2.79% | 0.88× |
| 2024 | 2.93% | 0.95× |
| 2025 | 3.27% | 1.01× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Pennsylvania surveyors cite →
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