Health inspection·July 25, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to perform wound treatment as ordered for 3 or 3 residents (R4, R6, R9), reviewed for Quality of Care in a sample of 3. Finding Include:1. On 7/18/2025 at 12:06 PM R4 stated while admitted to the facility he did not always receive his dressing change to his left knee as ordered.R4's Undated Face Sheet documents R4 was admitted to the facility on [DATE] and has a diagnosis of Pain in the Left Knee, Morbid Obesity, Presence of Left Artificial Knee Joint, and Hypertension.R4's Quarterly Minimum Data Set (MDS) dated [DATE] documents R4 is cognitively intact, needed supervision/touching assistance with showering/bathing, lower body dressing, personal hygiene, rolling left and right, sitting to standing, and chair/bed to chair transfers.R4's Care Plan date initiated 4/7/2025 documents skin complications related to right knee surgery, skin at risk for skin complications related to impaired mobility and obesity.R4's Physician Order dated 5/15/2025 at 10:09 AM documents cleanse wound to left knee with wound cleanser, pat dry, pack with iodoform packing gauze, and cover with bordered gauze. Change daily and as needed (PRN), one time a day for to promote wound healing.R4's May Treatment Administration Record (TAR) dated 5/1/2025 through 5/31/2025 reviewed with no treatment documented on 5/21/2025, 5/26/2025, 5/27/2025, 5/30/25, and 5/31/2025.R4's June TAR dated 6/1/2025 through 6/30/2025 reviewed with no treatment documented on 6/3/2025, 6/4/2025, 6/5/2025, 6/10/2025, 6/12/2025, 6/13/2025, 6/17/2025, and 6/18/2025.2. On 7/22/2025 at 3:46 PM R6 stated the facility changes the dressing to his left middle finger most days, but not every day.On 7/22/2025 at 3:46 PM V10, Licensed Practical Nurse (LPN)/Wound Nurse, completed R6's dressing change to R6's left middle finger.R6's Undated Face Sheet documents R6 was admitted to the facility on [DATE] and has a diagnosis of Type 2 Diabetes and Hypertension.R6's MDS dated [DATE] documents R6 is moderately cognitively intact and needs partial/moderate assistance with showering/bathing.R6's Care Plan date initiated 1/17/2024 documents skin: at risk for skin complications related to Cerebrovascular Accident (CVA) and malnutrition.R6's Physician Order dated 6/20/2025 at 9:59 AM documents cleanse left hand with wound cleanser daily apply xeroform, 4x4 and gauze wrap once daily and PRN.R6's June Treatment Administration Record (TAR) dated 6/1/2025 through 6/30/2025 reviewed with no treatment documented on 6/24/2025, 6/26/2025, and 6/28/2025.R6's July TAR dated 7/1/2025 through 7/31/2025 reviewed with no treatment documented on 7/10/2025, 7/11/2025, 7/19/2025, and 7/20/2025.3. On 7/22/2025 at 3:19 PM R9 stated the facility staff does not change the dressing to his left lower leg daily, and he has gone multiple days without the dressing being changed. On 7/22/2025 at 3:23 PM V10, LPN/Wound Nurse completed R9's dressing change to R9's left lower leg.R9's Undated Face Sheet documents R9 was initially admitted to the facility on [DATE] and has a diagnosis of Cellulitis of the Right and Left Lower Limb, Hypertension, and Congestive Heart Failure.R9's MDS dated [DATE] documents R9 is cognitively intact, needs supervision or touching assistance with lower body dressing, and needs partial/moderate assistance with showering/bathing and personal hygiene.R9' Care Plan with dated initiated 3/5/2024 Residents Affected - Few Page 1 of 6 145427 145427 07/25/2025 Nexus at Alton 3523 Wickenhauser Alton, IL 62002

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few documents skin: at risk for skin complications related to venous hypertension.R9's Physician Order dated 6/20/2025 at 6:13 PM documents cleanse bi-lateral shin apply xeroform and border gauze, then apply ace bandages to both legs one time a day for swelling and blisters once daily and PRN if needed.R9's June Treatment Administration Record (TAR) dated 6/1/2025 through 6/30/2025 reviewed with no treatment documented on 6/24/2025, 6/26/2025, and 6/28/2025.R9's July TAR dated 7/1/2025 through 7/31/2025 reviewed with no treatment documented on 7/10/2025, 7/11/2025, 7/17/2025, 7/19/2025, and 7/20/2025. On 7/22/2025 at 10:20 AM V2, Director of Nursing (DON), stated when a dressing change is completed it is to be signed off on the resident's TAR. V2, DON, stated dressing changes should be documented as soon as they are done and if a resident's TAR does not have any documentation on a day, it would appear as if the dressing change was not performed. On 7/22/2025 at 3:40 PM V10, LPN/Wound Nurse, stated when a resident's dressing change is completed it is documented on the resident's TAR.The Facility's Skin Management: Monitoring of wounds and documentation policy dated 1/2022 documents It is important that the facility have a system in place to assure that the protocols for daily monitoring and for periodic documentation of measurements, terminology, frequency of assessment, and documentation are implemented consistently throughout the facility. 145427 Page 2 of 6 145427 07/25/2025 Nexus at Alton 3523 Wickenhauser Alton, IL 62002

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to administer medications as ordered for 4 of 5 residents (R4, R6, R7, and R9) in a sample of 5.Finding Include:1. On 7/18/2025 at 12:06 PM R4 stated while admitted to the facility he did not always receive his medications daily.R4's Undated Face Sheet documents R4 was admitted to the facility on [DATE] and has a diagnosis of Pain in the Left Knee, Chronic Diastolic (Congestive) Heart Failure, Morbid Obesity, Epilepsy, Cortical Age-Related Cataract, Low-Tension Glaucoma, Cardiomegaly, Barrett's Esophagus, Hypothyroidism, and Hypertension.R4's Quarterly Minimum Data Set (MDS) dated [DATE] documents R4 is cognitively intact, needed supervision/touching assistance with showering/bathing, lower body dressing, personal hygiene, rolling left and right, sitting to standing, and chair/bed to chair transfers.R4's Physician Order dated 4/1/2025 at 4:25 PM documents Bumetanide Oral Tablet 1 MG (Bumetanide) Give 1 tablet by mouth one time a day every other day.R4's Physician Order dated 4/1/2025 at 4:25 PM documents Aspirin Oral Capsule 81 MG (Aspirin) Give 1 capsule by mouth one time a day.R4's Physician Order dated 4/1/2025 at 4:25 PM documents Lansoprazole Oral Capsule Delayed Release 30 MG (Lansoprazole) Give 1 capsule by mouth two times a day. R4's Physician Order dated 4/1/2025 at 4:25 PM documents Apixaban Oral Tablet 2.5 MG (Apixaban) Give 1 tablet by mouth two times a day.R4's Physician Order dated 4/1/2025 at 4:56 documents Famotidine Oral Tablet 20 MG (Famotidine) Give 2 tablet by mouth at bedtime. R4's Physician Order dated 4/1/2025 at 4:56 PM documents Latanoprost Ophthalmic Solution 0.005 % (Latanoprost) Instill 1 drop in both eyes at bedtime.R4's Physician Order dated 4/1/2025 at 4:56 PM documents Lansoprazole Oral Capsule Delayed Release 30 MG (Lansoprazole) Give 1 capsule by mouth two times a day.R4's Physician Order dated 4/1/2025 at 5:20 PM documents Levothyroxine Sodium Oral Tablet 200 MCG (Levothyroxine Sodium) Give 1 tablet by mouth in the morning, take with 25 mcg tablet. R4's Physician Order dated 4/1/2025 at 5:20 documents Levothyroxine Sodium Oral Tablet 25 MCG (Levothyroxine Sodium) Give 1 tablet by mouth in the morning, take with 200 mcg tablet.R4's Physician Order dated 4/1/2025 at 5:24 PM documents Loratadine Oral Capsule 10 MG (Loratadine) Give 1 capsule by mouth one time a day. R4's Physician Order dated 4/1/2025 at 5:24 PM documents Lisinopril Oral Tablet 10 MG (Lisinopril) Give 1 tablet by mouth one time a day.R4's Physician Order dated 4/1/2025 at 5:50 PM documents Phenytoin Sodium Extended Capsule 100 MG Give 3 capsule by mouth at bedtime.R4's Physician Order dated 4/1/2025 at 5:56 PM documents Propranolol HCl Oral Tablet 60 MG (Propranolol HCl) Give 1 tablet by mouth one time a day.R4's Physician Order dated 4/1/2025 at 5:58 PM documents Tamsulosin HCl Oral Capsule 0.4 MG (Tamsulosin HCl) Give 1 capsule by mouth two times a day.R4's May Medication Administration Record (MAR) dated 5/1/2025 through 5/31/2025 does not document R4 received Levothyroxine 200 mg, Levothyroxine 25 mg, and Claritin 10 mg as ordered on 5/13/2025 and 5/21/2025 at 6:00 AM. R4's May MAR dated 5/1/2025 through 5/31/2025 does not document R4 received Atorvastatin 10mg, Famotidine 20 mg 2 tablets, Latanoprost Ophthalmic Solution 0.005% 1 drop, Phenytoin Sodium Extended Capsule 100 mg, Apixaban 2.5 mg, Lansoprazole Delayed Release Capsule 30 mg 3 capsules, and Tamsulosin 0.4 mg as ordered on 5/31/2025 at 8:00 PM. R4's May MAR dated 5/1/2025 through 5/31/2025 does not document R4 received Levothyroxine 200 mg, Levothyroxine 25 mg, and Claritin 10 mg as ordered on 5/13/2025 and 5/21/2025 at 6:00 AM. R4's June MAR dated 6/1/2025 through 6/30/2025 does not document R4 received Claritin 10 mg, Levothyroxine 200 mg, and Levothyroxine 25 mg as ordered on 6/1/2025 at 6:00 AM. R4's June MAR dated 6/1/2025 through 6/30/2025 does not document R4 received Bumetanide 1 mg, Lisinopril 10 mg, Propranolol 60 mg, Apixaban 2.5 mg, Lansoprazole 30 mg, Tamsulosin 0.4 mg as ordered on 6/5/2025 at 9:00 AM. R4's June MAR dated 6/1/2025 through 6/30/2025 does not document R4 received 145427 Page 3 of 6 145427 07/25/2025 Nexus at Alton 3523 Wickenhauser Alton, IL 62002

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Claritin 10 mg, Levothyroxine 200 mg, and Levothyroxine 25 mg as ordered on 6/1/2025 at 6:00 AM. R4's June MAR dated 6/1/2025 through 6/30/2025 does not document R4 received Bumetanide 1 mg, Lisinopril 10 mg, Propranolol 60 mg, Apixaban 2.5 mg, Lansoprazole 30 mg, Tamsulosin 0.4 mg as ordered on 6/5/2025 at 9:00 AM.2. R6's Undated Face Sheet documents R6 was admitted to the facility on [DATE] and has a diagnosis of Type 2 Diabetes, Hyperlipidemia, Bipolar Disease, Seizures, and Hypertension.R6's MDS dated [DATE] documents R6 is moderately cognitively intact and needs partial/moderate assistance with showering/bathing.R6's Physician Order dated 10/14/2024 at 1:03 PM documents Aspirin Oral Capsule 81 MG (Aspirin) Give 1 capsule by mouth one time a day.R6's Physician Order dated 10/14/2024 at 1:04 PM documents Clopidogrel Bisulfate Oral Tablet 75 MG (Clopidogrel Bisulfate) Give 1 tablet by mouth one time a day.R6's Physician Order dated 10/14/2024 at 1:05 PM documents Caplyta Oral Capsule 42 MG (Lumateperone Tosylate) Give 1 capsule by mouth one time a day.R6's Physician Order dated 10/14/2024 at 1:11 PM documents Atorvastatin Calcium Oral Tablet 80 MG (Atorvastatin Calcium) Give 1 tablet by mouth one time a day.R6's Physician Order dated 10/14/2024 at 1:13 PM documents Valproate Sodium Oral Solution 250 MG/5ML (Valproate Sodium) Give 10 ml by mouth with meals.R6's Physician Order dated 10/14/2024 at 1:14 PM documents Venlafaxine HCl Oral Tablet 75 MG (Venlafaxine HCl) Give 1 tablet by mouth with meals.R6's Physician Orders dated 1/8/2025 at 11:05 AM documents Lisinopril Oral Tablet 5 MG (Lisinopril) Give 0.5 tablet by mouth one time a day related.R6's Physician Order dated 1/23/2025 at 9:42 AM documents GLUCERNA two times a day.R6's Physician Order dated 3/16/2025 at 4:54 AM documents cloNIDine HCl Oral Tablet 0.2 MG (Clonidine HCl) Give 1 tablet by mouth three times a day.R6's Physician Order dated 3/16/2025 at 4:55 AM documents busPIRone HCl Oral Tablet 15 MG (Buspirone HCl) Give 1 tablet by mouth three times a day.R6's June MAR dated 6/1/2025 through 6/30/2025 does not document R6 received Valproate Sodium Oral Solution 250mg/5 ml take 10 ml and Venlafaxine HCL 75 mg as ordered on 6/4/2025 at 12:00 PM.R6's June MAR dated 6/1/2025 through 6/30/2025 does not document R6 received Buspirone 15 mg and Clonidine 0.2 mg as ordered on 6/4/2025 at 2:00 PM.R6's June MAR dated 6/1/2025 through 6/30/2025 does not document R6 received Valproate Sodium Oral Solution 250mg/5 ml take 10 ml and Venlafaxine HCL 75 mg as ordered on 6/4/2025 at 6:00 PM.R6's June MAR dated 6/1/2025 through 6/30/2025 does not document R6 received Buspirone 15 mg and Clonidine 0.2 mg as ordered on 6/5/2025 at 8:00 AM.R6's June MAR dated 6/1/2025 through 6/30/2025 does not document R6 received Aspirin 81mg, Atorvastatin Calcium 80 mg, Caplyta 42 mg, Clopidogrel Bisulfate 75 mg, Lisinopril 5 mg take 1/2 tablet, Glucerna, Valproate Sodium Oral Solution 250mg/5 ml take 10 ml, and Venlafaxine HCL 75 mg as ordered on 6/5/2025 at 9:00 AM.R6's June MAR dated 6/1/2025 through 6/30/2025 does not document R6 received Valproate Sodium Oral Solution 250mg/5 ml take 10 ml and Venlafaxine HCL 75 mg as ordered on 6/5/2025 at 12:00 PM.R6's June MAR dated 6/1/2025 through 6/30/2025 does not document R6 received Buspirone 15 mg and Clonidine 0.2 mg as ordered on 6/5/2025 at 2:00 PM.3. R7's Undated Face Sheet documents R7 was admitted to the facility on [DATE] and has a diagnosis of Hypertension, Gastro-Esophageal Reflux Disease, Chronic Ischemic Heart Disease, Peripheral Vascular Disease, and Hypertension.R7's MDS dated [DATE] documents R7 is mildly cognitively impaired, needs supervision or touching assistance with toileting hygiene, showering/bathing, personal hygiene.R7's Physician Order dated 2/12/2025 at 3:57 PM documents Aspirin 81 Oral Tablet Chewable (Aspirin) Give 81 mg by mouth one time a day.R7's Physician Order dated 2/12/2025 at 4:13 PM documents Folic Acid Oral Tablet 1 MG (Folic Acid) Give 1 mg by mouth one time a day.R7's Physician Order dated 2/12/2025 at 4:33 PM documents Keppra Oral Tablet 500 MG (Levetiracetam) Give 500 mg by mouth two times a day.R7's Physician Order dated 2/12/2025 at 4:35 PM documents Metoprolol Tartrate Oral Tablet (Metoprolol Tartrate) Give 25 mg by mouth two times a day.R7's Physician Order dated 2/12/2025 at 4:36 PM documents 145427 Page 4 of 6 145427 07/25/2025 Nexus at Alton 3523 Wickenhauser Alton, IL 62002

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Protonix Tablet Delayed Release 40 MG (Pantoprazole Sodium) Give 1 tablet by mouth two times a day.R7's Physician Order dated 2/21/2025 at 4:40 PM documents Thiamine HCl Oral Tablet 100 MG (Thiamine HCl) Give 100 mg by mouth one time a day.R7's Physician Order dated 6/12/2025 at 5:10 PM documents Vitamin D3 Oral Capsule 1.25 MG (50000 UT) (Cholecalciferol) Give 1 capsule by mouth one time a day every 7 day(s) for Vitamin D deficiency for 8 Weeks.R7's Physician Order dated 6/19/2025 at 1:32 PM documents Sucralfate Tablet 1 GM Give 1 tablet by mouth three times a day.R7's June MAR dated 6/1/2025 through 6/30/2025 does not document R7 received Sucralfate Oral Suspension 10 ml as ordered on 6/4/2025 at 12:00 PM.R7's June MAR dated 6/1/2025 through 6/30/2025 does not document R7 received Sucralfate Oral Suspension 10 ml as ordered on 6/4/2025 at 6:00 PM.R7's June MAR dated 6/1/2025 through 6/30/2025 does not document R7 received Aspirin 81 mg, Folic Acid 1 mg, Thiamine HCL 100 mg, Keppra 500 mg, Metoprolol Tartrate 25 mg, Protonix Delayed Release 40 mg as ordered on 6/5/2025 at 9:00 AM.R7's June MAR dated 6/1/2025 through 6/30/2025 does not document R7 received Sucralfate Oral Suspension 10 ml as ordered on 6/5/2025 at 12:00 PM.4. On 7/22/2025 at 3:19 PM R9 stated there have been days where he does not receive all his medications but cannot recall a particular date. R9's Undated Face Sheet documents R9 was initially admitted to the facility on [DATE] and has a diagnosis of Cellulitis of the Right and Left Lower Limb, Chronic Obstructive Pulmonary Disease, Gastro-Esophageal Reflux Disease, Hypertension, and Congestive Heart Failure.R9's MDS dated [DATE] documents R9 is cognitively intact, needs supervision or touching assistance with lower body dressing, and needs partial/moderate assistance with showering/bathing and personal hygiene.R9's Physician Order dated 4/8/2025 at 2:24 PM documents Metformin HCL Oral Tablet 500 mg (Metformin HCL) Give 2 tablets by mouth two times a day.R9's Physician Order dated 4/8/2025 at 3:11 PM documents Polyethylene Glycol 3350 Oral Packet 17 gm (Polyethylene Glycol 3350) Give 1 packet by mouth two times a day.R9's Physician Order dated 4/8/2025 at 3:20 PM documents Spironolactone Oral Tablet 25 MG (Spironolactone) Give 0.5 tablet by mouth one time a day.R9's Physician Order dated 4/9/2025 at 12:07 PM documents Protonix Tablet Delayed Release 20 MG (Pantoprazole Sodium) Give 1 tablet by mouth one time a day.R9's Physician Order dated 4/9/2025 at 12:07 PM documents Eliquis Oral Tablet 5 mg (Apixaban) Give 1 tablet by mouth two times a day.R9's Physician Order dated 4/9/2025 at 12:08 PM documents Trelegy Ellipta Inhalation Aerosol Powder Breath Activated 100-62.5-25 MCG/ACT (Fluticasone-Umeclidinium-Vilanterol) 1 puff inhale orally one time a day.R9's Physician Order dated 4/9/2025 at 12:08 PM documents Vitamin D3 Oral Tablet 50 MCG (2000 UT) (Cholecalciferol) Give 1 tablet by mouth one time a day.R9's Physician Order dated 4/9/2025 at 12:09 PM documents Vitamin-B Complex Oral Tablet (B-Complex Vitamins) Give 1 tablet by mouth in the morning.R9's Physician Order dated 4/9/2025 at 12:09 PM documents Aspirin 81 Oral Tablet Chewable (Aspirin) Give 81 mg by mouth one time a day.R9's Physician Order dated 4/9/2025 at 12:13 PM documents Ipratropium-Albuterol Solution 0.5-2.5 (3) mg/3ml 3 ml inhale orally three times a day.R9's Physician Order dated 4/9/2025 at 12:14 PM documents Alprazolam Oral Tablet 0.5 mg (Alprazolam) Give 1 tablet by mouth three times a day.R9's Physician Order dated 4/9/2025 at 12:14 PM documents Buspirone HCL Oral Tablet 10 mg (Buspirone HCL) Give 15 mg by mouth three times a day.R9's Physician Order dated 4/9/2025 at 12:15 PM documents Magnesium Oral Tablet (Magnesium) Give 400 mg by mouth three times a day.R9's Physician Order dated 4/9/2025 at 12:16 PM documents Ferrous Sulfate Tablet 325 (65 Fe) mg Give 1 tablet by mouth two times a day.R9's Physician Order dated 4/9/2025 at 12:16 PM documents Fish Oil Oral Capsule 1000 MG (Omega-3 Fatty Acids) Give 1 capsule by mouth in the morning.R9's Physician Order dated 4/9/2025 at 12:17 PM documents Calcium 600 Oral Tablet (Calcium Carbonate) Give 1 tablet by mouth one time a day.R9's Physician Order dated 4/9/2025 at 12:18 PM documents Tacrolimus Oral Capsule 0.5 mg (Tacrolimus) Give 1 capsule by mouth two times a day.R9's 145427 Page 5 of 6 145427 07/25/2025 Nexus at Alton 3523 Wickenhauser Alton, IL 62002

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Physician Order dated 4/9/2025 at 12:18 PM documents Potassium Chloride ER Tablet Extended Release 20 meq Give 1 tablet by mouth three times a day.R9's Physician Order dated 4/9/2025 at 12:35 PM documents Pregabalin Oral Capsule 100 mg (Pregabalin) Give 1 capsule by mouth two times a day.R9's Physician Order dated 4/9/2025 at 12:36 PM documents Jardiance Oral Tablet 10 MG (Empagliflozin) Give 1 tablet by mouth one time a day.R9's Physician Order dated 5/13/2025 at 2:48 PM documents Lasix Oral Tablet 40 mg (Furosemide) Give 1 tablet by mouth 2 times a day.R9's June MAR dated 6/1/2025 through 6/30/2025 does not document R9 received Metformin HCL 500 mg 2 tablets, Tacrolimus 0.5 mg, Alprazolam 0.5 mg, Buspirone HCL 10 mg take 15 mg, Ipratropium-Albuterol Solution 0.5-2.5 mg/3 ml, Magnesium 400 mg, and Potassium Chloride Extended Release 20meq as ordered on 6/1/2025 at 6:00 AM.R9's June MAR dated 6/1/2025 through 6/30/2025 does not document R9 received Metformin HCL 500 mg 2 tablets and Tacrolimus 0.5 mg as ordered on 6/4/2025 at 6:00 PM.R9's June MAR dated 6/1/2025 through 6/30/2025 does not document R9 received Alprazolam 0.5 mg, Buspirone HCL 10 mg take 15 mg, Ipratropium-Albuterol Solution 0.5-2.5 mg/3 ml, Magnesium 400 mg, and Potassium Chloride Extended Release 20meq as ordered on 6/4/2025 at 12:00 PM.R9's June MAR dated 6/1/2025 through 6/30/2025 does not document R9 received Lasix 40 mg as ordered on 6/4/2025 at 4:00 PM.R9's June MAR dated 6/1/2025 through 6/30/2025 does not document R9 received Aspirin 81 mg, Calcium 600 mg, Fish Oil 1000 mg, Jardiance 10 mg, Protonix Delated Release 20 mg, Spironolactone 25 mg take 1/2 tablet, Trelegy Ellipta Inhalation Aerosol Powder Breath Activated 100-62.5-25 MCG/ACT 1 puff, Vitamin D3 50 mcg, Vitamin-B Complex 1 tablet, Eliquis 5 mg, Ferrous Sulfate 325 mg, Lasix 40 mg, Polyethylene Glycol 3350 Oral [NAME] 17 gm, Pregabalin 100 mg, as ordered on 6/5/2025 at 9:00 AM.R9's June MAR dated 6/1/2025 through 6/30/2025 does not document R9 received Alprazolam 0.5 mg, Buspirone HCL 10 mg take 15 mg, Ipratropium-Albuterol Solution 0.5-2.5 mg/3 ml, Magnesium 400 mg, and Potassium Chloride Extended Release 20meq as ordered on 6/5/2025 at 12:00 PM.On 7/22/2025 at 10:20 AM V2, Director of Nursing (DON), stated when a medication is given, the medication should be documented as soon as is dispensed on the resident's MAR. V2, DON, stated if the resident's MAR does not have any documentation on a day, then the medication was not given.The Facility's Medication Administration Policy last revised 5/2017 documents All medication are administered safely and appropriately to aid residents to overcome illness relieve and prevent symptoms and help in diagnosis. Document as each medication is prepared on the MAR. 145427 Page 6 of 6