Inspection visit
Inspection
1 citation recorded
Inspector’s narrative
What the inspector wrote
This survey cited 1 deficiency. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0760
Ensure that residents are free from significant medication errors.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview, and record review, the facility failed to follow physician orders when administering
medications including multiple doses of intravenous antibiotics for two (R7, R8) residents out of three
residents reviewed for medication administration in a sample list of eight residents.
Residents Affected - Few
Findings include:
1. R7's Electronic Medical Record (EMR) documents medical diagnoses as Multiple Sclerosis, Heart
Failure, Epilepsy, Acute Osteomyelitis, Sacral Pressure Ulcer, Need for Personal Care, and Bacteremia.
R7's Minimum Data Set (MDS), dated [DATE], documents R7 as cognitively intact.
R7's Physician Order Sheet (POS), dated February 2025, documents a physician order starting 2/1/25 for
Ertapenem Sodium one Gram (GM) every 24 hours intravenously for wound infection until 2/3/25. This
same POS documents a physician order starting on 2/3/25 for Ertapenem Sodium one gram (gm) every 24
hours intravenously for wound infection until 2/11/25. Notify Physician if medication is missing.
R7's Medication Administration Record (MAR), dated February 2025, documents R7 was not administered
Ertapenem Sodium One GM on 2/1/25, 2/2/25, 2/5/25, 2/8/25 and 2/10/25.
R7's Nurse Progress Notes do not document R7's Ertapenem Sodium One Gram (GM) not being
administered on 2/1/25, 2/2/25, 2/5/25, 2/8/25 and 2/10/25. R7's Nurse Progress Notes do not documents
notifications being made to R7's Physician, R7, nor R7's Power of Attorney (POA).
R7's Medication Error Report, dated 2/3/25, documents R7's Ertapenem Sodium One GM was not
administered on 2/1/25 and 2/2/25 due to staff not being able to locate the medication.
The facility was unable to provide medication error reports due to R7's Ertapenem Sodium not being
administered on 2/5/25, 2/8/25 and 2/10/25.
On 2/11/25 at 1:00 PM, R7 was laying in his bed with a Peripherally Inserted Central Catheter (PICC) line
in place in his Left Upper arm.
On 2/11/25 at 1:05 PM, R7 stated the nurses are 'hit an miss' administering his Ertapenem Sodium One
Gram (GM) via his PICC (peripherally inserted central catheter) line. R7 stated, Sometimes they (staff) are
good about it and other times I have to wait for hours. Then I ask about it and they tell me they will get it. No
one ever returns to give me the antibiotic. That is the entire reason I have to have this PICC line. If they
(staff) aren't going to give it to me, then I should not have to
(continued on next page)
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other
safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the
date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER
REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Facility ID:
If continuation sheet
Page 1 of 3
Event ID:
146162
Printed: 05/15/2026
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
146162
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/13/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Moweaqua Rehab & Hcc
525 South Macon Street
Moweaqua, IL 62550
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 0760
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
have this PICC line. Now I was told that I have to have it (IV antibiotic) for more days due to the staff didn't
give it right. That isn't right.
On 2/11/25 at 1:45 PM, V7, Agency Registered Nurse (RN), stated she worked on 2/1/25 and 2/2/25 as
R7's nurse. V7 RN stated she looked for R7's Ertapenem Sodium IV antibiotic, but was not able to find it.
V7, RN, stated she did not give R7's antibiotic on those two days, and did not notify the Physician. V7, RN,
stated she was told later that the facility has a back up medication storage system, which did include the
antibiotic, which was onsite that weekend. V7, RN, stated, I guess I should have called somebody, but I
can't be expected to give something I can't find. I should not have to call the doctor every time someone
doesn't get their medication.
2. R8's Electronic Medical Record (EMR) documents medical diagnoses of Epilepsy and Dementia.
R8's Minimum Data Set (MDS), dated [DATE], documents R8 as severely cognitively impaired.
R8's Physician Order Sheet (POS), dated December 2024, documents a physician order starting 12/6/24
for Briviact Oral Tablet 50 milligram (MG). Give 50 mg by mouth two times a day for Epilepsy.
R8's Medication Administration Record (EMR), dated December 2024, documents R8 received the
scheduled doses of Briviact 50 mg in the morning and evening of 12/17/24.
R8's Nurse Progress Note, dated 12/17/24 at 8:04 PM, documents R8 was given the wrong dose of Briviact
(anti-epileptic) medication. This same note documents, (R8) was mistakenly given two doses from a card of
another resident with 100 milligram (mg) Briviact, though (R8) is ordered 50 mg of Briviact.
R8's Medication Error Report, dated 12/17/24, documents R8 received the wrong dose of Briviact. This
same report documents R8 was ordered 50 mg Briviact twice daily and was mistakenly given Briviact 100
mg on 12/17/24.
On 2/11/25 at 3:00 PM, V5, Nurse Practitioner (NP), stated R7's Intravenous (IV) antibiotic Ertapenem
Sodium One GM was ordered daily for R7's Sacral Pressure Ulcer, which is infected. V5, NP, stated
Ertapenem wound be considered a critical medication necessary for R7's wound healing. V5, NP, stated V5
is not aware R7 had any side effects from the staff not administering this medication, but 'absolutely could
have'. V5, NP, stated there is no excuse for V7, Agency Registered Nurse (RN), to not call V5, NP, on 2/1/25
to report R7's medication could not be located. V5, NP, stated the facility did in fact have R7's Ertapenem,
which was in the Stat Safe medication storage system. V5, NP, stated she found out R7 did not have his
Ertapenem on 2/3/25. V5, NP, stated V5 is onsite five days per week for half days, which is during the time
R7 is scheduled to receive his IV antibiotic through his PICC line. V5, NP, stated the staff could have
notified her while she was in the building, and she would have addressed the situation immediately. V5, NP,
stated R8 has Briviact 50 mg ordered twice daily for his Seizure Disorder. V5, NP, stated all residents
medications should be administered as ordered by the prescriber. V5, NP, stated V6, Agency Licensed
Practical Nurse (LPN), mistakenly administered Briviact 100 mg to R8. V5, NP, stated R8 did not have any
significant medical complications due to this error. V5, NP, stated, (R8) was lucky to not have any significant
issues due to this error. It could have been much worse. Overdosing the resident's neurological symptoms
could cause ill effect.
On 2/13/25 at 10:05 AM, V1, Administrator, stated the facility does not have a policy or guidelines
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
146162
If continuation sheet
Page 2 of 3
Printed: 05/15/2026
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
146162
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/13/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Moweaqua Rehab & Hcc
525 South Macon Street
Moweaqua, IL 62550
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 0760
Level of Harm - Minimal harm
or potential for actual harm
on medication errors. V1 stated it is the expectation for nursing staff to follow the physician orders, and if
there a reason a resident does not get their medication or gets the wrong dose, then the staff should reach
out to the provider.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
146162
If continuation sheet
Page 3 of 3
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Back to topCitations
1 citation recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F760 - Residents are free of any significant medication errors
Ensure that residents are free from significant medication errors.
FAQ · About this visit
Common questions about this visit
What happened during the February 13, 2025 survey of MOWEAQUA REHAB & HCC?
This was a inspection survey of MOWEAQUA REHAB & HCC on February 13, 2025. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at MOWEAQUA REHAB & HCC on February 13, 2025?
Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Ensure that residents are free from significant medication errors."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
Concerned about a resident’s care?Find your local ombudsman through the Eldercare Locatoror file a complaint with your state survey agency.
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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.