Health inspection·January 29, 2026

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 resident and family interview, staff interview, review of facility medication incident report, record review, and facility policy review, the facility failed to ensure residents were free of significant medication errors. This affected one resident (Resident #9) out of four residents reviewed for medication administration. The facility census was 53.Findings include:Review of the medical record for Resident #9 revealed an admission date of 05/23/25 with diagnoses including hypertension, hypothyroidism, hyperlipidemia, anemia, history of falls and history of fracture of right femur. Residents Affected - Few Review of the facility document titled Medication Incident Report dated 07/14/25 at 10:45 A.M. revealed Registered Nurse (RN) #805 gave Resident #9 the wrong medications during their 9:00 A.M. medication pass. RN #805 did not verify she had the right resident and RN #805 administered the following wrong medications: Amlodipine (treats high blood pressure), Bupropion (antidepressant), Lisinopril (treats high blood pressure), Paxil (antidepressant) and Prednisone (corticosteroid). RN #805 stated in a written statement that she went into the residents' room and stated, I have your medicine and proceeded to give Resident #9 the medications. The statement additionally said when RN #805 attempted to give Resident #9 a Lovenox (blood thinner) shot, Resident #9 stated I have never been given a shot since I have been here, it was at that point RN #805 questioned herself and went out to check the medications and realized she was in the wrong room and administered Resident #9 the wrong medications. Review of Resident #9's progress notes dated 07/14/25 at 3:02 P.M. authored by the previous Director of Nursing #700 revealed at 11:00 A.M. she contacted the Nurse Practitioner and reviewed and discussed Resident #9's morning medications and received a new order to monitor her vital signs every two hours for 12 hours. Review of Resident #9's quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed the resident had intact cognition, needed substantial to maximal assist for Activities of Daily Living (ADLs), was independent with eating and required staff assistance with medication administration. An interview on 01/29/26 at 9:20 A.M. with Resident #9 revealed she confirmed in July 2025 she was given the wrong medications. She stated the nurse, who she had never seen before and had not seen since this incident, came in her room and stated, I have your medicine. Resident #9 stated she took the medications, and then when the nurse attempted to give her a shot, she questioned the nurse stating, I have never been given a shot here. The nurse left the room and did not return. Resident #9 stated the DON at the time came in the room later in the afternoon and told her what happened and that she had been given the wrong medications. An interview on 01/29/26 at 12:22 P.M. with Resident #9's family revealed their mother called them Page 1 of 2 366329 366329 01/29/2026 Hampton Woods Nursing Center, Inc 1525 East Western Reserve Road Poland, OH 44514

F 0760 Level of Harm - Minimal harm or potential for actual harm in July and stated she was given the wrong medications. She stated this type of incident has not happened since July but was worried it could happen again. An interview on 01/29/26 at 1:10 P.M. with the current Director of Nursing #701 revealed she confirmed RN #805 did give Resident #9 the wrong medications. Residents Affected - Few Review of the facility policy titled Medication Administration last revised July 2025 revealed the individual administering the medications were to verify the resident's identity before giving the resident his/her medications. This deficiency represents non-compliance investigated under Complaint Number 2580337. 366329 Page 2 of 2