The Frequently Cited Violations Report is a useful tool to help you focus on common areas that can be problematic, and to help you avoid violations and improve your compliance in your care home. 

The top violations in the current report are related to medication administration, and the majority were repeat frequently-cited violations from last quarter.

See our summary below of the top violations: ​

Staffing & Facility Records

• Background checks [repeat from last report]: All subject individuals (licensee, staff, occupants over 16, etc.) must have approved background checks with verification records kept in the facility records.

• Fire Evacuation Drills [repeat from last report]: These drills are required to be conducted at least every 90 calendar days and at least once annually during sleeping hours. Documentation must be kept in the facility records. The drill must be clearly documented and signed by the person conducting the drill.
  • Additional Note: the first-year fire drill requirement for Multnomah County ONLY is at least once every 60 days. It is at least 90 days for all other counties.

Resident Records

• Narratives must be documented at least weekly and be signed and dated by the person writing the narratives.

Medication Administration

• Initial the MAR immediately after administering a medication. A MAR must contain a legible signature that identifies each set of initials.
• PRN parameters must be ordered and documented for all PRN (as needed) medications, including what the medication is for, specific dose, and specific frequency. Any instructions must be available to the caregiver to review before administration of the medication.
• Medication supplies must be available, including scheduled, PRN, and OTC medications. Refills must be obtained before current supplies run out. Attempts to order refills must be documented.
• Carry out all orders, including all medications (OTC medications, included), treatments, and therapies as prescribed. As a reminder, the resident, or their legal representative, has the right to decline to receive medications, treatments or therapies. In these cases, the doctor needs to be notified.
• Changes to a written order may not be made without an order from a prescribing practitioner and must be correctly documented on the MAR. Phone orders must be followed up with a written order within seven (7) calendar days. Changes require a new, properly labeled medication container or a separate label attached to the original container. 
• Medication Administration Records: a current MAR or e-MAR must be kept for each resident and all discontinued and changed orders must be correctly documented on the MAR. A changed order must be written on a new line with a line drawn to the start date and time.
• Medications must be disposed of properly, this includes outdated, discontinued, recalled or contaminated medications. They must be disposed of within 10 calendar days and the disposal documented. Medications for residents who have died must be disposed of within 24 hours. Correct, safe disposal of transdermal patches must be followed.

After a several-month hiatus, our Care Home Conversations Podcast will be back soon with a very special guest.

In our next episode, which will be available later this month, we'll have a great conversation with Amie Clark, co-founder of TheSeniorList.com and AgingToday.com.