Failure to Provide Timely Pain Medication Due to Lapsed Prescription
Penalty
Summary
The facility failed to ensure that a resident with chronic pain conditions, including a chronic left foot ulcer and gout, had access to prescribed pain medication. The resident, who was cognitively intact and able to make decisions, reported running out of pain medication and experiencing pain for several days, which affected his sleep. The care plan instructed staff to medicate the resident as ordered and to advise him to request pain medication before pain became severe. However, staff interviews and record reviews confirmed that the prescription for the resident's pain medication had expired and was not renewed in a timely manner, resulting in the resident not receiving pain relief as needed. Licensed nurses and a CNA confirmed that the resident regularly requested pain medication and that there was no pain medication available for several days. The process for medication reordering was not followed, as no renewal or authorization form was sent to the attending physician before the prescription expired. Staff also indicated that the lack of medication was exacerbated by the timing of the prescription running out over a weekend, making it more difficult to obtain a physician's signature for renewal. The Director of Nursing acknowledged the expectation that pain medications should be available to prevent resident suffering.