Failure to Administer Medications According to Physician Orders and Scheduled Times
Penalty
Summary
The facility failed to ensure that medications were administered according to physicians' orders and within the scheduled time frames for three residents. Observations showed that a registered nurse administered 9 AM medications to multiple residents several hours after the scheduled time. The medications included Keppra, Metoprolol, Duloxetine, and others, all of which were ordered to be given twice daily at specific times. The nurse reported being delayed due to a medical emergency earlier in the day but did not notify the Director of Nursing (DON) about the delay or seek guidance regarding the late administration of medications. Record reviews indicated that the affected residents had significant cognitive impairments and multiple diagnoses, including seizure disorders, dementia, depression, and heart disease. The facility's policy required medications to be administered within 60 minutes before or after the scheduled time, and any adjustments to the schedule were to be made by a physician. The DON confirmed awareness of the late administration but did not contact the provider to determine if the late doses should be rescheduled. The Nursing Home Administrator stated that the expectation was for medications to be administered as ordered.