Failure to Provide Physician-Ordered Medication Due to Supply and Communication Issues
Penalty
Summary
The facility failed to provide a prescribed cancer medication, Nubeqa, as ordered by the physician for a resident with a history of prostate cancer, high blood pressure, and depression. According to the Medication Administration Record, the medication was not administered on multiple occasions over several days due to it being unavailable. Documentation indicated that the medication was to be supplied by the resident's family, but there were repeated notations that it had not arrived or was unavailable. The facility's policy requires staff to take immediate action to obtain medications from the pharmacy or seek alternate physician orders if the medication cannot be obtained, but this was not documented as having occurred. Interviews with the DON revealed that the resident's brother had previously supplied the medication out-of-pocket, but was no longer able to do so. Another family member was willing to assist, but the resident, who is his own responsible party, refused to allow the facility to communicate with his brother regarding his care. The resident also did not provide clear direction to the facility on how to proceed with obtaining the medication, and at times refused to discuss the matter. As a result, the facility did not provide the medication as ordered for an extended period.