Failure to Honor Resident's Right to Refuse Medication
Penalty
Summary
A resident with diagnoses including cerebral palsy and dysarthria, and with intact cognition as evidenced by a Brief Interview for Mental Status score of 15/15, reported being held down by staff after refusing medications. The resident, who is able to make their needs known but has impaired communication, was admitted with orders allowing medications to be given by mouth if the G-tube was inaccessible. On the date in question, documentation and staff interviews revealed that the resident was combative and refused medications multiple times. Despite this, staff proceeded to administer medications via the resident's G-tube after the resident's repeated refusals. Staff interviews confirmed that a nursing assistant assisted by distracting or holding the resident while a nurse administered the medications. The resident later verbally stated to the surveyor that they had said no repeatedly and did not want the medications, expressing distress over being held down. The Director of Nursing and Administrator confirmed that facility policy requires staff to respect a resident's right to refuse medication and to notify the provider in such cases, which was not followed in this incident.