Failure to Obtain Written Consent for Antipsychotic Medication
Penalty
Summary
The facility failed to ensure that a resident was fully informed and provided written consent prior to the administration of an antipsychotic medication, Seroquel. Record review showed that the resident, who had diagnoses including personality disorder, bipolar disorder, major depression, and anxiety, was cognitively intact and able to understand and communicate. The resident's care plan and physician orders documented the use of Seroquel for bipolar disorder, and medication administration records confirmed that the medication was being given as prescribed. However, the required Consent for Antipsychotic or Neuroleptic Medication Treatment (Form 3713) was not signed by the resident, despite her being her own responsible party and aware of the medication. Interviews with the resident, ADON, and Administrator confirmed that the consent should have been obtained and signed at the time the medication was ordered, in accordance with facility policy. The absence of a signed consent form indicated that the resident had not formally acknowledged the risks and benefits of the medication as required.