Failure to Follow Physician Orders for Scabies Treatment and Prophylaxis
Penalty
Summary
The facility failed to ensure that professional standards of practice were followed for three residents regarding the administration of medications for scabies treatment and prophylaxis. For one resident with schizophrenia and moderate cognitive impairment, the prescribed Permethrin cream was not administered as ordered, and an order for oral Ivermectin was not carried out. The Assistant Director of Nursing (ADON) confirmed that the medication was not signed off in the Medication Administration Record (MAR) and that there was no evidence the treatment was given, despite a physician's order. Another resident with Adult Failure to Thrive and dementia, also with moderate cognitive impairment, received Permethrin cream on two consecutive days instead of the single application as ordered. The MAR showed that staff entered and signed off on two separate orders, resulting in back-to-back administration. The ADON acknowledged this deviation from the order and noted the potential for side effects due to excessive use, confirming that the physician's instructions were not followed. A third resident with severe cognitive impairment and dementia did not receive Permethrin cream in a timely manner. Although the order was received, the medication was administered two days later without documentation explaining the delay. The ADON verified that there was no note or notification to the physician regarding the delay, and facility policy requires medications to be administered according to prescriber orders and within required time frames.