Failure to Provide Timely and Appropriate Pain Management
Penalty
Summary
The facility failed to provide safe and appropriate pain management for multiple residents, as evidenced by a lack of pain assessments, failure to obtain and follow physician orders, and delays in administering pain medication. One resident with a history of cervical radiculopathy and rheumatoid arthritis reported experiencing severe, unrelieved pain and stated that staff did not assess her pain regularly or provide her with prescribed pain medication, despite her repeated requests. The resident's care plan indicated a need for pain monitoring and medication administration, but there were no pain medications listed in her physician orders, and staff did not document or assess her pain as required. Another resident with dementia and palliative care needs was observed in apparent pain, with physical signs such as grimacing and guarding a bruised, swollen foot. Despite having orders for pain assessments and medications, staff failed to document pain assessments on multiple shifts and did not administer pain medication as prescribed. Communication barriers were not adequately addressed, and staff did not use available language services to assess the resident's pain level. Pain medication was not given according to the prescribed pain scale, and there were significant delays in administration. A third resident with a history of hip dislocation and sciatica also experienced lapses in pain management, with missing pain assessments on several days and a prescribed lidocaine patch marked as unavailable. Facility records and staff interviews confirmed that residents often waited a long time for pain medication, and staff training on pain management was insufficient, as evidenced by limited participation in in-service sessions. Facility policies required regular pain assessments and prompt administration of pain medication, but these were not consistently followed.