Failure to Provide Timely and Consistent Pain Management
Penalty
Summary
The facility failed to provide timely and appropriate pain management for residents, as evidenced by delayed administration of pain medications and inconsistent adherence to physician orders. One resident reported uncertainty about whether their pain medication was scheduled or as needed, and review of their records showed multiple instances where scheduled pain medications, including hydrocodone-acetaminophen and lidocaine patches, were administered more than two hours late. Facility policy required medications to be given within one hour before or after the scheduled time, but audit reports revealed repeated late administration due to interruptions and staffing issues, as confirmed by staff interviews. Another resident with a history of chronic pain, osteoarthritis, muscle spasm, and peripheral vascular disease reported frequent bilateral leg pain and delays in receiving pain medication, sometimes waiting about an hour. Record review showed that pain medications were administered outside of the ordered pain score parameters, with acetaminophen and hydrocodone-acetaminophen given for pain scores not matching the physician's instructions. Additionally, tramadol was administered multiple times without any documented parameters or pain assessments, and there were no non-pharmacological interventions documented for pain management. Medication administration records for this resident also revealed that scheduled pain medications and other treatments were given several hours late on multiple occasions. These delays and inconsistencies in medication administration were acknowledged by facility leadership during interviews, and documentation confirmed that staff did not consistently follow physician orders or facility policy regarding pain management.