Failure to Document and Communicate Monthly Pharmacist Drug Regimen Reviews
Penalty
Summary
The facility failed to ensure that a licensed pharmacist conducted and documented monthly drug regimen reviews for five residents with multiple diagnoses. Record reviews for each resident, covering both electronic and paper medical records over several months, did not show any written communication from the pharmacist to the residents' medical providers regarding medication reviews, recommendations, or provider responses. Despite the presence of multiple medication orders for each resident, there was no evidence that the pharmacist had submitted any recommendations or that the medical provider had reviewed and responded to such recommendations. Interviews with the Director of Nursing and the Administrator confirmed that while monthly meetings involving the contracted pharmacist and medical director occurred, no documentation of these discussions was maintained in the residents' records. The Administrator acknowledged the absence of a formal medication review process and confirmed that the pharmacist was not providing written recommendations to the medical provider, nor were there any pharmacy recommendations for the provider to respond to.