Delayed Response to Monthly Medication Regimen Reviews
Penalty
Summary
The facility failed to ensure timely responses to monthly medication regimen reviews (MRR) for two residents out of five reviewed for unnecessary medications. For one resident with severe cognitive impairment and multiple diagnoses, the pharmacist recommended a trial dose reduction of Trazadone and requested documentation in the progress notes regarding the necessity of continued therapy. However, the response from the certified nurse practitioner (CNP) addressing this recommendation was not documented until over a month later, well after the pharmacist's initial recommendation. Similarly, another resident with multiple chronic conditions and a history of psychiatric disorders was receiving scheduled antidepressant, antipsychotic, and antianxiety medications. The pharmacist recommended a trial dose reduction of Duloxetine, but the nurse practitioner's response to this recommendation was also delayed by more than a month. The Director of Nursing (DON) confirmed that pharmacy recommendations are provided to the prescribing physician, but acknowledged that the CNP did not respond to the November recommendations in a timely manner, contrary to facility policy requiring review and action by the physician by their next mandatory visit.