Failure to Develop Care Plan Interventions for Psychotropic Medication Use
Penalty
Summary
The facility failed to develop comprehensive care plans that included interventions for the use of psychotropic medications for one resident who was admitted with diagnoses of anxiety, hallucinations, and disorientation. Physician orders for this resident included multiple psychotropic medications such as Buspirone, Lamotrigine, Mirtazapine, Duloxetine, Olanzapine, and Haloperidol, each prescribed for specific symptoms including irritability, mood stabilization, insomnia, depression, and hallucinations. A review of the resident's care plan dated 2/24/25 revealed no documented interventions addressing the use of these psychotropic medications. Additionally, there was no evidence in the resident's health record of any resident-specific interventions related to psychotropic medication use. This lack of documentation was confirmed by the Director of Nursing Services during an interview.