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F0697
D

Failure to Administer Ordered Pain Medication

York, Pennsylvania Survey Completed on 05-22-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide pain management consistent with professional standards of practice for a resident with a history of thoracic vertebral fracture and polyneuropathy, who had a physician's order for daily Oxycodone to manage chronic pain. Clinical record review showed that the resident did not receive her scheduled pain medication on multiple occasions due to the medication being unavailable or not administered as ordered. The medication administration record, progress notes, and controlled substance declining count sheet confirmed missed doses on several specific dates. During an interview, the resident reported not receiving her scheduled pain medication at times, and the Director of Nursing confirmed that it was the facility's expectation for staff to administer pain medication as ordered.

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