Failure to Dispose of Discontinued Narcotics and Administer Medications per Prescriber Orders
Penalty
Summary
The facility failed to provide proper pharmaceutical services by not ensuring the timely and appropriate disposal of controlled medications after residents were discharged. During a medication storage room inspection, surveyors found that narcotic medications belonging to two discharged residents remained in a locked narcotic box more than a week after the residents had left the facility. Facility policy required discontinued or leftover medications to be removed from current medication supply in a timely manner, but staff were unable to explain why these medications had not been destroyed as required. Additionally, the facility did not ensure that medications were administered according to prescriber orders. In one instance, a resident with Alzheimer's disease and dementia was given a half dose of PRN alprazolam at the request of family, despite the physician's order specifying a full tablet. The DON confirmed that the medication was administered in a dosage different from the order and was unable to provide documentation of a provider order authorizing the change. This administration was not in accordance with the Wisconsin Nurse Practice Act, which prohibits nurses from altering medication dosages without a prescriber's order.