Physician Failed to Document Rationale for Disagreement with Pharmacist Recommendations
Penalty
No penalty information released
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 ensure that the physician documented the rationale for disagreeing with the pharmacist's recommendations regarding the discontinuation of several PRN medications for one resident. During a monthly drug regimen review, the pharmacist recommended discontinuing multiple PRN medications due to non-use, but the physician responded with 'Disagree' and left the rationale section blank. The document was signed by the physician without any explanation for the disagreement. Interviews with the Director of Nursing and the physician confirmed that pharmacy reviews are conducted monthly, and while the physician typically writes a rationale for disagreements, in this instance, no rationale was provided due to time constraints.