Failure to Provide Timely Access to Prescribed Medications
Penalty
Summary
The facility failed to ensure that prescribed medications were available and administered as ordered for two residents. For one resident with a history of heart failure and hypertension, the beta blocker Toprol XL 50mg was not administered from 8/8 to 8/11 because the medication was not available. The nurse on duty during those days stated that although she contacted the pharmacy for delivery, she did not retrieve the medication from the convenience box as required. The resident's care plan included interventions to administer medications as ordered for altered cardiac function, but the medication was marked as 'not available' in the electronic medication administration record for the missed dates. Another resident, diagnosed with low back pain, venous thrombosis, embolism, and post-traumatic stress syndrome with burn wounds, did not receive prescribed pain medication when requested during the night. The nurse confirmed that the pain medication was not available and, despite checking with the pharmacy and offering an alternative, did not obtain the medication from the convenience box. The resident reported a pain level of 8 out of 10 at the time. Facility policy requires staff to check for misplaced medications, contact the pharmacy, and obtain medications from the contingency or convenience box if available, but this protocol was not followed in these instances.