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F0757
D

Failure to Administer Medications Within Physician-Ordered Parameters

Overland Park, Kansas Survey Completed on 06-26-2025

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 ensure that medications were administered according to physician orders and within prescribed parameters for multiple residents. One resident with a history of hypotension, cognitive impairment, and other medical conditions received midodrine, an anti-hypotensive medication, outside of the physician-ordered blood pressure parameters on eight documented occasions. The medication was administered even when the resident's systolic blood pressure exceeded the maximum threshold specified in the order. Documentation also showed that the care plan required staff to observe for adverse effects and report to the physician as needed, but there was no evidence that the deviations from the order were reported. Another resident with severe cognitive impairment, hypertension, diabetes, and a history of stroke was prescribed metoprolol, an antihypertensive medication, with specific instructions to hold the medication and notify the physician if the systolic blood pressure was below 90 or the pulse was below 60. However, review of the medication administration records revealed that staff failed to monitor and document the resident's blood pressure and pulse prior to administering metoprolol on all opportunities in one month and on multiple occasions in the following month. There was no documentation that the physician was notified about the lack of required monitoring prior to medication administration. Interviews with nursing staff and administrative personnel confirmed that the expectation was to follow physician orders, including monitoring vital signs as required by medication parameters. The facility's policies also required accurate implementation of medication orders and adherence to the resident's plan of care. Despite these policies, staff did not consistently monitor or document vital signs as required, nor did they report deviations from physician orders, resulting in the administration of medications outside of prescribed parameters.

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