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F0755
D

Failure to Administer Prescribed Medication Due to Unavailable Supply

Baltimore, Maryland Survey Completed on 04-21-2025

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 to a resident as ordered, specifically regarding the administration of metformin, a medication used to treat type 2 diabetes. Record reviews and interviews revealed that the resident did not receive prescribed doses of metformin on multiple occasions over a two-month period. On certain dates, the medication was not available due to the facility waiting for pharmacy delivery, despite the medication not being new. Documentation on the Medication Administration Records (MAR) indicated missed doses, with some entries referencing progress notes for further explanation. Interviews with the resident confirmed that there were several occasions when the prescribed metformin was not provided because the facility had run out. The Director of Nursing (DON) verified that on specific dates, the medication was not administered due to delays in pharmacy delivery, and in some instances, there was no documentation explaining the missed doses. The facility's policy required established procedures to ensure a sufficient supply of medications for residents, but these procedures were not followed, resulting in the resident missing prescribed doses.

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