Failure to Follow Professional Standards for Medication Administration
Penalty
Summary
The facility failed to adhere to professional standards for medication administration for three residents. For one resident, a controlled pain medication (Norco) was administered at intervals shorter than the physician-ordered four hours, with doses given three hours apart and no documentation providing a rationale for this deviation. Another resident received Percocet doses at intervals of 2 to 2.5 hours instead of the ordered four hours, with no documentation explaining the early administration. In both cases, the medication administration records and electronic medical records lacked required documentation to justify the timing discrepancies. A third resident, prescribed Metoprolol with specific parameters to hold the medication if blood pressure or heart rate were below set thresholds, did not have vital signs assessed prior to several evening doses. Instead, morning vital sign results were inappropriately documented as if they were taken before the evening doses. The facility's own medication administration policy requires obtaining and recording vital signs when applicable or as ordered by the physician, and to hold medication for vital signs outside prescribed parameters. The Nursing Home Administrator confirmed these errors and reported no additional documentation to refute the findings.