Failure to Ensure Timely Medication Administration and Adequate Nursing Staff Competency
Penalty
Summary
The facility failed to ensure competent nursing staff were available to provide timely medication administration and to meet residents' physical and psychosocial needs. One resident reported issues with a travel nurse, including concerns about the nurse's attitude and timeliness in completing care. Multiple residents had also complained about the care provided by travel nurses, as documented in resident council meeting minutes. Staff responsible for covering nurse call-offs stated that some travel nurses did not request assistance when running late, resulting in late medication administration. The facility primarily relied on travel nurses due to recruitment challenges, with only one full-time nurse on staff. A review of medication administration records for a resident showed that several medications, including Lisinopril, Cystex, Miralax, and acetaminophen, were administered significantly later than the scheduled times on multiple occasions. Facility policy allows a one-hour window before and after the scheduled time for medication administration, but the medications in question were given well outside this window. The facility's staffing plan and competency requirements were reviewed, but the deficiency was related to the actual practice of timely medication administration and the ability of staff, particularly travel nurses, to meet residents' needs.