Failure to Protect Resident's Property: Missing Controlled Medication
Penalty
Summary
The facility failed to protect a resident's property from misappropriation when a medication card containing approximately six doses of alprazolam, prescribed for anxiety, and the corresponding narcotic sheet were discovered missing from the medication cart. The resident involved had diagnoses of anxiety disorder and major depressive disorder, with a BIMS score indicating moderate cognitive impairment. The missing medication was first noticed by a CMA, who was unable to locate the narcotic sheet at the nurse's desk and subsequently reported the incident to the DON. The DON confirmed being notified of the missing medications but was unable to determine what had happened to them. This incident demonstrates a failure to ensure the security of a resident's controlled medication and related documentation, as required by facility policy prohibiting misappropriation of property.