Failure to Administer Ordered Narcotic Pain Medication Due to Authorization Delay
Penalty
Summary
The facility failed to ensure that a resident received their prescribed narcotic pain medication as ordered by the physician. The resident, who was cognitively intact and had diagnoses including multiple sclerosis and chronic pain, was ordered to receive hydrocodone/acetaminophen every six hours, along with other pain management medications. According to the medication administration record, the resident did not receive the hydrocodone/acetaminophen at multiple scheduled times over a two-day period. Nursing notes indicated that the resident was given ibuprofen for a reported pain level of 7, and later had no complaints of pain, but the prescribed narcotic was not administered as ordered. The administrator confirmed that the facility was waiting for prior authorization from the resident's insurance for the hydrocodone/acetaminophen, resulting in a lapse in administration of the medication. The last dose of the narcotic pain medication was given the evening before the missed doses began. When asked about their pain, the resident expressed significant distress, stating they were "dying without their pain medication" and described their pain as severe. The failure to provide the ordered pain medication was directly related to the delay in obtaining insurance authorization.