Failure to Administer Ordered Medication and Notify Physician
Penalty
Summary
The facility failed to provide the highest practical care related to medication administration for a resident with a physician's order for Humira to treat psoriasis. The resident was admitted on November 11, 2024, and had multiple physician orders for Humira beginning June 30, 2025, including changes in dosage and frequency. Despite these orders, nursing documentation repeatedly noted that Humira was unavailable due to pending prior authorization from the pharmacy, with entries on June 30, July 8, July 21, August 4, August 18, and September 1, 2025, all indicating the medication was not available and had not been administered. Throughout this period, there was no documentation that the resident's physician was notified of the ongoing unavailability of Humira until September 1, 2025, despite the medication never being administered since the initial order. The deficiency was confirmed by interviews with the Nursing Home Administrator and Director of Nursing, who were unable to provide evidence of timely physician notification regarding the missed medication doses.