Failure to Complete and Document Monthly Pharmacy Reviews and Physician Follow-Up
Penalty
Summary
The facility failed to ensure that a licensed pharmacist performed monthly drug regimen reviews, including review of the medical chart, as required by policy. For one resident, there was no evidence that pharmacy consultant reviews were completed for multiple consecutive months. Additionally, for several residents, the consultant pharmacist identified medication irregularities or made recommendations, but there was no documented evidence that these irregularities were recorded or that the attending physician addressed the pharmacist's recommendations. Specifically, one resident's record lacked pharmacy consultant reviews for several months, while other residents' records showed that identified medication irregularities or recommendations for gradual dose reduction were not documented as addressed by the physician. An interview with the Nursing Home Administrator confirmed the absence of documentation for both the pharmacy reviews and physician follow-up on pharmacy recommendations.