Failure to Obtain Written Medication Consents for Two Residents
Penalty
Summary
The facility failed to ensure that two residents, both with significant medical and cognitive conditions, or their legal representatives, were fully informed and provided written consent for prescribed medications, including psychotropic and anticonvulsant drugs. For one resident with moderately impaired cognition and an activated Power of Attorney for Healthcare (POAHC), verbal consent was obtained for medications such as divalproex sodium (Depakote), buspirone, and clindamycin, but there was no documentation of written consent signed by the POAHC. This resident had diagnoses including dementia, stroke, diabetes, seizures, and depression, and was unable to make healthcare decisions independently. Another resident, who was cognitively intact and made their own healthcare decisions, was prescribed multiple medications including quetiapine, hydroxyzine, Ambien, Lyrica, Lexapro, and oxcarbazepine for conditions such as bipolar disorder, depression, anxiety, insomnia, and neuropathic pain. The facility did not obtain any medication consents for these psychotropic medications. The Nursing Home Administrator confirmed that signed medication consents should have been obtained for both residents.