Failure to Administer Pain Medication as Ordered
Penalty
Summary
The facility failed to provide safe and appropriate pain management for a resident with significant medical conditions, including a fistula of the vagina to the large intestine, malignant neoplasm of the rectum, and a cutaneous abscess of the buttock. The resident had physician orders for multiple pain medications, including morphine sulfate extended release, oxycodone with acetaminophen in two strengths for varying pain levels, and acetaminophen for mild pain. Despite these orders, the resident did not consistently receive the prescribed medications as scheduled or as needed. On several occasions, the medications were not administered because they were not available, and in some instances, the wrong medication or dosage was given in response to the resident's reported pain levels. Interviews with nursing staff and review of the Medication Administration Record (MAR) and Pain Level Summary revealed that the resident experienced moderate to severe pain, as indicated by pain scores ranging from five to eight out of ten, without receiving the appropriate pain medication. The Assistant Director of Nursing confirmed that the pain medications were not readily available, resulting in the resident experiencing unnecessary pain during daily activities. The facility's actions were not consistent with their Pain Assessment and Management policy, which required staff to identify and address pain according to the resident's needs and physician orders.