Failure to Provide Complete Discharge Medication List
Penalty
Summary
The facility failed to ensure that a resident's discharge medication list was complete and that all necessary medications were provided upon discharge. Specifically, the discharge medication list for one resident did not include Verapamil (for blood pressure), Ambien (for insomnia), and oxycodone-acetaminophen (for pain relief). Medical record review confirmed that these medications were ordered for the resident up to and including the day of discharge, but were not marked as given to the resident upon leaving the facility. The omission was verified during an interview with a registered nurse, who confirmed that the medications were not provided at discharge. The resident, who had diagnoses including PTSD, anxiety, and high blood pressure, reported leaving the facility because she did not receive her Verapamil or Ambien medications. The facility's records showed active orders for these medications, as well as for oxycodone-acetaminophen, at the time of discharge. The failure to provide these medications was identified through a complaint and subsequent review of the resident's medical and discharge records.