Failure to Facilitate Resident Choice of Pharmacy for VA Medications
Penalty
Summary
The facility failed to ensure that a resident and/or their representative was able to exercise the right to choose a pharmacy, specifically regarding the use of Veterans Administration (VA) pharmacy benefits. The resident, who had no cognitive impairment and diagnoses including diabetes, Alzheimer's disease, anxiety disorder, and agitation, was documented as a veteran eligible for VA medications. Despite this, the facility did not facilitate the process for the resident to receive medications through the VA, resulting in the resident paying full price for multiple medications. Documentation showed that the resident's spouse inquired about VA coverage, and the Social Services Coordinator, Administrator, and Director of Nursing were made aware of the issue. However, the process to obtain VA medications was not completed, and the resident continued to receive medications outside of the VA system. Staff interviews and record reviews revealed that the necessary steps to transition the resident's medications to the VA pharmacy were not followed through, partly due to staff turnover and miscommunication. The Administrator assumed the process was handled after initial paperwork was completed, but later discovered it had not been finalized. The record lacked evidence that the resident was ever successfully enrolled to receive VA medications, and staff confirmed that the resident was not receiving medications through the VA at the time of the review.