Failure to Timely Provide Prescribed Pain Medication
Penalty
Summary
The facility failed to timely provide prescribed medication to meet the needs of a resident admitted for rehabilitation following an acute care stay. The resident had multiple diagnoses, including paralytic syndrome after cerebral infarction, pain, hypertension, dementia, restless leg syndrome, neuralgia/neuritis, and a sacral ulcer. A physician's order for Tramadol 50 mg to be administered four times daily was written, but the medication was not available and not administered at multiple scheduled times over several days, as documented in the Medication Administration Record (MAR). Interviews with the Assistant Director of Nursing (ADON), a Registered Nurse unit manager, and an LPN revealed that there was no valid reason for the delay in obtaining the medication, as the pharmacy could have delivered it within four hours if contacted. The LPN stated that the process required the doctor to call the pharmacy, but also mentioned that the resident's spouse did not want the medication administered due to concerns about drowsiness. There was no documentation that the physician was contacted when the medication was unavailable, and the LPN was unsure if this step had been taken.