Unlicensed Staff Administered Prescription Medications
Penalty
Summary
Prescription medications for one resident were administered by a Certified Nursing Assistant (CNA), contrary to facility policy and regulatory requirements. The resident had diagnoses including anxiety disorder, depression, personality disorder, and unspecified psychosis, and had physician orders for Haloperidol Lactate and Valium. Facility documentation and interviews revealed that the CNA administered these medications using food, ice cream, and a syringe, with another staff member holding the resident's hand and the CNA holding the resident's chin to squirt the medication into the resident's mouth. This administration was performed under the direct supervision of a Registered Nurse (RN), but the CNA had not completed any medication administration training or competency evaluation. Facility policies explicitly state that only licensed nurses or nurse technicians are permitted to administer medications, and that CNAs may not administer medications except for applying topical creams to unbroken skin or providing oral care with mouthwashes. Despite this, the Director of Nursing (DON) confirmed that it was common practice for CNAs to administer medications under direct nurse supervision, without additional training or competency assessment. This practice was in direct violation of both facility policy and regulatory standards, resulting in the identified deficiency.