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F0760
D

Failure to Provide and Administer Prescribed HIV Medication

Los Angeles, California Survey Completed on 12-09-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that a necessary medication, Biktarvy, prescribed for the treatment of HIV, was available and administered as ordered for a resident. The resident was admitted with a diagnosis of HIV and had a physician's order for daily administration of Biktarvy. Despite this, the resident did not receive the medication for six consecutive days, as documented in the Medication Administration Record (MAR), with the reason for omission noted only on the first day and no further documentation for the subsequent days. Review of the resident's medical chart and nursing progress notes revealed that the medication was not administered due to a lack of supply, and the nurse had contacted the pharmacy regarding a refill. However, there was no documentation explaining the omissions for the remaining days, nor evidence of ongoing assessment or follow-up as required by facility policy. The resident expressed concern about missing doses and reported symptoms of diarrhea, as well as anxiety about the interruption in treatment. Interviews with facility staff confirmed that the medication was not available due to issues with insurance coverage and the need for a physician appointment to obtain a refill. The Director of Nursing verified the omissions and acknowledged that the medication should have been administered as ordered, and that omissions should have been properly documented and communicated. Facility policy required immediate assessment and documentation of any medication omissions, which was not followed in this case.

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