Failure to Administer Medications and Treatments per Physician Orders
Penalty
Summary
The facility failed to provide appropriate treatment and care according to physician orders, resident preferences, and goals for multiple residents. For one resident with diagnoses including dysphagia and rhabdomyolysis, there was a physician's order for weekly weights, but only one weight was obtained over several weeks, and there was no documentation of refusal or explanation for the missed weights. Nursing assistants were responsible for obtaining weights, but the resident was only listed for monthly weights, contrary to the physician's order. The facility's policy required weights to be obtained as ordered, but this was not followed. Another resident with spina bifida and a stage 4 pressure ulcer did not receive a prescribed topical medication because it was not available in the facility. The LPN responsible for reordering the medication delayed faxing the request to the pharmacy, resulting in missed doses. There was no documentation that the physician was notified about the missed medication, as required by facility policy. Additionally, the medication was not available for administration for more than a day, and the resident missed several scheduled applications. For three residents, medications were not administered at the scheduled times according to physician orders. An LPN administered morning medications several hours late without notifying the physician, and the medication administration record was inaccurately documented to reflect the scheduled rather than actual administration times. Another resident missed multiple scheduled medications, including antipsychotics, blood thinners, and diabetic agents, with no documentation of refusal or explanation in the nursing notes or MAR. The facility's policies required timely administration and documentation, but these were not followed.