Failure to Include Stop Dates for PRN Psychotropic Medications
Penalty
Summary
The facility failed to ensure that physician orders for as-needed (PRN) psychotropic medications included a required stop date for two residents who were receiving Lorazepam for anxiety. Specifically, one resident had two separate PRN orders for Lorazepam, both lacking a stop date, and another resident also had a PRN Lorazepam order without a stop date. Both residents were on hospice care at the time. During an interview, the Assistant Director of Nursing acknowledged that sometimes a 14-day stop date is provided and sometimes it is not, and that chart audits are performed to identify and correct such omissions. Facility policy requires that PRN psychotropic medications not be used beyond 14 days unless the prescribing practitioner documents the clinical rationale and expected duration for continued use.