Misappropriation of Narcotic Medication by LPN
Penalty
Summary
An LPN at the facility misappropriated narcotic pain medication prescribed to two residents who were both cognitively impaired and unable to advocate for themselves. The LPN was regularly assigned to these residents and documented the administration of hydrocodone-acetaminophen on the narcotic count sheets, but did not record these administrations on the residents' Medication Administration Records (MARs). The discrepancies were discovered when another nurse noticed unusual documentation and a rapid decrease in the pill count for one resident, despite the resident rarely requesting or receiving narcotic pain medication. Upon review, it was found that the LPN had signed out significantly more doses on the narcotic count sheets than were documented as administered on the MARs for both residents. The LPN admitted to taking the medication for personal use, stating she was in pain and did not have health insurance. She described a method of removing the medication from the cart, signing it out, and then pretending to administer it in the resident's room, where she would instead pocket the pills. The facility's audit confirmed that the LPN had taken a substantial number of pills over a period of several weeks. The residents involved had diagnoses including chronic pain, GERD, osteoarthritis, and cholecystitis, and were prescribed hydrocodone-acetaminophen on an as-needed basis. Both residents were described as not interviewable and did not have a history of frequent narcotic use. The misappropriation was only detected due to the vigilance of another nurse who noticed inconsistencies in the documentation and pill counts, leading to an internal investigation and subsequent admission by the LPN.