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F0697
D

Failure to Follow Pain Management Orders and Document Nonpharmacological Interventions

New Haven, Indiana Survey Completed on 01-09-2026

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

A resident with multiple pain-related diagnoses, including arthritis, lupus, and sciatica, had physician orders for oxycodone-acetaminophen to be administered every 8 hours as needed for severe pain greater than 7 on the pain scale. However, the medication was administered on several occasions when the resident reported pain levels below the threshold specified in the order, with documented pain scores of 4 and 6. There was no documented justification for administering the medication outside the prescribed parameters. Additionally, the resident's care plan included interventions for nonpharmacological pain management, such as position changes, relaxation, a quiet environment, back rubs, and diversional activities. Despite this, there was no documentation in the progress notes that these nonpharmacological interventions were provided on the dates when the medication was administered for pain levels below 7. The DON confirmed that the medication should not have been given for pain less than 7 and could not provide a reason for the deviation from the physician's order.

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