Failure to Accurately Document Medication Administration on MARs
Penalty
Summary
The facility failed to maintain accurate medication administration records (MAR) in accordance with professional standards for three residents. For each resident, there were discrepancies between the narcotic log sheets and the MARs. Specifically, medications such as Oxycodone/Acetaminophen and Morphine Sulfate were documented as administered on the narcotic log sheets, but these administrations were not recorded on the corresponding MARs for multiple dates. One resident with primary generalized osteoarthritis and multiple wounds, who was also under hospice care, had several instances where the narcotic log indicated administration of Oxycodone/Acetaminophen, but the MAR did not reflect these administrations. Another resident with a stage 2 pressure ulcer and chronic pain, also on hospice, had Morphine Sulfate administration documented on the narcotic log but not on the MAR. A third resident with spinal stenosis and a stage 2 pressure ulcer, also under hospice care, had multiple doses of Oxycodone/Acetaminophen recorded on the narcotic log but not on the MAR. Interviews with nursing staff, including an LPN and the DON, confirmed that facility procedures require nurses to document medication administration on both the narcotic log and the MAR. Both staff members acknowledged that the narcotic log and MAR should match, and confirmed that in these cases, the MARs did not accurately reflect the administrations recorded on the narcotic logs.