Failure to Limit PRN Psychotropic Medication to 14 Days Without Provider Rationale
Penalty
Summary
The facility failed to ensure that as needed (PRN) psychotropic medications for a resident included a stop date not exceeding 14 days, as required. A male resident with diagnoses of schizoaffective disorder, bipolar disorder, and anxiety disorder was prescribed hydroxyzine, an antihistamine also used for anxiety, on a PRN basis. The medication orders were written with start and discontinue dates that exceeded the 14-day limit for PRN psychotropic medications, and there was no documentation of a provider rationale to justify extending the use beyond this period. During an interview, the Director of Nursing (DON) confirmed that PRN psychotropic medications should be limited to 14 days unless a provider documents a rationale for extension. Review of the resident's orders showed that the required 14-day stop dates were not implemented for both instances of the hydroxyzine prescription, and no provider rationale for the extended use was provided by the time of the survey exit.