Failure to Provide Timely Administration of Ordered Medication Due to Ordering and Authorization Delays
Penalty
Summary
The facility failed to ensure that a resident's physician orders for Zepbound, a medication prescribed for diabetes management and weight loss, were followed and that the medication was available for administration as scheduled. The resident, who was cognitively intact and had diagnoses including class III obesity and type 2 diabetes with neuropathy, did not receive her ordered Zepbound injection on the scheduled day. The medication administration record confirmed the dose was missed, and the resident reported to staff that she had not received her shot within the expected timeframe. Staff interviews revealed that the medication was not present in the facility at the time it was due, and it was still on order. Further investigation showed that the delay was due to issues with insurance prior authorization, requiring administrative approval before the pharmacy could dispense the medication. The pharmacy confirmed that a refill request was received, but the medication was not covered by insurance, prompting them to contact the facility for approval. The administrator authorized the medication after being contacted by the pharmacy, but there was a lack of clarity regarding who was responsible for ensuring the medication was available for timely administration. This resulted in the resident missing a scheduled dose of her prescribed medication.