Failure to Honor Resident's Right to Refuse Medications
Penalty
Summary
A deficiency occurred when facility staff failed to honor a resident's right to refuse medications and treatments. The resident, who had diagnoses including myxedema coma and dysphagia and demonstrated intact cognition, repeatedly refused prescribed medications. Despite these refusals, staff made multiple attempts to administer the medications, including mixing them into a nutritional supplement without a provider's order. On one occasion, a medication technician enlisted another staff member to physically hold the resident's arm while attempting to administer the medications, resulting in the resident spitting out the mixture and expressing distress. Progress notes and staff interviews confirmed that the resident was agitated, cried, and verbally objected to the administration attempts. Facility policy states that residents have the right to refuse medications and treatments, and staff are expected to document and report refusals rather than attempt to coerce or force compliance. Interviews with the DON and Nurse Practitioner confirmed that medications should not be mixed into food or drink to coerce residents, and refusals should be documented and reported to medical providers. The actions taken by staff, including physical restraint and unauthorized mixing of medications, directly violated the resident's rights and facility policy.