Failure to Provide Timely and Appropriate Pain Management
Penalty
Summary
A resident with a recent C2 vertebra fracture, chronic pain syndrome, depression, anxiety disorder, and insomnia was admitted to the facility and consistently reported unmanaged pain and lack of staff response to requests for pain medication. The resident experienced long call light wait times and voiced concerns that staff, particularly an LPN, were not assisting with her needs. Documentation shows that the resident was in significant pain, as evidenced by pain scores of 10, and was heard yelling in discomfort when repositioned. The resident did not receive her prescribed acetaminophen on the first day and had to wait for narcotic pain medication due to delays in prescription processing and pharmacy communication issues. Staff interactions with the resident were marked by escalating behaviors and verbal altercations. The LPN instructed CNAs to provide care in pairs due to the resident's behaviors and eventually advised staff to avoid the resident for their own safety, following continued threats and verbal abuse from the resident. The LPN was later suspended for inaccurate and subjective charting and for instructing staff to stop providing care to the resident. During this period, the resident continued to express pain and dissatisfaction with the care provided, ultimately deciding to leave the facility against medical advice. The facility's medication administration records confirmed that the resident did not receive all prescribed pain medications in a timely manner. Delays were attributed to prescription errors and issues with the medication dispensing system. Interviews with staff and review of progress notes indicated that the resident's pain was not adequately managed during her short stay, and staff responses to her needs were inconsistent and, at times, insufficient.