Failure to Re-Evaluate PRN Psychotropic Medication and Monitor Behavioral Symptoms
Penalty
Summary
The facility failed to prevent the use of unnecessary psychotropic medication and chemical restraints for one resident by not providing ongoing re-evaluation of the need for PRN Haloperidol. The order for Haloperidol, prescribed for schizoaffective disorder, did not include an end date as required, and the medication was not limited to a 14-day period before re-evaluation by a physician. Additionally, there was no documented monitoring of the resident's behavioral manifestations related to schizoaffective disorder to determine the continued need for the medication. The resident involved had diagnoses including COPD, schizoaffective disorder, and unspecified dementia, with severely impaired cognitive functioning and required maximal assistance with daily activities. The facility's own policy required that antipsychotic medications be prescribed at the lowest possible dosage for the shortest period, with PRN orders not to be renewed beyond 14 days without physician evaluation and documentation. These requirements were not followed, as confirmed by staff interviews and record reviews.