Late Administration of Scheduled Morning Medications Beyond Allowed Time Window
Penalty
Summary
The deficiency involves the facility’s failure to ensure medications were administered within the facility’s required time window for one resident. During an observation, an LVN was seen preparing and administering a group of seven scheduled medications for a resident, including docusate sodium 100 mg, escitalopram 10 mg, levetiracetam (Keppra) 500 mg, losartan 50 mg, a multivitamin with minerals, vitamin D3 125 mcg (5000 IU), and ferrous sulfate 325 mg. The resident was seated in a wheelchair while the LVN measured the resident’s blood pressure and then prepared and administered the medications. The administration occurred at approximately 11:00 AM, even though the medications were scheduled for 9:00 AM, placing the administration more than one hour after the scheduled time. Interviews with staff confirmed that the facility’s policy required medications to be administered within one hour before or one hour after the scheduled time, and that nurses were to follow the “Right Time” as part of the six rights of medication administration. The RN supervisor stated that morning medications were scheduled at 9:00 AM with an 8:00 AM to 10:00 AM administration window, and acknowledged that with an average assignment of 30 residents per nurse and approximately 5 minutes per resident, some medication passes could extend beyond the 2-hour window. The LVN who administered the medications acknowledged awareness that the medications for this resident were late and attributed the delay to unforeseen events on the unit. The facility’s written policy confirmed the requirement to administer medications within the ordered time window, which was not met in this instance.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.