Failure to Administer Ordered Lyrica Due to Lack of Timely Physician Authorization
Penalty
Summary
The deficiency involves the facility’s failure to provide pharmaceutical services and administer Lyrica as ordered for a resident with neuropathy. The resident was admitted with diagnoses including diabetes mellitus and end stage renal disease on hemodialysis, and had intact cognition but required varying levels of assistance with ADLs. The physician’s order, dated at admission, specified Lyrica 150 mg by mouth three times daily for neuropathy. Review of the MARs for December and January showed that Lyrica was not administered, with documentation indicating the medication was unavailable from the pharmacy. The DON reported that the pharmacy had faxed a Request for New/Continuance of Schedule II–V Medication Therapy authorization to the facility and the attending physician, but the physician did not respond. The DON stated the attending physician was not responding to the facility or pharmacy regarding the resident’s care, and that the medical director subsequently took over the resident’s care. The registered pharmacist stated that the pharmacy faxed the authorization request on two occasions, but the authorization was not received from the physician until several weeks later, and the pharmacy was not informed of the change in attending physician. Facility policies on Medication Therapy and Physician Services required review of the medication regimen shortly after admission and ensuring another physician supervises care when the attending is unavailable, but Lyrica remained unavailable and was not administered as ordered during the period reviewed.
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