Failure to Administer Ordered Topical Antifungal Medication Every Shift
Penalty
Summary
The deficiency involves the facility’s failure to administer a prescribed topical antifungal medication as ordered by the physician for one resident. A physician order dated 07/09/24 directed that Nystatin powder be applied to the resident’s skin folds, abdomen, and neck every shift. A significant change assessment dated 11/17/25 documented that the resident had candidiasis of the skin and nails and a BIMS score of 15, indicating the resident was cognitively intact for daily decision making. Review of the November 2025 medication administration record for the night shift showed that the resident did not receive the ordered Nystatin powder on multiple specified dates throughout the month. During interview, the ADON stated that if the checkbox on the medication administration record was not marked to indicate completion, they assumed the task had not been done. These findings show that, despite an active physician order and documented skin candidiasis, the ordered Nystatin powder was not administered on numerous night shifts as required, and the facility relied on unchecked MAR boxes as an indication that the treatment had not been provided.
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