F0755

D

Failure to Administer and Properly Manage Ordered Repatha Injection

Marshall, Texas Survey Completed on 02-19-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to provide pharmaceutical services that ensured accurate acquiring, receiving, dispensing, and administering of medications for a resident receiving Repatha injections for hyperlipidemia. The resident, an older adult female with a history of CVA, hemiplegia, and hyperlipidemia, had an order and care plan interventions for Repatha 140 mg/mL subcutaneous every two weeks. Review of the January MAR showed the Repatha dose due on 01/26/2026 was not administered by the assigned LVN, despite the standing order. The resident reported she missed her cholesterol injection at the end of January, that no one contacted the MD, and that her family brought the medication to the facility the day after it was due.

The LVN acknowledged missing the Repatha injection scheduled for 10:00 a.m. on 01/26/2026, stating the family supplied the medication and could not bring it on time due to weather, and that she marked the dose as not given but did not document the reason for the missed dose on the MAR or notify the MD. She also stated she was unaware she needed to call the MD when a medication was unavailable. The DON confirmed the resident missed the injection because the family could not bring the medication during an ice storm and that it had been arranged prior to admission for the family to supply the drug due to cost. The DON further stated the nurse did not notify anyone that the medication was held and that the issue came to light only after the resident complained about the missed dose. Facility policy on medication administration required that whenever a medication is held, the nurse must circle initials on the MAR, document the reason on the back of the MAR, and notify the physician, which did not occur in this case.