Failure to Follow PRN Oxycontin Pain-Level Parameters
Penalty
Summary
The deficiency involves the facility’s failure to provide pain management in accordance with professional standards and the physician’s orders for one resident receiving oxycontin for pain. The resident reported that at times the facility did not have his pain medication available and had to obtain it from the emergency supply. Physician orders dated 12/16/25 and 01/05/26 specified oxycontin 5 mg by mouth every four hours as needed for severe pain, to be used only when the resident’s pain level was 8 or above on a 0–10 pain scale. The pain scale defined 8 as very strong pain, 9 as intense pain with inability to converse, and 10 as the worst pain possible. Medication Administration Record review showed that staff repeatedly administered oxycontin when the resident’s documented pain scores were below the ordered threshold of 8. In December, oxycontin was given on multiple dates when pain levels were recorded as 5, 6, and 7, and in January it was administered when pain levels were documented as low as 2 and 3, as well as 5 and 6. During interview, an RN acknowledged she was not used to following physician orders that specified a particular pain level and confirmed that all administrations with pain levels under 8 did not follow the physician’s orders. The Regional Nurse Consultant also confirmed that the oxycontin orders had not been followed when the medication was administered for any pain level under 8.
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