Late Administration of Scheduled Medications Outside Required Time Frame
Penalty
Summary
The deficiency involves the facility’s failure to administer scheduled medications as ordered by the physician and within the facility’s required time frame for one resident. The resident was admitted with diagnoses including hypertension and constipation and had active physician orders for Metoprolol Tartrate 25 mg via G-tube twice daily for hypertension, with parameters to hold for heart rate less than 65 or systolic blood pressure less than 100, and MiraLax 17 gm/scoop via G-tube twice daily for constipation. The March 2026 MAR showed both Metoprolol and MiraLax were scheduled for 9:00 AM but were not administered until 12:07 PM on a specific date, outside the facility’s accepted window of one hour before or one hour after the scheduled time. During interview, the nurse who administered the medications stated he was an agency nurse working intermittently at the facility and reported that he fell behind on morning medication administration and did not give the resident’s morning medications until noon. He acknowledged that he did not request assistance to ensure medications were given on time. The DON stated that medications were required to be administered on time, that agency staff had been instructed to request assistance if they fell behind, and that medications should be given within one hour before or after the scheduled time. The Medical Director confirmed that the resident experienced no ill effects and that vital signs remained within normal limits, and he acknowledged the facility’s requirement that medications be administered within the one-hour window and his expectation that staff follow this policy.
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