F0684

D

Incomplete Physician Orders for Residents Receiving Methadone at Outside Clinics

Cheswick, Pennsylvania Survey Completed on 03-04-2026

Penalty

No penalty information released

Summary

The facility failed to obtain complete physician orders for residents receiving methadone treatment at outside clinics. For one resident with diabetes, anxiety, and chronic pain, the clinical record showed methadone orders for chronic back pain, including a schedule that split doses between the facility and an outpatient methadone clinic. However, these orders did not include the name, address, or phone number of the methadone clinic, the time of the clinic appointments, transportation service information, the need for an escort for all appointments, or instructions for monitoring for side effects. The facility’s policy for transfers to outside appointments required verification of a physician order for the appointment/consult and arrangements for transportation and escort as appropriate.

A second resident with arthritis, anxiety, and chronic pain also had incomplete methadone-related orders. Nursing documentation indicated the resident left via wheelchair with a nurse escort to an appointment, and physician orders directed that the resident dose every Monday at a clinic and receive six take-home doses to be administered by facility staff, with additional orders specifying daily methadone dosing at the facility on non-clinic days. These orders likewise omitted the methadone clinic’s name, address, and contact phone number, the appointment time, transportation service information, the need for an escort for all appointments, and monitoring for side effects. During interviews, nursing staff and the DON described a process in which residents go to the clinic weekly with a nurse escort and transportation arranged by a scheduler, but the DON later acknowledged that the existing orders for the residents going to the methadone clinic were incomplete.