complaint·March 11, 2026

Report Continued from LIC 9099C... It was alleged that staff does not ensure resident's prescribed medication is filled. It was reported that pain medication had been prescribed for the resident; however, the resident had not yet received the medication. A review of R1’s physician’s report dated 09/17/2025 lists the primary diagnoses as metabolic encephalopathy, emphysema, protein-calorie malnutrition, alcohol dependence, immunodeficiency, GERD, repeated falls, depression, neuropathy, and cannabis abuse. According to the report, R1 is able to care for their own personal needs, including bathing, dressing/grooming, feeding, managing toileting needs, managing personal cash resources, communicating their needs, following directions and instructions, and leaving the facility unsupervised. R1’s routine medication list includes Gabapentin 300 mg, one capsule by mouth three times daily; Aspirin EC 81 mg, one tablet by mouth once daily; and Lidocaine 4% patch, applied to the affected area for 12 hours once daily for pain. According to the medication review, R1’s routine medications are being administered as prescribed. Additionally, R1 has PRN medications that include Acetaminophen 325 mg, take two tablets by mouth every four hours as needed for pain, and Ibuprofen 800 mg, take one tablet by mouth every eight hours as needed for moderate to severe pain. However, according to the medication review, Ibuprofen has only been administered six (6) times since it was filled on 02/17/2026. An interview conducted with R1 revealed that they are currently taking Gabapentin for neuropathy pain. Although they experience pain and are aware that PRN pain medications are available, they prefer not to take them because they feel the medications take too long to take effect. Interviews conducted with staff revealed that R1 does have PRN pain medications prescribed; however, the resident does not request the medication to be administered when staff assist with routine medications. Staff also reported that all prescriptions are sent directly from the prescribing physician’s office to the pharmacy and then delivered to the facility. Furthermore, seven out of seven residents interviewed reported no concerns regarding their medications. Based on the information obtained and reviewed, the Department has insufficient evidence to say the alleged violation occurred. Therefore, allegation “staff does not ensure resident's prescribed medication is filled” is deemed Unsubstantiated at this time. Exit interview conducted. A copy of the report was provided.