complaint·June 16, 2022

Allegation states that resident has had the facility manage his medications for 2 years and has concerns about staff turnover and lack of supervision of the medication staff and has requested to manage his own medications. The facility is denying his request and has told him this is not possible. Resident states he is aware of all the medications he needs to take and the times he is required to take them. Resident has been reassessed and his physician has indicated resident can manage their own medications. The results of the investigation are as follows: Regional Nurse, Alisa Salluce, indicated on 3/22/22 that Regional Nurse, Cindy Barnes, consulted with her prior to assessing resident the first time to determine if resident could identify the medications he takes, and the reason and side effects of each one. Both regional nurses stated that several opportunities were given to resident who was not able to identify the majority of the medications being taken, or the reason or side effects of each one. Additionally, both regional nurses stated that Regional Nurse Barnes reached out to resident's Physician's Assistant to come in to the facility to assess resident with her, but it was not agreed upon. Following the phone call, resident's Physician's Assisted then immediately rescinded, on 3/14/22, her prior authorization, noted on the physician's report, allowing resident to mange his own medications. LPA observed fax documentation showing the authorization was rescinded from 'Yes" to "No" for resident to manage his own medications. LPA observed that resident's physician's Assistant wrote an order, effective 3/30/22, for resident to manage his own medication with the assistance of his daughter. Regional Nurse Barnes stated that she provided resident with two different opportunities in March 2022 to identify his meds and explain what each medication is for and the side effects and resident was not able to identify all of the meds he takes, and stated "he needs to be able to identify and know what meds he takes". They would also still need to provide supervision to ensure that resident is taking them per doctor's orders. Administrator, Kimberly Hagen, stated she spoke with resident on 4/15/22 and explained that if staff is supervising him while he takes medications that are prepared by resident's family member, they are still supervising him, and resident must be enrolled in the medication program. On 5/13/2022, LPA had a virtual meeting with resident, resident's representative, Administrator, and Regional Nurse Barnes to discuss the matter of resident managing his own medications further. Resident's representative explained that resident's physician and she and resident agreed that resident will have a check-list of what meds to take at which time to be able to manage his own medications. prescription. cont on 9099C(2)... Regional Nurse Barnes stated that resident needs to be able to identify his medications and he takes a lot of them, explaining that resident is currently managing his PRN meds in his room and the doctor keeps giving him more and some are prescription. Administrator stated on 5/13/22 that resident refused to discuss what medications any further with staff. LPA explained that the Department's nurse also reviewed the request for resident to manage his own medications and the facility would need to "develop a care plan that addresses his needs, restricted health condition and medications" and the care plan should indicate how to meet all of these requirements. Resident and resident's representative stated during the meeting on 5/13/22 that resident does not have to show the facility he can identify each medication he takes to be allowed to manage his own medications. LPA reviewed documentation of "Medication Policy" signed on 12/17/2019 by resident which says residents "can keep medicine in their apartments only if you manage all of your medications". Regional Nurse Barnes stated that they have Title 22 regulations to follow with the state as well as their own policy and cannot allow resident to manage his own medications if he cannot identify them and express his understanding of the reason for the medication and the side effects of usage. Based on information obtained during the investigation, LPA finds the allegation to be UNFOUNDED- A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. Exit interview conducted. Copy of report provided to Executive Director.