complaint·January 10, 2024

[CONTINUED FROM LIC 9099] According to R1’s prescribed medication orders: During the time-frame of the complaint, R1’s had only one medication which was in suppository form. R1’s doctor determined that this suppository could be given “rectally every day as needed for constipation, not to exceed one dose per 24 hours.” The prescription limited only the maximum amount to be given in a day; it did not specify a maximum number of days R1 could go without a bowel movement (BM) before the suppository was required to be given. According to the facility’s Medication Administrator Records (MARs): During April 2021, R1 was given the suppository once on 04/05/2021 (resulting in a medium BM), and once on 04/24/2021 (resulting in a large BM). During May 2021, R1 was given the suppository once on 05/04/2021 (resulting in a large BM), and once on 05/16/2021 (resulting in an extra-large BM). According to the facility’s Bowel Movement Logs: During April 2021, R1 had a total of 28 BMs, of which 23 BMs occurred on days when no suppository was given. On the two days when the suppository was given, R1 had not had a BM during the preceding four days. On all other days in April 2021, R1 had at least one BM every two days. During May 2021, R1 had a total of 24 BMs, of which 20 BMs occurred on days when no suppository was given. On the first day the suppository was given, R1 had not had a BM in the preceding three days. On the second day the suppository was given, R1 had not had a BM in the preceding two days. On all other days in May 2021, R1 had at least one BM every day, or every other day. According to R1’s LIC602 Physician’s Report (dated 10/15/2020): R1 was diagnosed with Alzheimer’s Disease. R1’s hospice agency records and facility care records corroborated this. Due to their baseline memory loss, R1 was unable to be a reliable historian/interviewee for this investigation. Based on record reviewed and interviews, a preponderance of evidence does not exist to prove that licensee did not give R1’s suppository as it was prescribed and needed by R1. The allegation is therefore unsubstantiated. An exit interview was conducted with Armour, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.