complaint·June 18, 2024

LPA interviewed outside agency (OA) who stated that the facility Administrator does not allow their staff to administer morphine to residents. OA stated that together R1's responsible party, the hospice agency and facility administrator devised a plan for R1's responsible party to administer the morphine to R1. OA stated that teaching was provided and that everyone was in agreement with the plan. OA further stated that they have a "good working relationship" with the facility since they are "not new" and they have worked with them in the past. OA further stated that they have provided various training's to the facility. LPA interviewed Administrator who stated that facility staff does not administer any form of morphine to the hospice residents. Administrator stated that the normal procedure for end stage hospice is they report symptoms to hospice; then they are instructed which medications to give. If hospice instructs to give morphine to a resident, the facility staff would give the morphine to the trained family member to administer, unless the hospice nurse is present at the facility. Administrator stated that the family had the option to wait for the hospice nurse to arrive or to administer the medication themselves. Administrator stated that on June 4, 2024 she along with R1's responsible party contacted the hospice agency to advise them of R1's symptoms. Hospice nurse authorized R1's responsible party to administer the morphine so that R1 would not have to wait in distress until she arrived at the facility. LPA reviewed outside agency clinical notes dated June 4, 2024. Clinical notes indicated Hospice nurse met with R1's responsible party and administrator for update. Clinical notes indicated that R1's responsible party administered morphine to R1 one hour prior to RN's arrival. Clinical notes further stated that R1 appeared to be transitioning to end of life care. Upon thorough investigation, it was determined that R1's responsible party, under the guidance of the hospice agency, administered the medication (morphine) to R1 as per established protocols and instructions provided by the hospice agency. Based upon the foregoing, the above listed allegation is unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegation is not valid. An exit interview was conducted with Jullia Arida. A copy of this report along with licensee rights (LIC 9058, 3/22) was provided to Jullia Arida whose signature below verifies receipt of these rights.