cms_WY: 26
Data source: Big Local News · About: big-local-datasette
rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
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26 | GRANITE REHABILITATION AND WELLNESS | 535013 | 3128 BOXELDER DRIVE | CHEYENNE | WY | 82001 | 2017-10-04 | 428 | E | 1 | 1 | GX9L11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on medical record review, pharmacy drug regimen review, and staff interview, the facility failed to ensure pharmacist recommendations were addressed for 8 of 16 sample residents (#3, #9, #17, #22, #64, #65, #82, #90). The findings were: 1. Review of the 8/28/17 to 8/29/17 Consultant Pharmacist Medication Regimen Review for resident #3 showed the pharmacist recommended the resident's scheduled Synthroid 25 micrograms (mcg) be changed from being given in the AM to being given at 6 AM or at HS (bedtime) in order to ensure the medication would be given on an empty stomach for optimal absorption. Review of the (MONTH) (YEAR) Medication Administration Record [REDACTED]. Further review of the medical record showed that the pharmacist recommendation had not been addressed. Continued review of the Consultant Pharmacist Medication Regimen Review showed the pharmacist noted that the resident's ordered eyedrops were scheduled to be given together. The eyedrop orders were for brimonidine 0.1% scheduled at HS (bedtime), timolol 0.5% scheduled at HS, and dorzolmide 2% scheduled at 8 AM, 2 PM, and 8 PM. The pharmacist made the recommendation to separate administration of each eye drop by at least 3 to 5 minutes. Review of the (MONTH) (YEAR) MAR indicated [REDACTED]. Review of the medical record showed that the recommendation had not been addressed. 2. Review of the 8/28/17 to 8/29/17 Consultant Pharmacist Medication Regimen Review for resident #17 showed the pharmacist recommended that the resident's scheduled Synthroid 50 mcg be changed from being given in the AM to being given at 6 AM or at HS (bedtime) in order to ensure the medication would be given on an empty stomach for optimal absorption. Review of the (MONTH) (YEAR) MAR indicated [REDACTED]. Review of the medical record showed that the recommendation had not been addressed. 3. Review of the 7/24/17 to 7/26/17, 8/28/17 to 8/29/17, and 9/25/17 to 9/26/17 Consultant Pharmacist Medication Regimen Reviews for resident #22 showed the pharmacist recommended that the resident's scheduled Flomax be changed from being given in the AM to being given approximately 30 minutes after the same meal each day since taking this drug on an empty stomach may increase risk of side effects such as blood pressure drop and dizziness. Review of the (MONTH) (YEAR) MAR indicated [REDACTED]. Review of the medical record showed that the recommendation had not been addressed. Continued review of the Consultant Pharmacist Medication Regimen Review showed the pharmacist recommended on 9/26/17 that the resident's 1/22/17 order for Seroquel 50 mg (milligrams) be given in the AM and be considered for a GDR (gradual dose reduction). Review of the (MONTH) (YEAR) MAR indicated [REDACTED]. Review of the medical record showed that the recommendation had not been addressed. 4. Review of the 7/24/17 to 7/26/17 and 8/28/17 to 8/29/17 Consultant Pharmacist Medication Regimen Review for resident #64 showed the pharmacist recommended the resident's scheduled Prilosec 20 mg be changed from being given in the AM to being administered approximately 30 minutes before the meal to achieve optimal therapeutic effect. Review of the (MONTH) (YEAR) MAR indicated [REDACTED]. Review of the medical record showed the recommendation had not been addressed. Continued review of the Consultant Pharmacist Medication Regimen Review for 8/28/17 to 8/29/17 and 9/25/17 to 9/26/17 showed the pharmacist recommended the resident's scheduled Synthroid 25 mcg be changed from being given in the AM to being given at 6 AM or at HS in order to ensure the medication would be given on an empty stomach for optimal absorption. Review of the (MONTH) (YEAR) MAR indicated [REDACTED]. Review of the medical record revealed the recommendation had not been addressed. 5. Review of the 8/28/17 to 8/29/17 and 9/25/17 to 9/26/17 Consultant Pharmacist Medication Regimen Review for resident #65 showed the pharmacist recommended the resident's scheduled Synthroid 50 mcg be changed from being given in the AM to being given at 6 AM or at HS in order to ensure the medication would be given on an empty stomach for optimal absorption. Review of the (MONTH) (YEAR) MAR indicated [REDACTED]. Review of the medical record showed the recommendation had not been addressed. 6. Review of the 8/28/17 to 8/29/17 and 9/25/17 to 9/26/17 Consultant Pharmacist Medication Regimen Review for resident #82 showed the pharmacist recommended the resident's scheduled Synthroid 25 mcg be changed from being given in the AM to being given at 6 AM or at HS in order to ensure the medication would be given on an empty stomach for optimal absorption. Review of the (MONTH) (YEAR) MAR indicated [REDACTED]. Review of the medical record showed the recommendation had not been addressed. 7. Review of the Consultant Pharmacist Medication Regimen Review dated 9/25/17-9/26/17 showed Resident #9 had a prescription for Ativan since 6/17/17. Further review showed the resident had received zero doses in 4 months. The pharmacist recommendation was to provide a risk versus benefit assessment if the current therapy was to be continued. Interview on 10/4/17 at 11:30 AM with the DON revealed The medication should have been discontinued but it hasn't been. 8. Review of the physician's orders [REDACTED].#90 showed Buspar (anti-anxiety medication)15 milligrams (mg) 3 times a day was ordered on [DATE], Guanfacine (for treatment of [REDACTED]. Review of the Consultant Pharmacist Medication Regimen Reviews dated 2/13/17-2/21/17 and 9/25/17-9/26/17 showed the pharmacist recommended the physician review the medications for a possible gradual dose reduction and document a risk versus benefits rationale if the physician determined the reduction should not be done. Review of the pharmacy consultation report, dated 2/27/17, and the Psychoactive Drug and Behavior Medication Review Form dated 6/20/17 showed the physician response on both was for the medication review to be done by the psychiatrist. Interview with the DON on 10/4/17 at 11:10 AM revealed a psychiatrist was not available at the time the pharmacist made his initial recommendation. She further stated the review for the gradual dose reduction had not been done because they did not have a psychiatrist until (MONTH) (YEAR). 9. Interview on 10/4/17 at 12 PM with the consultant pharmacy revealed he had identified the concern with the physician's not acting upon the recommendations and had recently presented it to the facility's quality assurance committee. | 2020-09-01 |