| Facility failed to meet the following Requirement(s): | Corrected Date | Level of Harm | Residents Affected |
| Injections shall be administered only by a physician or licensed nurse, except that insulin injections may be administered by a CMT or LIMA who has successfully completed the state-approved course for insulin administration, taught by a department-approved instructor. A resident who requires insulin, may administer his or her own insulin if approved in writing by the resident ' s physician and trained to do so by a licensed nurse or physician. The facility is responsible to monitor the resident ' s condition and continued ability for self-administration. I/II
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10/15/2021
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| The administrator/manager shall develop and implement a safe and effective system of medication control and use, which assures that all residents ' medications are administered by personnel at least eighteen (18) years of age, in accordance with physicians ' instructions using acceptable nursing techniques. The facility shall employ a licensed nurse eight (8) hours per week for every thirty (30) residents to monitor each resident ' s condition and medication. Administration of medication shall mean delivering to a resident his or her prescription medication either in the original pharmacy container, or for internal medication, removing an individual dose from the pharmacy container and placing it in a small container or liquid medium for the resident to remove from the container and self-administer. External prescription medication may be applied by facility personnel if the resident is unable to do so and the resident ' s physician so authorizes. All individuals who administer medication shall be trained in medication administration and, if not a physician or a licensed nurse, shall be a certified medication technician or level I medication aide. I/II
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10/15/2021
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| Medication Orders.
(A) Physician ' s instructions, as evidenced by the prescription label or by signed order of a physician, shall be accurately followed. If the physician changes the order which is designated on a prescription label, there shall be on file in the resident ' s record a signed physician ' s order to that effect with the amended instructions for use or until the prescription label is changed by the pharmacy to reflect the new order. II/III
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10/15/2021
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| All medication errors and adverse reactions shall be promptly documented and reported to the administrator/manager and the resident ' s physician. If the pharmacy made a dispensing error, it shall also be reported to the issuing pharmacy. II/III
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10/15/2021
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Missouri Department of Health & Senior Services