| Facility failed to meet the following Requirement(s): | Corrected Date | Level of Harm | Residents Affected |
| 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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4/4/2024
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| Medication Orders.
(B) Physician ' s written and signed orders are not required, but if it is the facility ' s or physician ' s policy to use the orders, they shall include: name of the medication, dosage, frequency and route of administration and the orders shall be renewed at least every three (3) months. Computer generated signatures may be used if safeguards are in place to prevent their misuse. Computer identification codes shall be accessible to and used only by the individuals whose signatures they represent. Orders that include optional doses or include pro re nata (PRN) administration frequencies shall specify a maximum frequency and the reason for administration. II/III
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4/4/2024
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| In emergency discharge situations the facility shall submit to the resident and his or her next of kin, legally authorized representative or designee a written notice of discharge. The written notice of discharge shall be given as soon as practicable and advise the resident of the right to request an expedited hearing. In the event that there is no next of kin, legally authorized representative or designee known to the facility, the facility shall send a copy of the notice to the appropriate regional coordinator of the Missouri State Ombudsman's office. II/III
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4/4/2024
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