INITIAL COMMENTS
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This report is a result of an on-site inspection conducted for the approval to use a narcotic agent, specifically buprenorphine, in the treatment of narcotic addiction. This inspection was conducted on January 28, 2014 by staff from the Division of Drug and Alcohol Program Licensure. Based on the findings of the on-site inspection, Livengrin Foundation, Inc. was found not to be in compliance with the applicable chapters of 4 PA Code and 28 PA Code which pertain to the facility. The following deficiencies were identified during this inspection.
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Plan of Correction
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715.15(b) LICENSURE Medication dosage
(b) The narcotic treatment physician shall determine the proper dosage level for a patient, except as otherwise provided in this section. If the narcotic treatment physician determining the initial dose is not the narcotic treatment physician who conducted the patient examination, the narcotic treatment physician shall consult with the narcotic treatment physician who performed the examination before determining the patient 's initial dose and schedule.
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Observations
Based on a review of patient records, the narcotic treatment program failed to document the consultation between the narcotic treatment physician determining the initial dose and the narcotic treatment physician extender performing the physical examination in 1 patient record.
The findings include:
Eleven patient records were reviewed January 28, 2014. Seven patient records were required to document a consult between the narcotic treatment physician determining the initial dose and the narcotic treatment physician extender performing the physical examination in seven of the seven patient records reviewed.
Patient # 4 was admitted August 10, 2013. The Certified Registered Nurse Practitioner (CRNP) completed the physical examination on August 11, 2013. The patient was dosed on August 11, 2013 at 10:00 AM. There was no documentation of the narcotic treatment physician completing a face to face determination and consulting with the CRNP who completed the history and physical.
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Plan of Correction
The narcotic physician will ensure that he has a consultation with the CRNP who completed the history and physical. The standard will be met. The Nurse Manager will make sure the narcotic physician consults with the CRNP that does the history and phyical. |