This report is a result of an on-site inspection conducted for the approval to use a narcotic agent, specifically methadone, in the treatment of narcotic addiction. This inspection was conducted on November 1-2, 2012 by staff from the Division of Drug and Alcohol Program Licensure. Based on the findings of the on-site inspection, Progressive Medical Specialists, 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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Observations
Based on a review of patient records on November 1 - 2, 2012, the facility failed to ensure that the narcotic treatment physician is documenting the medication orders and dosage changes for a patient in three of thirteen patient records.
The findings include:
Thirteen patient records were reviewed on November 1-2, 2012. All patient records were reviewed for medication order and dosage change which shall be written and signed by the narcotic treatment physician. Patient records # 5, 8, and 13 contained documentation of medication orders that were completed by someone other than the narcotic treatment physician.
Patient record #5 was admitted on June 28, 2012. A ten day detox schedule was completed on 9-11-2012. The detox schedule was not completed by the narcotic treatment physician.
Patient record #8 was admitted on March 13, 2012. A ten day detox schedule was completed on 6-4-2012. The detox schedule was not completed by the narcotic treatment physician.
Patient record #13 was admitted on December 1, 2010. A fourteen day detox schedule was completed on 11-1-2012. The detox schedule was not completed by the narcotic treatment physician.
The findings were reviewed with the facility director and were not disputed.
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Plan of Correction
Although the narcotic treatment physician always completes the detoxification schedule with the nursing staff, (the MD would verbally provide the schedule and the nursing staff would document on the form, then MD would review the schedule and sign the order) The medical director and the nurse supervisor were instructed by the project director on Friday, November 9, 2012 that any type of detoxification schedule must be completely written by the physician. All parties agreed.
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