INITIAL COMMENTS
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This report is a result of an onsite follow-up inspection pertaining to the plans of correction for the April 26-28, 2011 methadone monitoring inspection. The follow-up inspection was conducted on November 15-17, 2011 by staff from the the Division of Drug and Alcohol Program Licensure. Based on the findings of the onsite follow-up inspection, Discovery House-CU, Inc. was found not to be in compliance with the applicable chapters of 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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715.12(1-5) LICENSURE Informed patient consent
A narcotic treatment program shall obtain an informed, voluntary, written consent before an agent may be administered to the patient for either maintenance or detoxification treatment. The following shall appear on the patient consent form:
(1) That methadone and LAAM are narcotic drugs which can be harmful if taken without medical supervision.
(2) That methadone and LAAM are addictive medications and may, like other drugs used in medical practices, produce adverse results.
(3) That alternative methods of treatment exist.
(4) That the possible risks and complications of treatment have been explained to the patient.
(5) That methadone is transmitted to the unborn child and will cause physical dependence.
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Observations
Based on the review of patient records, the facility failed to ensure the patient signed the informed, voluntary, written consent to treatment prior to the administration of a narcotic agent in two of fourteen patient records.
The findings include:
Twenty-seven patient records were reviewed November 15-17, 2011. Fourteen records were reviewed for the informed consent to treatment having been signed prior to the administration of the narcotic agent.
Patient # 6 was admitted on August 4, 2011. There was no documentation of the informed consent having been signed at the time of the inspection. The patient has been dosing at the clinic daily.
Patient # 8 was readmitted on October 20, 2011. There was no documentation of the informed consent having been signed at the time of the inspection. The patient has been dosing at the clinic daily.
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Plan of Correction
The Program Director held a meeting on 11/18/11, with the medical personal. Effective immediately the medical personal will monitor the electronic record to ensure that each new patient signs the informed consent prior to the administration of a narcotic agent. This will be monitored by the Medical Director and Program Director will do sporadic check to ensure compliance.Patient #6 and #8 have signed there consent to treat with a narcotic. |
715.16(a)(3) LICENSURE Take-home privileges
(a) A narcotic treatment program shall determine whether a patient may be provided take-home medications.
(3) The narcotic treatment physician shall document in the patient record the rationale for permitting take-home medication.
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Observations
Based on the review of patient records, the facility failed to ensure the physician documented in the patient record the rationale for granting take home medication in one of seven patient records.
The findings include:
Twenty-seven patient records were reviewed November 15-17, 2011. Seven patient records were reviewed for take home medication documentation. Per regulation, the narcotic treatment physician shall document in the patient record the rationale for permitting take home medication. Patient record # 15 did not include documentation of the physician's rationale for granting the take home medication.
The facility director was provided with this finding and confirmed there was no documentation of the physician rationale for granting take home medication.
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Plan of Correction
The Program Director will held a medical training 11/18/11 with the Medical Director to review regulatory requirements for documenting the physicians' rationale for granting take home medications. The Program Director will check take home orders to ensure the rationale is documented |