This report is a result of an on-site follow up inspection regarding the plans of correction from the January 21, 2010 inspection for the approval to use a narcotic agent, specifically methadone and buprenorphine, in the treatment of narcotic addiction. The follow up inspection was conducted on August 30, 2010 by staff from the Division of Drug and Alcohol Program Licensure. Based on the findings of the on-site inspection, Freedom Healthcare Services, Llc was found not to be compliance with the applicable chapters of 28 PA Code which pertain to the facility. Deficiencies were identified during this inspection and a plan of correction is due on October 4, 2010. .
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Plan of Correction
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Observations
Based on a review of patient records and an interview with the facility director, the facility failed to provide an appropriate dosage level in one of three patient records.
The findings include:
Six patient records were reviewed August 30, 2010. Three patient records reviewed pertained to patients subscribed suboxone. The patient record reviews for patients receiving Suboxone medication revealed that the facility physician was prescribing suboxone with the instructions that the Suboxone tablets could be halved. A Suboxone tablet is not to be halved or scored. The facility director was interviewed on August 30, 2010. She confirmed that staff were aware that medication prescriptions were not to be issued with doses that indicated the tablet was to be split. Patient # 3 was prescribed 2 1/2, 8 milligram tablets of Suboxone daily (for a total of 20 milligrams daily). Patient # 3 was prescribed this dose weekly from May 21, 2010 through August 20, 2010.
This is a repeat citation; the facility was previously cited on January 21, 2010 and July 23, 2009.
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Plan of Correction
After 8/30/10 visit, the Project/Facility Director reviewed with the Medical Director how prescriptions are still being halved and can not be. During the week of 8/30/10, all of the physicians were advised by the Medical Director that all prescriptions were to be written in 8mg tablets or 2mg tablets as recommended and that pills can not be halved. They were also advised that they must write two separate prescriptions if necessary in order to equal the patient's dose. All physicians began as of 8/31/10 writing the prescriptions in the manner advised. All physicians were advised by Medical Director that if this should happen again then they were follow Freedom Healthcare's disciplinary process.
In order to ensure that this deficiency does not happen again, the Project Director/ Facility Director will review medical charts every Monday during case reviews with the Medical Director. The Project Director/facility Director will monitor the compliance of this to ensure that the physicians are not writing prescriptions in a manner that the Suboxone tablets are halved. |