Observations
Based on a review of one patient record, the facility failed to ensure the narcotic treatment physician was determining the proper dosage level. A Certified Registered Nurse Practitioner (CRNP) issued written orders for methadone dose and schedule changes, rather than the narcotic treatment physician.
Patient # 1 was admitted on March 2, 2022 and was active at the time of the investigation. A medication order was written and signed by the CRNP on February 2, 2023.
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Plan of Correction
Lansdowne Treatment Services will get clarification from the PA Department of State, Board of Nursing regarding the parameters of the CRNP Prescriptive Authority license and collaborative agreement with the Medical Director. In addition to the prescriptive authority license, the CRNP also has a Mid-Level Practitioner Waiver from CSAT. Until such time as clarification is received, the Executive Director will ensure that all methadone orders will be provided verbally and be signed within 3 days by the Medical Director. In the event that the Prescriptive Authority license does not apply to NTP, all methadone orders will be signed by the Medical Director. |