CORINTH, MS - A nurse at Ms Care Center of Alcorn County withheld prescribed pain medication from a resident recovering from multiple fractures, leaving him without relief for nearly 20 hours, according to a federal complaint investigation completed on January 30, 2025. The facility received a citation for actual harm under federal nursing home regulations.
Resident Left Without Pain Relief Overnight
The resident, admitted with a left-sided maxillary fracture, a fracture of the left medial orbital wall, multiple left-sided rib fractures, and a fracture of the lower radius, had an active physician's order for Hydrocodone-Acetaminophen 5-325 mg, to be administered every six hours as needed for pain.
According to the facility's own medication administration records, the resident received a dose of pain medication at 1:34 PM on October 20, 2024. The next documented dose was not administered until 9:58 AM the following morning — a gap of more than 20 hours for a patient dealing with multiple bone fractures.
Progress notes from October 21 at 1:39 AM document the resident calling out to staff. "I asked for my medicine an hour ago. Do you just not have any help?" the resident stated, according to the facility's records.
A witness statement from another licensed practical nurse on staff that night revealed the reason for the delay. LPN #2 reported hearing LPN #3 state that she was not giving the resident pain medication because he could not have a bowel movement.
Constipation Is Not a Medical Basis to Withhold Prescribed Pain Medication
While opioid medications such as hydrocodone can contribute to constipation, the presence of constipation is not a clinically accepted reason to unilaterally withhold a physician-ordered pain medication. A nurse does not have the authority to override a physician's prescription based on a side effect concern without first consulting the prescribing doctor and obtaining a revised order.
When a patient with multiple fractures — particularly rib fractures — is denied pain medication, the consequences extend beyond discomfort. Untreated pain from rib fractures can lead to shallow breathing as patients instinctively guard against the pain of deep inhalation. This restricted breathing pattern increases the risk of pneumonia and atelectasis, a partial collapse of the lungs. For elderly residents, these respiratory complications can become life-threatening.
The facility's own pain assessment, completed on October 1, 2024, documented that the resident rated his pain at 5 out of 10 and that pain was already limiting his ability to perform daily activities. Withholding medication under these circumstances directly contradicted the facility's own pain management policy, which requires pain management consistent with professional standards and the resident's care plan.
Facility Leadership Confirmed the Violation
The Director of Nursing told investigators that when she arrived at work on the morning of October 21, she discovered the situation through two sources: nursing notes documenting the resident's unanswered requests and a direct report from the resident's son, who told her his father had been told by the nurse that he "did not need" pain medication due to stomach issues.
The DON confirmed that she interviewed LPN #3, who acknowledged withholding the medication because the resident was constipated. The DON stated clearly to investigators that this was not a valid reason to withhold pain medication and that the hydrocodone should have been administered as ordered by the physician. She agreed that the resident's pain went untreated throughout the night.
The facility's MDS Coordinator told investigators that failure to administer pain medication as prescribed could lead to unrelieved pain, anxiety, and difficulty participating in therapy and activities of daily living — all of which directly affect a resident's recovery trajectory.
Cognitive Status Rules Out Miscommunication
Investigators noted that the resident's cognitive assessment, completed on October 22, 2024, yielded a BIMS score of 15 — the highest possible score, indicating the resident was fully cognitively intact. This means his reports of pain and his requests for medication were clear, competent communications that should have been acted upon promptly.
Federal Citation for Actual Harm
The Centers for Medicare and Medicaid Services cited Ms Care Center of Alcorn County under F-697, a deficiency tag related to pain management, at a severity level of actual harm. This classification indicates that the violation moved beyond the potential for harm and resulted in documented negative outcomes for the resident.
The resident was ultimately discharged home on October 26, 2024. The complaint investigation was completed on January 30, 2025.
Ms Care Center of Alcorn County is located at 3701 Joanne Drive in Corinth, Mississippi. The full inspection report is available through the Centers for Medicare and Medicaid Services. Residents and families with concerns about care at any nursing facility can contact the Mississippi State Department of Health or the local long-term care ombudsman program.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Ms Care Center of Alcorn County, Inc-snf from 2025-01-30 including all violations, facility responses, and corrective action plans.
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