Norwalk Skilled Nursing & Wellness Centre, Llc

During a review of Resident 5's Order Summary Report (a summary of all currently active physician orders), dated 7/25/24, indicated on 3/31/24, Resident 5 was prescribed divalproex sodium 500 milligrams (mg - a unit of measure for mass) by mouth two times a day for poor impulse control manifested by getting agitated easily leading to verbal and physical aggression.

During a review of the consultant pharmacist's recommendation, dated 6/4/24, indicated the consultant pharmacist asked the physician to consider monitoring Resident 5's valproic acid levels related to the use of divalproex sodium.

During a review of Resident 5's clinical record indicated there was no physician response to the pharmacist's recommendation to monitor Resident 5's valproic acid level related to the use of divalproex sodium and no laboratory monitoring of valproic acid levels had been ordered or conducted.

During an interview on 7/25/24 at 11:01 AM with the Director of Nursing (DON), the DON stated the facility failed to respond to the pharmacist's request to monitor the valproic acid level for Resident 5's divalproex sodium use.

The DON stated the facility failed to monitor the valproic acid level at any other time to ensure the medication was effective and not toxic.

The DON stated failure to monitor the valproic acid level for a resident with divalproex sodium therapy could cause the medication to be ineffective at controlling behaviors if the level is too low or could be toxic if the level is too high possibly leading to medical complications requiring hospitalization .

555668

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 555668 B.

Wing 07/26/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Norwalk Skilled Nursing & Wellness Centre, LLC 11510 Imperial Highway Norwalk, CA 90650