Luther Manor At Hillcrest

Observation on 9/16/25 at 8:30 a.m., Resident #1 sitting in wheelchair in their room.

Call light with in reach.

Resident appeared to be dressed appropriately.

Interview on 9/16/25 at 8:30 a.m., Resident #1 explained that he had to call 911 to take him to the ED for his uncontrolled pain in his left leg.

Resident stated that the facility did not have any oxycontin medication to give him from 8/13/25 until 8/18/25.

Resident stated that his pain was a 10/10 and unbearable.Interview on 9/16/25 at 2:40 p.m., Staff D, Registered Nurse (RN) stated that the expectation of the nurses are to notify the primary care provider of any medications that are not available and to call the primary care provider every day until a prescription is obtained.

The Pain-Clinical Protocol dated 10/22, instructed that, if the physician determines that opioid medication is an appropriate option for managing acute (or in some cases chronic) pain in the resident, the lowest possible effective dose is prescribed for the shortest time possible with ongoing staff monitoring for effectiveness and adverse effects. If pain has not been adequately controlled, the multidisciplinary team, including the physician, shall reconsider approaches and make adjustments as indicated.

Contact the prescriber immediately if the resident's pain or medication side effects are not adequately controlled.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

09/18/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Luther Manor at Hillcrest

3131 Hillcrest Road Dubuque, IA 52001

SUMMARY STATEMENT OF DEFICIENCIES