Northview Health And Living

During that communication, on 12/10/25, the facility was advised to continue giving Resident E both carbidopa-levodopa and extended-release carbidopa-levodopa.

The order was clarified as carbidopa-levodopa ER 50-200 mg 4 times daily- upon waking, late morning, late afternoon and in the evening and carbidopa-levodopa 25-100 mg 4 times daily - upon waking, late morning, late afternoon and in the evening.

Both carbidopa-levodopa ER 25-100 and carbidopa-levodopa 1.5 tablets were to be given together.

There had been no communication between neurology office and the facility since 12/10/25.

During an interview on 12/30/25 at 3:45 p.m., RN 1 indicated she audited orders from the hospital websites.

RN 1 intended to clarify the carbidopa-levodopa orders with the Nurse Practitioner (NP) due to the amount confusion with the carbidopa-levodopa orders during the last admission. RN 1 indicated the orders should have been clarified.

During an interview on 12/31/25 at 9:15 a.m., LPN 4 indicated any unclear or questionable order should have been clarified with the NP.

The NP would usually order to hold the medication until they could review the order.

The NP was in the facility at least three times a week.

During an interview on 12/31/25 at 11:27 a.m., both the DON and ADON indicated Resident E's admission orders on 12/26/25 should have been clarified.

During an interview on 12/31/25 at 12:51 p.m., Resident E's neurologist indicated the neurologist office had not had any communication with the facility since 12/10/25.

The neurologist indicated Resident E had been taking carbidopa-levodopa in both regular and extended release form at the same time routinely for the past 1-2 years.

Due to issues with the electronic record between the hospitals and the neurologist office, the neurologist had not been aware the resident was re-admitted to the facility and was unaware the medication order had been changed.

The neurologist indicated the resident had experienced a recent decrease in mobility and the medication was under revision due to resent significant weigh loss.

The neurologist indicated the situation was not ideal and the facility should have reached out for clarification of the order.

The original order should be resumed, and the facility should communicate with the neurology office. A review of the job description titled Charge Nurse was provided by the DON on 12/31/25 at 9:48 a.m. and signed by RN 1 on 5/10/25.

The job description indicated the following: . SPECIAL SKILLS AND ABILITIES REQUIRED: .4.

Communicate effectively with physicians and pharmacies regarding resident needs and necessary orders.5.

Knowledgeable of facility policies in order to assure compliance.A Nurse Orientation Checklist was provided by the DON on 12/31/ at 9:48 a.m.

The checklist was signed by RN 1 on 5/14/25.

The checklist indicated RN 1 was checked off on admission/discharge procedures, resident clinical record/electron heath records, medication and treatment charting, transcription of orders and admission procedures.A current undated policy, titled Medication Reconciliation was provided by the DON on 12/31/25 at 6:48 a.m.

The policy indicated the following: .

Definitions: Medication reconciliation refers to the process of verifying that the resident's current medication list matches the physician's order for the purpose of providing the correct medications to the resident at all points throughout his or her stay.Policy Explanation and Compliance Guidelines:1.

Medication reconciliation involves collaboration with the resident/representative and multiple disciplines, including admission liaisons, licensed nurses, physicians, and pharmacy staff.4. admission Processes:a.

Verify resident identifiers on the information received.b.

Compare orders to hospital records, etc.

Obtain clarification orders as needed.

This citation is related to Intake 2681141. 3.1-14(i)

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