Anoka Rehabilitation And Living Center

at 4:45 p.m. R1's Primary Care Physician (PCP) stated the pain regimen R1 was on should cover his pain.

The PCP was not aware that R1 was not receiving his PRN morphine sulfate. He stated he was not certain why the staff was not utilizing the PRN medication and was going to emphasize with the staff that they should be using the medication and that was why he ordered it.

Upon interview on 11/13/25 at 1:10 p.m.

RN-B the nurse manager stated she was aware R1 had pain during cares as he had complained of staff being rough with him and the staff was educated and told to be gentle and go slowly with R1.

She stated R1 was extremely sensitive due his fragile skin.

The moment staff touched R1 he cried, but cares needed to be conducted, or his skin would breakdown. RN-B stated she was not certain why R1 was not pre-medicated prior to cares with his PRN morphine sulfate.

She did not have a system in place for checking the usage of PRN medications on the unit.

Upon interview on 11/13/25 at 1:55 p.m. the assistant director of nursing (ADON) stated prior to the beginning of the survey he was not aware of R1's pain. He spoke with the nurse manager and staff on the unit during the survey on 11/12/25 and found out R1 had pain and anxiety about his pain.

The ADON had not visualized R1's cares. He was not certain why the staff was not utilizing R1's PRN morphine sulfate. He was not aware of a system on the unit for tracking PRN medication or narcotic medication usage. A facility policy titled Pain Management dated 4/14/25 indicated the facility used a systematic approach for recognition, assessment, treatment, and monitoring of pain, ensuring that pain management is provided to residents who require such services, consistent with professional standards of practice, the comprehensive per the person-centered care plan, and the resident's goals and preferences.

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