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Based on medical record review, review of facility documents, facility policy review, and interview, the facility failed to ensure home medication information was promptly available on admit for one (#1) of five patients reviewed.

The findings included

Medical record review revealed patient #1 was seen in the Emergency Department (ED) on August 21, 2010 at 4:25 p.m. with chief complaint of "Congestion and Chest Pain with Cough". The patient was 2 weeks post Triple Bypass Surgery. After ordered lab work and radiology studies were completed and reviewed by the physician the patient was subsequently ordered to be admitted to the facility's inpatient medical surgical (med-surg) unit for treatment for Left Lower Lobe Pneumonia on August 21, 2001 at 11:20 p.m. with actual transfer occurring on August 22, 2010 at 2:40 a.m.

Continued medical record review revealed a list of the patient's current medications was obtained from the daughter, but no doseage or frequency for the medications was obtained. The list of medications was entered in the computer in the ED and was sent to the med-surg unit when the patient was transferred to in-patient status.

Review of facility documents, dated September 20, 2010, submitted by the receiving nurse on the med-surg unit, revealed the daughter was not with the patient upon arrival to the med-surg unit when the patient was admitted on August 22, 2010.. Continued review revealed the Nurse Practitioner (NP) for the Hospitalist Group Admitting Physician saw the patient on August 22, 2010 at 2:40 a.m., and requested the nurse verify the medication list with the daughter. Continued review revealed the patient requested the daughter not be disturbed as she needed rest but would be arriving in the early morning and the patient related having taken all prescribed medications for the day.

Continued review revealed the daughter arrived on August 23, 2010 at 8:00 a.m., and was asked by the nurse for verification of the medications. Continued review revealed the daughter related not living far and a willingness to return home for the list of medication. Continued review revealed the physician was contacted on August 23, 2010 at 3:20 p.m. for verification of orders to continue or discontinue the home medications and the orders were faxed to the pharmacy. Continued review revealed the physican orders were not given as STAT (NOW) which allows the pharmacy two hours from receipt of the order to delivery of the medications. Continued review revealed the "routine home" morning medications were not delivered and available until the afternoon medications were due.

Medical record review of the Flowsheet, dated August 23, 2010 revealed the medications were not administered until 6:13 p.m., 15 hours after admit to the med-surg unit. Review of the facility policy Medication Reconciliation for Inpatients and Outpatients, Policy # BRMC - AD - 17000 - -113 - PO, last reviewed November 2008, revealed "...It is the policy...to collect and communicate information about a patient's home medications and allergy history in an accurate and legible manner...information collected at presentation...will include all medications a patient is currently taking...Every effort should be made to obtain a complete list of home medications..." Interview in the Risk Management office on November 29, 2010 at 3:30 p.m., with the Assistant Risk Manager confirmed the ordered medication had been delayed and the facility policy for medication reconciliation of home medications had not been followed.

C/O # 26883