Pennsylvania Attorney General Michelle Henry announced charges against a Lawrence County personal care administrator who failed to provide a resident’s medications, which led to a seizure that caused the man’s death in 2021.
The defendant, 48, was the administrator at a personal care home in New Castle when she failed to renew a prescription for a resident’s anti-seizure medication. She then altered medical records to indicate that a healthcare provider discontinued the medication — which was not true.
As the administrator of the personal care home, the defendant was responsible for the administration and management of the home, including the health, safety, and well-being of the residents. This included ensuring the residents’ paperwork was complete, that they attended all medical appointments, and that they received their prescribed medication in a timely manner.
According to the complaint, the resident was diagnosed with a seizure disorder and was prescribed anti-seizure medication to control his seizures. He died at the care home on Dec. 2, 2021, after not receiving his medication for over 10 days. Upon autopsy, it was discovered that the seizure disorder caused his death and that the levels of anti-seizure medication in his system were well below therapeutic levels.
The defendant was charged on November 28, 2023, with felony counts of neglect of a care dependent person and tampering with records, and misdemeanor involuntary manslaughter.
“The resident relied on this defendant’s care and professionalism — his life depended on it — and the defendant neglected that duty leading to tragic consequences,” Attorney General Henry said. “My office has no tolerance for providers who violate their duty of care and put our most vulnerable residents at risk.”
Compliance Perspective
Issue
Honesty, accuracy, and integrity are imperative for the provision of safe and effective nursing care. Nurses are expected to exhibit honesty, accuracy, and integrity in the provision of care, including performing nursing assessments, reporting changes in condition, acknowledging errors in practice and reporting them promptly, accurately charting and reporting, implementing care as ordered, complying with all laws and rules affecting the practice of nursing, and complying with the minimum standards of nursing. Falsification of documents regarding care, incomplete or inaccurate documentation of care, failure to provide the care documented, or other acts of deception or omission raise serious concerns about an individual’s ability to provide safe nursing care and prevents subsequent caregivers from having a complete and accurate picture of the resident’s care and condition. Falsifying medical records can be viewed as fraud, and quick action should be taken when falsified medical records are discovered.
Discussion Points
- Review your policies and procedures for following standards of care and requirements for documentation in medical records. Also review policies on cooperation with state investigations. Update as needed.
- Train all appropriate staff on your policies and procedures for following standards of care and meeting regulatory requirements for medical record content as set forth in F842 Medical Records: “Reflect the resident’s condition and the care and services provided across all disciplines to ensure information is available to facilitate communication among the interdisciplinary team. The medical record must provide an accurate representation of the actual experiences of the resident and include enough information to provide a picture of the resident’s progress, including his/her response to treatments and/or services, and changes in his/her condition, plan of care goals, objectives and/or interventions.” Document that these trainings occurred and file the signed documents in each employee’s education file.
- Periodically audit medical records to ensure that documentation is complete, meets standards for content and timeliness, and that entries have not been falsified or erroneously reported in any way.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
