Via Elegante, Vineyard.

“Based on record review and interview, the manager failed to ensure a medication administered to a resident was administered in compliance with a medication order, for one of two sampled residents receiving medication administration. Findings include: 1. A review of R1's medical record revealed a service plan, dated November 20, 2025, for personal care services including medication administration. 2. A review of R1's medical record revealed a list of medication orders, dated November 9, 2025, which include an order for "Incruse Ellipta 62.5 mcg Inh, Inhale 1 puff by mouth once daily for emphysema." 3. A review of R1's medical record revealed an electronic Medication Administration Record (eMAR), dated November 2025. The eMAR documented Ellipta had been administered to R1 starting on November 6, 2025. The eMAR documented Ellipta had not been administered to R1 on November 7, 2025, November 9, 2025, November 10, 2025, November 12, 2025, November 14, 2025, and November 15, 2025, due to the medication being unavailable on these days. However, Ellipta was marked administered on November 8, 2025, November 11, 2025, and November 13, 2025, in between days when the medication had been marked unavailable. 4. In an interview, E2 reported R1's Ellipta inhaler ran out on November 7, 2025; however, a prior authorization was required by R1's insurance before the pharmacy would provide a refill. E2 reported R1's medical practitioner was contacted immediately to provide the prior authorization; however, this did not occur in a timely manner. E2 reported the facility purchased the Ellipta for R1, paying the full price and bypassing insurance, and Ellipta was filled by the pharmacy by November 16, 2025. E2 reported R1 was completely out of Ellipta between November 7, 2025 and November 15, 2025 and reported the eMAR was not accurately completed on November 8, 2025, November 11, 2025, or November 12, 2025, as R1 had not received the medication on those days. 5. In an exit interview with E1 and E2, the findings were reviewed and no additional information was provided.”