What is the facilitys responsibility for residents who refuse to follow physician orders or refuse to pay for medications?
Refusal to follow medication orders must be documented on the MAR as required by rules 10A NCAC 13F .1004(j)(7) and 10A NCAC 13G .1004(j)(7). In order to comply with rules 10A NCAC 13F .0902 and 10A NCAC 13G .0902, the facility should notify the resident’s physician about refusals. The facility should advise the resident about the importance of following physician orders and what the health repercussions are of not following orders. The resident’s responsible person should also be informed. If the physician does not change the order and the resident continues to refuse, the facility should continue to document refusals and inform the resident that a discharge may be necessary because the facility is unable to meet the resident’s needs. Depending on the circumstances, i.e., how serious a health threat it is, the facility can do less than a 30-day discharge according to Part (b)(1) of rule or a 30-day discharge according to Part (b)(6) of rule. For refusal of payment (not lack of funds t
