Foundations RTC program cited for PRN medication treatments, despite state prohibition for use

Foundations Behavioral Health Perseverance Hall, a Residential Treatment Center for children, was cited by the Pennsylvania Department of Human Services (DHS, or formerly known as the Dept. of Public Welfare) for deficiencies related to PRN medications, restrictive procedures plans, health assessments and safety plans, and medication error logs. Pennsylvania law states that “A Pro Re Nata (PRN) order for controlling acute, episodic behavior is prohibited.” However, interviews with staff revealed that “Pro Re Nata (PRN) medications are given to control acute, episodic behaviors” at the facility. DHS wrote that “resident 1 has been involved in restraints” on 9 different dates from February 2012 to November 2012 but did not have a “restrictive procedure plan” as required by state law. The law states that a “restrictive procedure plan shall be written and included in the ISP…prior to the use of restrictive procedures” including restraints. DHS also wrote that “child 1 has ongoing issues with self-injury, Pica, and aggressive behavioral but a safety plan was never done,” even though state regulations require one to be completed following assessments that identify health or safety risks. According to DHS, “a safety plan should have been completed or updated” based on eight events. DHS also cited the facility after it found that “the facility does not keep a copy of information regarding medication errors in the medication administration log for any of the children” as required by law. The facility submitted a plan of correction to address the cited deficiencies.