The nursing home ran out of mom's medication for over 24 hours. Is this common or is this something that should be reported?

I made an an error, the meds listed above are DEA Schedule 2 drugs, not 3. Doctors cannot order refills on these meds, so a hard copy is needed every month.  I misread Tired' comment & apologize for any misunderstanding. 

Tired, JoAnn outlined the procedure and she icorrect. I am also a RN. Narcotics must be hand written by a physician or physician extender (P.A., or CRNP) on a prescription pad, never faxed or called in, and only a 30 day supply is written. You lose the bottle or prescription and the doctor will require you to file a police report of the theft and the doctor can and will call the police to verify the report, or you wait until the thirty day interval is up because they aren't going to write another. 
I believe we are talking about Schedule 3 Controlled substances i.e. norco, oxycodone, dilaudid, OxyContin, Morphine & fentanyl, not sure but maybe tramadol (why I don't know). Are your meds in that class? 
No snark either, please. That was uncalled for.  As far as what else you wrote I didn't particularly agree with it, but it's your opinion and I respect it. 

To quote "Tired" -

"You are only correct in needing a hard copy refill on opioids "If and only if" physician has not placed numbered count of refills allowed upon original prescription" -
Tired, this statement is blatantly incorrect for the narcotics listed above. Doctors don't give refills on those anymore. 

Tired, I was talking about ALs and nursing homes. My daughter works in them. I also worked for a pharmacutical warehouse. The DEA controlled drugs were handled the way I explained. My Gson is on a controlled drugs and has to have a monthly prescription. It really depends on how controlled I think. The pharmacy better have a prescription for every order. They can't keep a stock. Order, delivery, right to the customer. We had the DEA ask for order info on a pharmacy. The pharmacist had ordered more oxycoten than he had prescriptions for. He was selling it on the street. We had a pharmacist fired because he gave a customer one pill to carry her over till he could fill her prescription.

Is someone that works there, taking her pain meds?? Just a thought.

Joanne it's handled differently in Alf and skilled care from physician pharmacy facility than it is for civilian process.

... Shane, I have 3 pill vials here ( happen to save them for an odd reason, I keep loose change in them) with refill count on label. All dated 2017. If that's all you took from what I've written, well, let's just hope you've absorbed more. 

This is how it works when a controlled substance is involved. First you have to have a prescription from the doctor for only the month. The prescription cannot be faxed or telephoned in. Must be hand delivered or mailed. The pharmacy is offsight. If the pharmacy I out of it you have to wait. Here is what also could happen, doctor made perscription for 30days and there were 31days. The staff could have asked the doctor to prescribe something else if there was a problem getting the med. Saying to give it when needed. This way it's on hand. Getting it from somewhere in the facility doesn't seem right. The only medication allowed in a NH is those meds for the patients. I would discuss this with someone in charge. Ask first how Mom's med is ordered. Then ask why she went so long without it. It may have been beyond their control.

Good job, EBeach!

Tired, physicians are no longer able to check the refill box on narcotics. No option exists in my state (Maryland) to do so. That's why pain management patients must be seen monthly. There are very strict rules that dictate narcotics prescriptions and no refills is one of them. 

I'm glad to read replies even tho hubby still home. Sends alert to future & count days of which they have & alert nursing home to reorder. Too much temptation today for even dispensers.

Report the incident for the safety of your mom and others. This is one reason why nursing facilities have a bad reputation. Be prepared to be looked at as the "BAD" guy. You are not, you are doing the right thing. It could be you or me and I would want someone to look out for me, too.

This sounds fishy to me. Your mom should have had her personal meds placed safely and she should not have run out early. Sounds like you are on top of this--and you knew she had more, but they couldn't be "found". A NH isn't like a hospital where there is a general pharmacy that for SOME meds has to be contacted and the meds delivered to the floor. In an NH, mom's pills should be clearly labeled as "hers" just like they are at home. What is the point of the NH if they can't be relied upon to give mom the pills prescribed???
Norco is a VERY inexpensive and widely used narcotic. I can't imagine a NH "running out" and actually, they had only "run out" of your mom's.

Pill pilfering is rampant in NH's. It's a real problem. When my mom had one of her many surgeries and was taking Norco daily, she'd go as long as she could between doses, and then they'd string her along until she'd be gritting her teeth in pain. THEN the pain was out of control and instead of one dose helping, she'd be miserable until the dosage in her body was sufficient. Going 24 hrs in terrible pain takes a toll that one pill isn't going to cover. It could take a couple of days to "catch up".

I'd for sure raise a stink. This has all the earmarks of someone in the NH stealing patients meds.

The "opioid epidemic" is more a problem of people selling them on the street than people in chronic pain having access to what they need to get by on a daily basis. Sadly, however, they've made sweeping laws that essentially throw the baby out with the bathwater. Drs. are afraid to treat people who have chronic pain, people WITH chronic pain are treated as junkies.

... Comment to "apples newton" ...regarding facilities and prescriptions even in cases of hospital stays and returns; You are only correct in needing a hard copy refill on opioids "If and only if" physician has not placed numbered count of refills allowed upon original prescription. The time lapse of a refil prescription does not occur if hospital and facility and pharmacy are in communication and if facility has acted correctly regarding prescribed medication disbursement practices in the first place, which is "a legal right" mind you of every facility resident. There are time lapse safeguards already in place thru all entities, facility, hospital (or other outside care) and pharmacy. Need I remind you it takes an assurance phone call from any source listed to enact and to insure the safeguarded process. And it takes as little effort of due diligence to ensure a time lapse does not occur. So no, it is not to be assumed a "usual problem" within a facility, and actually that mind set only insures failure and leaves room for misappropriation and neglect thru inappropriate medication, and medication neglect offenses to thrive.

** Typo notice.. #1. the word "cohort" within my first sentence above Is an iPad misplacement and incorrect word usage in context of sentence
#2. The wording "you do not ever 'not rely on others" Should read "you do not ever rely on others to report"

.... this is a subject that draws very near to radar. Your distrust of this or any facility is cohorts, and that distrust needs to stay and behave and act and react, as distrust (while also keeping a clear mind) ... we are hard wired as humans to distrust, but 9 times out of 10 there is valid reason. And, regardless any out-come or explainations fro anyone, you should always be cautious, and remain so, I repeat, always.  

A few key points need to be made. First of all by what you've explained, your mothers meds (no matter the class of actual med be-them opioids or not) have been on-going and have refill history that is not sudden, nor new. Meaning any issues would have been long worked out, so if that is a reason the facility is using, they are lying, even if the pain meds needed another written hard copy to fill the order. These facilities are not new to the processes and stipulations of medications. Medication is one of the few regulatory areas that is "regulated and fined when medication dispursment is misappropriated within facilities. 
Secondly; do not listen to anyone if they suggest you do not report it to your state regulatory entities. I read you stated the facility ombudsman will report and investigate (an ombudsman in its capacity is paid and employed by facility regardless what they tell you about being advocate for your mother. 
(Always look for advocacy (loyalty) within a paycheck) ...You do not ever not rely on those or anyone else to report this or any neglect, abuse or malpractice. I repeat, you do not rely on others to report. 
You"" You yourself must Report the event to your state authorities as soon as humanly possible regardless any other person telling you "they will report and/ or even investigate.  You will need to make sure that "you yourself report this incident to the exec management of facility and state entities. 
Doesn't matter the order in which you report, state then facility, but! It does matter that when you report to both state and facility, etc, I strongly request you do so "in writing" (email is considered writing) to all entities, and you make a copy of each report and you retain those copies in a safe place for an indefinite amount of time. 
If you do not do so in writing and if you then do not retain-copies, the chances the incident being reported to proper entities in a regulatory fashion are slim to none by the facility, and the chances of the report being lost within any state system (or eve being set aside) are high. 

Now, I want you to stop and think of the facility telling you "we have an emergency stash" ... stop and think about that. Where and how has an emergency stash been created. An emergency stash is created by A. A resident left and left meds behind by either leaving the facility, died, or discontinued med /meds. B. A resident for what ever reason had not been able to ingest their prescribed meds for a period of time. C. A prescription was sent with too many in number and did not match the prescribed amount per month.   ...... ---- Now that I've explained the possible reason/s an emergency stash could be created, I now need to tell you that within a facility all medications not used, not ingested, not prescribed, in any and all cases all "All" medications are to be disposed of, or returned to pharmacy, and that process is to be documented and is intended to be regulated. In laymen's terms, an emergency stash is never allowed to be in a facilities posesssion, legally. The act of Medication misappropriation (ingestion mistakes, withholding medication  (intent to harm) or theft, are all illegal activities deemed punishable by fine or liscensure risk and penalty. 

Facilities need "watch dogs" the states do not do the job. The families and friends of these individuals that are left in these facilities must, I say must be the "watch dogs" and whe a problem is alerted and found by the family and friends of the or other individuals it becomes your responsibility to become serious about what ever neglect and abuse and medical malpractice is seen and heard of. 

Last mention by me; If it is a pain medication that she has been taking for any length of time, Your mother could have very likely gone into a physical and mental withdrawal, which then could lead to physical stress and mental stress causing medical emergencies and possibly death by the chai reaction of withdrawal and what it does to a body i.e.; heart central nervous system and brain functions.

Way to go Ebeach!
This happened at my dad AL. h His diabetic medicine ran out and a couple of times they couldn't get him lancets!! Long story...they always passed the blame to someone else.
Thanks to Aging Care I know what to do next time. Dad not there anymore but mom is so now I have knowledge on how to handle it.
Yay for you and your mom!!

When my sister in law was in rehab they were giving her half of what she was supposed to be getting. Turns out someone was putting down she was getting full dosage and then keeping the half she wasn't getting for herself. Apparently, happens a lot. REPORT it.

It is common, yes. The MD has to write a hard copy script for meds like norco and there are so many rules and regs regarding controlled drugs that they can't be ordered ahead of time. It doesn't take much to cause a delay.

Thank you for all the responses. I called their pharmacy, the pharmacy told me they didn't receive the order for her meds until the day after the nursing home ran out. Also, by the way my mom is in long term care, so they know her meds. I asked the pharmacy if the nursing home needs to run out of her meds to place an order, (I assumed no but still wanted to ask) and they said no, they prefer the orders several days in advance... when it's low. I called the social worker who said she will report all of this to the administrator and that they would investigate it. I also plan to call the ombudsman, I don't fully trust to nursing home to 100% take care of this.

Unbelievable. I am sorry for you and your mom. Definitely report this to both the Administrator and the Ombudsman.

This is totally unacceptable.
Raise it first with the NH staff and if your get no satisfaction go to the state.
Pharmacies do frequently run out of medication which is a good reason to order a few days early for everyone.
Pharmacies tend to run their inventories very low to save money so this can happen a lot. It has happened to us several times with very common drugs not narcotics.
Often the NH staff will "borrow" from another patient till the new supply arrives. i don't know if this is legal or not but it does go on.
As for the emergency stock, every nurse in the place who has access to medications should know about the emergency stock. The nurses on duty when your Mom was admitted should have been questioned.

Note to all caregivers. Make sure you always have a list of your loved ones current medications with you at all times. When admitted to any facility ask the nurses to confirm all medications are available and have been provided. Question any aditions or deletions and understand the reason for the change.
Hospitals generally have their own pharmacy so being out of stock is an not usually an issue, but the time it takes the Dr to write the order, the pharmacy to approve it and send it to the floor can take several hours. You need to do these things on admission because you have be advised not to visit for a couple of weeks when admitting a dementia patient to a NH.

Norco is a Narcotic, thus a controlled substance. Therefore there are a lot of steps involved regarding ordering and giving said pills to a patient. Each and every pill has to be accounted for.

Like Shane mentioned above, have administration sort out what happened. The pharmacy manufacturer could have stop production of said pills, which is common.... thus the nursing home pharmacy supplier wasn't able to obtain said pill, some even try to contract other branches of that pharmacy to see if they had said pill in stock.

As for the locked vault for controlled substance, usually it takes a certified med tech that can open that vault, and at the time maybe none was on duty.

This situation could have happened even if the elder was living at home. My Dad use to wait until the pill bottle was empty collecting dust before he would mentioned he ran out of pill. I couldn't use the local pharmacy, Dad only wanted to use the mail order pharmacy, which is another week delay.... [sigh]. Tried to get Dad to go on automatic delivery but he refused.

I would give the administrator the opportunity to address it first before calling the state.
It was terrible that your mom was in pain for that long.
I would ask the administrator to complete an incident report ( an internal document) and ask the admin to bring it to the Center's Quality Assurance Committee for their review.
Then ask then what steps they are going to take so that this type of episode doesn't happen again for anyone in their care. 

EB, who HAVE you discussed this with? I would have assumed that you'd spoken to both the DON and the SW already?

Would reporting it to the state be best? Or the manager, or even social worker?

Dear EBeach,

I'm so sorry to hear what happened with your mom's pain meds. I would report it as well. That does not seem in line with proper patient care. Its like you said if they had an emergency stash, why wouldn't they use it right away? Your mom needed that medication. I wouldn't let this slide and report it.

I'd report it, for at least two reasons.

1. Your mother was left in pain. She shouldn't have been. If that was the fault of the system the NH is using, they need to tighten up the system.

2. Suddenly discovering that they did have some after all in their magic cupboard makes me narrow my eyes. You only have the nurse's word for it that the pharmacy supply hadn't been delivered. It's not impossible that only that day's meds mysteriously "went astray" and for "some reason" the staff didn't want to ask for replacements.

But don't make any accusations: report what happened and ask how it will be prevented from happening again.

I can vouch for pharmacies running out of narcotics as mine does quite frequently. The inventory on opiates is highly scrutinized now. There are different laws going into effect almost monthly regarding opiates.
Next time if, God forbid, this happens have the staff call the NH/rehab doctor, let him know the situation, and ask him/her to write for another pain med- even if it's a different strength. The nursing staff can either give the patient a stronger pill cut in half (the pill must be scored and not a time released formula so it can be cut in half properly) or the pharmacy can cut the pills in half for the NH to administer. The NH should inform the pharmacy that they will only need enough pills to last 2-3 days or long enough for the pharmacy to restock and provide the correct dose to the NH for your mom, but enough to get her through a few days. 

I don't know about reporting one way or the other but when my mom was transferred from the hospital to rehab on a Friday afternoon she was out of luck for over 24 hours on getting her pain meds. I had some and gave them but not until I pitched a b did they get the meds on site.
My guess is that the folks left in charge are caught between a rock and a hard place. They don't want to elevate the problem for whatever reason until you make it more comfortable for them to do so than not.
I got a lot of lip on why it didn't happen properly but bottom line until I complained nothing happened. I hesitate to complain for fear I might make the situation worse but when your loved one is in pain and you are the one trying to help them it makes it very hard to do nothing.