CMS concurs with the recommendations, according to the report. CMS also recently initiated efforts to reduce the use of anti-psychotic drugs in skilled nursing home residents by 15% by the end of this year. CMS plans to work with hospitals as well, because anti-psychotic use may originate in acute care settings prior to the patient being transferred to a nursing home facility.
The four levels of requirement for anti-psychotic drug use that were not met are:
1. Nursing facility staff must prepare a comprehensive assessment upon admission, whenever there is a significant change in the resident's physical or mental condition, and at least once a year. A registered nurse is required to conduct or coordinate each assessment with the participation of other health professionals.
One-third of the reviewed records failed to meet this requirement.
2. Attention to "triggering conditions" that may alter decision-making in the care plan. For example, the OIG report indicates that if a resident taking an atypical antipsychotic drug experiences periods of lethargy, that observed state should trigger a resident assessment protocol (RAP).
About 4% of the reviewed records failed this requirement.