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Nearly All Nursing Homes Fail Federal Rules on Anti-Psychotics

Cheryl Clark, for HealthLeaders Media, July 13, 2012

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.

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2 comments on "Nearly All Nursing Homes Fail Federal Rules on Anti-Psychotics"


lynn (7/14/2012 at 12:39 AM)
I have always said that we nurses and health Care Professionals need to look at different ways to help patients with Psych difficulties-these patients have lost their homes ect..high stress time for them.I hate it when a team of psych comes in and puts an elderly patient on an antidepressant- antipsychotic-mood stabilizer...you know that patient is most likely going to become lethargic and have a decreased appetite so they will loose weight become dehydrated ect ect..then you will go to a ''care plan'' meeting and they will all sit around and say "whats up with mrs Smith-she has lost weight-and lethargic" Makes no sence to me.I am glad that the field is starting to look at new avenues to handle this problem.

Susan Ward (7/13/2012 at 10:35 AM)
Psychiatrists and psychologists won't come to the hospital to evaluate a drug overdose patient, but the federal experts think they should visit nursing homes regularly to assess patients and help develop the plan of care. You have set almost every nursing home up to be noncompliant with the regulations. These experts need to spend some time in the nursing homes and observe the care patients receive and see how easy it is to get a physician to visit and assess patients, let alone a psychiatrist. It is time the people who make the regulations get out into the real world and learn what goes on day to day in health care.