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Nearly All Nursing Homes Fail Federal Rules on Anti-Psychotics

Cheryl Clark, for HealthLeaders Media, July 13, 2012

3. Nursing facilities must develop a care plan for each resident within seven days after the completion of the comprehensive assessment. These plans must include objectives and timeframes to meet residents' physical, mental, and psychosocial needs. These plans are supposed to be completed by an interdisciplinary team with participation, to the extent practicable, of the resident's family or legal representative.

Nearly all, or 98.9%, of records failed to meet this requirement.

4. Implementation of the care plan requires, for example, that the nursing home attempt gradual dose reductions of antipsychotic drugs at least once per quarter, monitor resident for side effects of these drugs, and document that the implementation actually occurred.

About 17.9% of the reviewed records failed to meet this requirement.

The report also says that a psychiatrist, geriatrician, or psychologist should be involved in developing care plans. "However, only two (out of the 375) care plans involved such practitioners," the report says. And 20% of the records indicated that an RN, a social worker, or a licensed practical nurse was solely responsible for developing the plan.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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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.