EFFECTIVE OCT. 1, 2018   Facilities that are found non-compliant will have their Medicare Payment reduced 2%. Drug Regimen Review Quality Measure – At the Beginning of the Stay the following questions will be asked:  Did a complete drug regimen review identify potentially clinically significant medication issues?  Did the facility contact the physician or designee by midnight of the nest calendar day and complete prescribed/recommended actions in response to the identified potential clinically significant medication issues?  At the End of The stay the following question will be asked:  Did the facility contract and complete the physician or designee prescribed/recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the Admission?  (This Quality Measure will affect the FY 2020 payment determination and subsequent years)

Medication reconciliation is the formal process in which health care professionals partner with patients to ensure accurate and complete medication information transfer with the patient from one care level to another.  Patients admitted to a hospital have a 50% chance that a medication error will occur.  Many adverse drug events (ADE) occur as a result of poor communication between health care professionals and patients or caregivers when they are admitted to the hospital, change rooms within the hospital, are discharged to a skilled nursing facility and discharged home to the community.  When a patient’s transition from one setting to the next is inadequate, the repercussions include hospital readmission, an adverse drug event and even death.

CMS has included skilled nursing facility requirements to ensure patient’s medications are managed appropriately and to reduce adverse drug events.  The following requirements include aspects of medication management:

Steps to implement a Medication Management Program:

  • Medication Reconciliation upon admission
  • Develop a single medication list, shared by all disciplines
  • Consultant pharmacist complete Drug Regimen Review
  • Identify patients with Medication Management issues
  • Work within the Interdisciplinary Team
  • Explain medications to patient/caregiver and answer all questions
  • Complete Medication Reconciliation upon discharge (send home with supply of medications)

The following are excellent tools for creating and implementing a medication management program at your facility:

Medication Reconciliation at Transitions “MATCH” Toolkit

The HIgh 5s Project SOP “Assuring Medication Accuracy at Transitions in Care: Medication Reconciliation”