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
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In May, 2018 a nurse working at a Wisconsin nursing home was charged with 11 felony and misdemeanor charges. The charges were: intentionally subjecting an individual at risk to abuse, theft, imitation of a controlled substance, possession of narcotic drugs and obtaining a prescription drug with fraud. According to the criminal complaint: A nurse training with the accused nurse witnessed her diverting narcotics. The nurse trainee said that when he worked with the accused nurse, patients complained of pain even after the nurse gave them their medication. But when training with other nurses, the trainee said the same residents were not complaining of pain after receiving pain medication. The accused nurse was brought into the DON office and admitted to diverting narcotics but didn’t state the amount of drugs she took or how long she had been doing it. The accused told the nursing director that she gave the narcotics to her son because he is an addict and becomes violent toward her. An investigation showed that instead of giving residents scheduled doses of hydrocodone or Percocet, the accused nurse was giving them Tylenol. The accused nurse was in charge of the narcotics cart, and all medications were signed off and dispensed by her to the nurses for administering to the patients. The Director of Nursing reported the theft to
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On October 1, 2018, data will be collected to ensure that medication reconciliation is also completed at the time of admission. The new Quality Measure – Drug Regimen Review, will evaluate the percentage of resident stays in which drug regimen review was conducted at time of admission and if facility staff followed up with the physician before midnight the next calendar day. Facilities that are found non-compliant will have their Medicare Payment reduced 2%. Skilled nursing facilities are required to reconcile patient medications prior to discharge back to the community. F661 – Discharge Summary states “Facility staff must compare the medications listed in the discharge summary to medications the resident was taking while in the facility. Any discrepancies must be assessed and resolved, and resolution documented in discharge summary with rationale.” The Advancing Excellence “Medications at Transitions and Clinical Handoffs” (MATCH) toolkit incorporated experiences and lessons learned from staff of facilities that have implemented MATCH. The toolkit helps facilitate a review and improvement of current practices to strengthen the process and improve patient safety. The World Health Organization has developed a Standard Operating Protocol for Medication Reconciliation and assuring medication accuracy in transitions in care. To write your policy and start your program, click the link below:
