New Requirements on Psychoactive Drugs in Skilled Nursing Homes

Because of general “aging” of America’s population, the proportion of individuals who need long-term care is expected to increase, meaning that more and more people will be seeking care in senior living settings such as skilled nursing homes or assisted living facilities. In order to provide a specific standard of care for each person’s unique requirements, facilities have requirements for how to fulfill that care, especially as it relates to dispensing medications. Long-term care pharmacies also have regulations they must follow, but there are some new regulations in the pharmacy services section pertaining to the oversight of psychoactive drugs.

The Final Rule

The following research in September 2016, the Centers for Medicare & Medicaid (CMS) approved and released the first phase of the Final Rule that included new Medicare and Medicaid regulations for long-term care pharmacy services as part of their ongoing strategy to reduce the use of unnecessary antipsychotic medications in nursing homes. The second phase was effective on November 28, 2017.

These new regulations are the first major changes to the Nursing Home Requirements for Participation in three decades, and they affect many aspects of pharmacy practice, including long-term care pharmacy services. For example, the monthly drug-regimen review that requires that any irregularities in the pharmacist’s medication regimen found during the month must be documented in a separate report sent to the patient’s physician as well as the long-term care facility’s Medical Director and Director of Nursing, is still in place, but there is an added requirement in the pharmacy services section of long-term care rules that there be a simultaneous review of a patient’s medical chart. Additionally, there are new restrictions in the pharmacy services section regarding the use of psychotropic medications, which are often used in long-term care facilities to calm unruly residents.

Effects of The Final Rule

While nursing homes and other long-term care facilities won’t have to deal with new independence rules, there are additional regulations pharmacists and skilled nursing homes face that go beyond the ones in the new pharmacy services section. In order to regulate the use of psychotropic medications, now long-term care facilities will be required to:

  • Develop and implement a minimum care plan for every patient within 48 hours of admission. This will include instruction on how to provide effective, resident-centered care that follows the professional standard of care.
  • Develop a program for infection prevention and control as well as an antibiotic stewardship program.
  • Develop, implement, and maintain a data-driven performance improvement and quality assurance program that is effective, comprehensive, and centers on care systems, care outcome and quality of life.

Long-term care facilities are now focused on getting their procedures in line in order to be compliant with the new Final Rule regulations. At the same time, these new rules are shifting more responsibility onto pharmacists.

At Atkinson’s Pharmacy, we pride ourselves on providing quality service to long-term care facilities. As part of your care team, our qualified staff of 40 is dedicated to customizing our services in order to meet your unique needs. From a seven days a week delivery to personal telephone consultations with a pharmacist, Atkinson’s has been providing Jacksonville area correctional facilities, long-term care, assisted living, and skilled nursing facilities with personalized service for 25 years. Do you have questions about the new Final Rule regulations? Give us a call today at (904) 264-7578