Reviewing a resident’s medical records should be the first thing any plaintiff lawyer investigates. Medical records should include, among other things, documentation of all communications with the attending physician’s chart to assess his or her evaluation of the resident’s condition in relation to the prescribed medications. An experienced plaintiff lawyer should pay particularly close attention to the attending physician’s chart to assess his or her evaluation of the resident’s condition in relation to the prescribed medications. Additionally, billing records can be checked against any pharmacy records for discrepancies.
It is important to evaluate whether the prescribed medications were necessary. A resident’s medication regime should promote the highest practicable health, and should include only medications that are clinically indicated to treat a resident’s assessed conditions.
Federal nursing home regulations define unnecessary drugs as any medication used in excessive doses, for an excessive duration, without adequate monitoring, without adequate indications for use, or in the presence of adverse consequences indicating the dose should be lowered or stopped altogether.
Federal nursing home regulations also mandate that residents who have not used anti-psychotic drugs should not be given these drugs unless anti-psychotic drug therapy is necessary to treat a specific condition, as diagnosed and documented in the resident’s clinical record. For residents who do require anti-psychotic drugs, the facility must ensure that the resident receives gradual dose reductions and behavioral interventions in an effort to discontinue such drugs, unless to do so would decrease the standard of care for a resident.
On May 30, 2012, the Centers for Medicare and Medicaid Services (CMS) announced an initiative to reduce the use of anti-psychotic drug administration in nursing homes. A 2010 report by CMS indicated that more than 17 percent of nursing home patients had daily doses of anti-psychotic medications exceeding recommended levels. Further, CMS found that almost 40 percent of patients with dementia were receiving anti-psychotic drugs at some point in 2010, even though there was no diagnosis of psychosis.
By obtaining and reviewing all records and documents related to a resident’s care plan, a personal injury lawyer will be able to identify the resident’s needs, and how the facility met those needs. These records include the resident’s pre-admission assessment, the discharge and transfer records from the hospital, physician orders for medications and laboratory procedures, and any communications between the nursing home staff and the physician that verifies or clarifies the medication orders.
For the other parts in this series, click on the following:
Mismanaged Medications in Nursing Homes: An Overview (Part 1 of 6)
Mismanaged Medications in Nursing Homes: Proper Medication Management (Part 2 of 6)
Mismanaged Medications in Nursing Homes: Maintaing Adequate Staffing and Staffing Procedures (Part 4 of 6)
Mismanaged Medications in Nursing Homes: A Nursing Home and Its Pharmaceutical and Laboratory Services (Part 5 of 6)
Mismanaged Medications in Nursing Homes: Conclusion (Part 6 of 6)
The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care. If you believe you or your loved one has suffered medication errors because the nursing home failed to do its job, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.