F-Tag in focus: F-425

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Sonja Quale
Sonja Quale

F-Tag 425 requires that centers' pharmacy services provide residents the routine and emergency drugs they need, with the overall goal of ensuring the safe and effective use of medications. The risk of adverse consequences associated with medication use in the nursing home is a serious concern. 

If recent study findings are extrapolated to all US nursing homes, approximately 350,000 adverse drug events may occur annually, including 20,000 fatal or life threatening events. Gurwitz, et al, evaluated the incidence and preventability of adverse drug events and noted that 51% of the fatal, life threatening or serious events and 34% of the significant events were determined to be preventable.

Since pharmaceutical services is integral to the preventability of adverse drug events and the care provided to residents, in this blog, I'll explain how facilities can reduce their risk for a F-Tag 425 citation.

According to CASPER (March 2016 data), 10.3% of facilities were cited for a F-425 deficiency, putting it among the top 20 most frequent citations.

The F-425 requirement has four features: 

  1. Provide routine and/or emergency medications and biologicals.
  2. Have procedures for pharmaceutical services to meet the residents' needs.
  3. Have a licensed pharmacist who provides consultation and oversees all aspects of pharmaceutical services.
  4. Follow applicable laws and regulations about who may administer medications.

To comply, a center should:

  • assure each resident has a sufficient supply of their prescribed medication

  • follow applicable laws and regulations about who can administer medications

  • have procedures in place for the acquisition, receipt, dispensing and administration of medications

  • utilize the services of a pharmacist

Collaborating with the facility and medical director, a licensed pharmacist is responsible for developing procedures for pharmaceutical services, ensuring medications are requested, received and administered in a timely manner, and resolving complex medication-related issues, among others. 

Providing pharmaceutical consultation is a challenging, interactive process. The facility and the pharmacist must collaborate for effective consultation, using innovative methods and resources, such as technology (e.g., effective use of electronic medication regimen review) and additional personnel (e.g., pharmacy nurse consultants).    

For additional information, PharMerica consultants can help you determine if you are in compliance with F-425 by reviewing your procedures, conducting mock audits and more.

Thank you for your interest in my series of F-Tags so you can better prepare today to succeed tomorrow.

Sonja Quale, Pharm.D. is the vice president and chief clinical officer at PharMerica Corporation.



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