Federal watchdog agency joins chorus for observation stay reform, reports on scope of the problem

Many nursing facilities are not compliant with federal regulations governing residents who take atypical antipsychotic medications, a federal review released Monday reveals.

The report, which is a review of a previous study by the Health and Human Services Office of the Inspector General, found that in nearly all (99.5%) of the 375 records reviewed, nursing facility staff failed to meet one or more federal requirements for resident assessments and/or care plans for residents taking atypical antipsychotics.

According to the OIG, 99% of records reviewed did not contain evidence of compliance with federal requirements for care plan development; one-third of the records did not comply with federal requirements regarding resident assessments; for 4% of records, nursing facility staff did not document consideration of the resident assessment protocol for psychotropic drug use as required; and 18% of records reviewed did not contain evidence to indicate that planned interventions for antipsychotic drug use actually occurred, the report states.

According to report authors, the Centers for Medicare & Medicaid Services has agreed to the following changes:

  • to improve the detection of noncompliance with federal requirements for resident assessments and care plans for residents receiving antipsychotic drugs
  • to take appropriate action to address noncompliance with these requirements, and
  • to provide methods for nursing facilities to enhance the development and usefulness of resident assessments and care plans.

Since the original OIG report was released, CMS has implemented an initiative aimed at reducing antipsychotic use among nursing home residents by 15% by the end of 2012.

Click here to read the full OIG report.