Tuesday July 24, 2012
This study used a random sample of records from a previous
Office of Inspector General (OIG) study of elderly nursing facility
residents with Medicare claims for atypical antipsychotic drugs
between January and June 2007. They reviewed the records for
evidence of compliance with Federal requirements for resident
assessments and documentation of decision-making. They also
reviewed the records for evidence of compliance with Federal
requirements for care plan development and implementation.
Nearly all records reviewed (99 percent) failed to meet one or
more Federal requirements for resident assessments and/or care
plans. The resident assessment and care plan process involves four
steps. One-third of records reviewed did not contain evidence of
compliance with Federal requirements regarding resident
assessments, the first step. Further, for 4 percent of records,
nursing facility staff did not document consideration of the
Resident Assessment Protocol for psychotropic drug use as required,
the second step. Ninety-nine percent of records did not contain
evidence of compliance with Federal requirements for care plan
development, the third step. Finally, 18 percent of records
reviewed did not contain evidence to indicate that planned
interventions for antipsychotic drug use-the fourth step-actually
occurred.
Please read the following attachments for more details and
CMS response to the report.
OIG Report Care Plans for Residents Receiving Atypical
Anitpsychotic Drugs