Failure to Ensure Medical Necessity for Psychotropic Medication
Penalty
Summary
The facility failed to ensure the medical necessity for the administration of psychotropic medication to a resident diagnosed with dementia. The resident was admitted with multiple diagnoses, including Alzheimer's disease with early onset and dementia. A physician order was documented for the resident to start Seroquel, an antipsychotic drug, for dementia with behavioral disturbance. However, the FDA has documented that elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death, and Seroquel is not approved for such patients. On a later date, the pharmacist recommended discontinuing Seroquel, but there was no documented response from the attending physician to this recommendation. The Director of Nursing stated that the recommendation was sent to the attending physician, but no response was received.