Antipsychotic Medication Administered Without Proper Diagnosis
Penalty
Summary
The facility failed to ensure that a resident’s drug regimen was free from unnecessary drugs by administering Seroquel (quetiapine), an antipsychotic medication, without a proper diagnosis supporting its use. The resident in question had a diagnosis of unspecified dementia without behavioral or psychotic disturbances, as well as hallucinations, but the documentation did not indicate behavioral symptoms that would warrant antipsychotic therapy. The care plan and medical records showed the medication was ordered for 'lewy body dementia with behavioral disturbance,' but interviews with nursing staff and the ADON revealed that lewy body dementia alone is not an appropriate diagnosis for antipsychotic use, and staff were aware of the associated risks and black box warning for elderly patients with dementia-related psychosis. Despite the presence of a facility policy stating that psychotropic medications should only be used when nonpharmacological interventions are contraindicated and not for discipline or staff convenience, the medication was continued without clear justification. Staff interviews indicated confusion regarding the appropriateness of the diagnosis for Seroquel, and the DON confirmed that the physician provided the diagnosis but did not clarify the clinical rationale. The resident did not exhibit side effects at the time of review, but the facility did not address the lack of a proper diagnosis for the ongoing use of the antipsychotic medication.