Unnecessary Use of Antipsychotic Medications for Dementia Diagnoses
Penalty
Summary
The facility failed to ensure that residents did not receive unnecessary antipsychotic medications for the diagnosis of dementia. Two residents with severely impaired cognition, as indicated by a BIMS score of 3, were prescribed antipsychotic medications (Seroquel and Risperdal) specifically for dementia with mood disturbance or agitation. Facility policy stated that antipsychotic medications should only be used when necessary to treat specific conditions for which they are indicated and effective. However, prescription orders for both residents listed dementia as the indication for use, and there was no documentation of psychotic symptoms such as hallucinations or delusions. Interviews with facility staff, including the ADON, MDS coordinator, and DON, revealed a misunderstanding regarding the appropriate use of antipsychotic medications, with some staff believing these medications could be used for dementia with behaviors. The DON acknowledged that antipsychotic medications were not FDA-approved for treating dementia and suggested the orders may have been clerical errors. Additionally, an LPN reported that no one had instructed them to monitor for psychotic symptoms in one of the residents receiving antipsychotic medication, and they had not observed hallucinations or delusions in that resident.