Unnecessary Use of Psychotropic Medication Without Adequate Indication
Penalty
Summary
The facility failed to ensure that each resident's drug regimen was free from unnecessary psychotropic medications, as required by policy and regulation. Specifically, a resident with diagnoses of COPD, diabetes, and dementia (without behavioral, psychotic, or mood disturbances) was administered quetiapine, an antipsychotic medication, without an adequate indication for use. The physician orders for quetiapine did not list an associated diagnosis, and the resident's care plan for the medication lacked specific goals or evidence of behavioral symptoms that would justify its use. Behavior monitoring documentation over a two-and-a-half-month period showed no documented behaviors that would warrant antipsychotic therapy. Further review of psychiatric progress notes indicated the resident was diagnosed with major depressive disorder, generalized anxiety disorder, dementia, and primary insomnia, but there was no documentation of psychotic symptoms. Additionally, a psychiatric assessment was unable to be completed due to the resident's excessive sleepiness. During an interview, the Nursing Home Administrator confirmed the failure to ensure that residents' drug regimens were free from unnecessary medications used without adequate indications.