Failure to Conduct Required Quarterly IDT Review for Psychotropic Medication Use
Penalty
Summary
The facility failed to ensure that a quarterly behavior management interdisciplinary team (IDT) meeting was conducted for a resident who was prescribed psychotropic medications, specifically sertraline and mirtazapine, for depression and related symptoms. The resident, who had diagnoses including cerebrovascular disease, major depressive disorder, and vascular dementia, was admitted with moderate cognitive impairment and was receiving antidepressant therapy as documented in the medical record. Despite facility policy requiring quarterly IDT reviews for residents on psychotropic medications, the last documented behavioral IDT for this resident occurred at the time of admission, with no subsequent quarterly reviews completed. Interviews with facility staff, including the Assistant Director of Nursing (ADON), a Registered Nurse (RN), the Administrator, and the Director of Nursing (DON), confirmed that the required quarterly behavioral IDT reviews were not performed. Staff acknowledged that the IDT process is essential for evaluating the continued need for psychotropic medications, discussing the resident's behavior with the physician, and determining whether medication adjustments or discontinuation are appropriate. The absence of these reviews meant that the resident's behavior and medication regimen were not reassessed as required by facility policy. A review of the facility's policies and procedures further supported the requirement for regular, at least quarterly, IDT reviews for residents on psychotropic medications to ensure appropriateness and minimize adverse consequences. The failure to conduct these reviews was acknowledged by the DON, who stated that the resident could potentially be taking unnecessary medication due to the lack of ongoing assessment and follow-up with the physician.