Unnecessary Antipsychotic Medication Prescribed for Dementia
Penalty
Summary
A deficiency was identified when a resident was prescribed and administered Seroquel, an antipsychotic medication, for the diagnosis of unspecified dementia with behavioral disturbances and anxiety. Facility policy states that antipsychotic medications should only be used when necessary to treat specific, indicated conditions. However, the medication administration record showed the resident received Seroquel twice daily over several days for dementia, a diagnosis for which the medication is not approved. Staff interviews revealed that the primary behaviors observed were attempts by the resident to leave the facility and statements about needing to go to work. Further interviews with a certified medication aide, an LPN, and the DON confirmed that the medication was being used for dementia-related behaviors and anxiety. The DON acknowledged awareness that CMS does not approve Seroquel for the treatment of dementia and that the resident had been on the medication since admission for these behaviors. The documentation and staff responses did not indicate a specific, approved psychiatric diagnosis justifying the use of the antipsychotic, resulting in the finding of unnecessary medication use.