Long-Term Care Survey Alert

Make sure to double check fentanyl patches. Actavis Inc. in October announced a voluntary recall for Fentanyl Transdermal System 25 mcg/hour C-II patches. The recall involves 18 lots. The company discovered that one patch in a lot "released its active ingredient faster than the approved specification in laboratory testing." The FDA notice cautions that accelerated drug release can lead to respiratory suppression, apnea, and over-sedation.

Clinical tip: Beware using any fentanyl patch on very underweight residents. That's because "the fentanyl is absorbed through the skin and deposited into the subcutaneous fat where it equalizes between storage and the blood stream," cautions Al Barber, PharmD, with Golden Living based in Ft. Smith, Ark. "If you don't have enough subcutaneous fat, you can get a dumping effect."

Do you have these two compliance areas on your radar screen? The HHS Office of Inspector General does. In its 2011 work plan, the agency plans to look at these items among others, according to Chicago attorney Neville Bilimoria:

Nursing Home Emergency Preparedness and Evacuations During Selected Natural Disasters. The OIG work plan says the agency "will review nursing homes' emergency plans and emergency preparedness deficiencies cited by State surveyors to determine the sufficiency of the nursing homes' plans and their implementation of the plans."

Criminal Background Checks for Nursing Facility Employees. The OIG plans to "determine whether and the extent to which nursing facilities have employed individuals who have criminal convictions," states the agency's work plan.

Resource: Read the OIG work plan in its entirety at http://oig.hhs.gov/publications/workplan/2011/FY11_WorkPlan-All.pdf.