Long-Term Care Survey Alert
Accurately Document And Report Negative Outcomes Of Psychotropic Drugs
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Question: How do we indicate monitoring of certain drugs?
Answer: Since so many psychotropic medications can cause adverse or side effects, it is crucial that staff know what to look for and what the various definitions are, in order to accurately document and report negative outcomes.
Chapter N of the RAI manual clearly identifies the definitions and monitoring requirements. In order to properly document, and remain in compliance with federal regulations, facility staff should become familiar with these terms.
Do not merely “check off” that there are no negative responses to the drug’s use. Analysis of what is being observed must be clearly indicated and reported.
Question: I am confused about inactivation vs. modification. Can you explain the differences?
Answer: The May 2013 RAI updates changed the requirements. Basically, you can make a modification when there is an error in the target date, (entry and discharge dates, and ARD), reason for assessment, and clinical items. However, there are certain requirements that you also must meet in order to do a modification.
For example, you can modify the ARD only if the reason is due to a data entry or typographical error. If the look-back period would need to change, a modification is not appropriate.
Another example is in the case of the reason for assessment. If an error was made in the reason(s) for assessment, and the same item set would be utilized, a modification is acceptable. However, if you would need a more stringent item set, a modification is not appropriate.
Modification of an assessment is not permitted if the error is related to the type of provider, or the submission requirement needs to be changed. In the former situation an inactivation is required; for the latter, a manual correction/deletion is required. In addition, if a different item set would be required or the look-back period would change, inactivation rather than modification is necessary.
Please refer to chapter 5 in the RAI manual for specifics related to this question.
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Accurately Document And Report Negative Outcomes Of Psychotropic Drugs
Question: How do we indicate monitoring of certain drugs?