BOSTON-Federal officials say nearly 2,500 Massachusetts nursing home residents were given powerful antipsychotic drugs last year that were not intended or recommended for their medical condition.
The Boston Globe reports that data collected by the Centers for Medicare and Medicaid Services show that 28 percent of Massachusetts nursing home residents were given antipsychotics in 2009. Of that group, more than one out of every five did not have a medical condition that called for such treatment.
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Federal officials say the drugs are often given to patients with dementia, which puts them at risk for serious side effects, even death.
An official with the organization that represents the state's nursing homes acknowledges that the number is too high and says better training is needed.
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Information from: The Boston Globe
Can you say DUH? We all know antipsychotics aren't the best choice for older people or people with dementia, but as long as the hospitals keep sending us people with behaviors, because there aren't enough long term geri-psych beds available, we'll have to keep using these drugs.
But last I knew (& I've been out of MDS for a year or so now so don't beat me if I'm wrong), but it has to be coded correctly on the MDS for the quality indicators to capture the actual diagnosis with the use of the antipsychotic. If not within the first 2 lines of the empty spots in section I then the quality indicators indicate as not having the appropriate diagnosis. Did that even make any sense? I will have to double check my facts tomorrow at work when I have my resources available. Can anyone help me out with this?
Huh. That might be why I trigger RAPs on people who DO have the correct diagnoses.
Huh. That might be why I trigger RAPs on people who DO have the correct diagnoses.
No you are still gonna trigger raps on those with psychotropics even with the correct ICD9.
I am referring to the quality indicator report that tends to capture meds w/o diagnosis if the correct ICD9's are not within the first 2 spots on section I3. I would assume that this is where the government is pulling their statistics from.
The exclusions are ICD-9 codes Psychiatric disorder 295.00 - 295.95 or 297.00-298.9; Schizophrenia; Tourette's syndrome (307.23); Huntingdon's disease (333.4); Hallucinations; End-stage disease; and Hospice. These need to be on a full MDS and will not count on a quarterly.
I am MDS coordinator in a specialized facility that only accepts patients with major psychiatric conditions that have been denied from at least 5 other nursing homes. Our quality indicators have us as sky high for antipsychotic use in absence of condition because of the limited number of ICD 9 codes recognized. This article makes me sooo angry. A coding issue makes it look like we're improperly medicating our residents. Schizophrenia is recognized, but schizoaffective (same thing, but with a mood disorder as well) is not??!! Also, antipsychotics are appropriately uses as adjunctive therapy for bipolar disorders and depression that is resistive to treatment. It also angers me when the assumption is made that all nursing home residents are elderly. We have some in their 20's and very few older than 75.
That article was brought into me by a family member. She wanted her mother taken off Seroquel now! Had to explain that we need to titrate her down first she did not want to hear it. What a pain, stupid article.
I am MDS coordinator in a specialized facility that only accepts patients with major psychiatric conditions that have been denied from at least 5 other nursing homes. Our quality indicators have us as sky high for antipsychotic use in absence of condition because of the limited number of ICD 9 codes recognized. This article makes me sooo angry. A coding issue makes it look like we're improperly medicating our residents. Schizophrenia is recognized, but schizoaffective (same thing, but with a mood disorder as well) is not??!! Also, antipsychotics are appropriately uses as adjunctive therapy for bipolar disorders and depression that is resistive to treatment. It also angers me when the assumption is made that all nursing home residents are elderly. We have some in their 20's and very few older than 75.
Our psychiatrist uses the adjunctive therapy dx often.
Specializes in LTC, ER, ICU, Psych, Med-surg...etc....
If I am in a nursing home and am so agitated and confused that I am suffering, please, please, give me Seroquel and a touch of ativan or something so that I am comfortable...I am all about the medications- nothing worse thatn suffering a mental torment that you cannot escape from....people scream in pain and we medicate them...what is the difference between that and screaming in pain from a mental anguish?
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SuesquatchRN, BSN, RN
10,263 Posts
Huh. That might be why I trigger RAPs on people who DO have the correct diagnoses.