Demystifying federal nursing home regulations to improve the effectiveness of psychopharmacological care.
OBJECTIVE
This paper attempts to demystify the federal regulations that govern the administration of medications to nursing home residents, describing the intent and correct implementation of F329 Unnecessary Drugs of the Omnibus Budget Reconciliation Act of 1987, most recently revised in 2006.


METHODS
Methods included a comprehensive review of the literature and cases from clinical practice.


CONCLUSIONS
Although the regulatory language is complex, less so with each subsequent revision, its requirements nevertheless parallel good clinical practice and insure that vulnerable older adults have a quality of life that includes freedom from unnecessary medication--defined as any medication prescribed in a nursing home without adequate indication, in an excessive dose, for excessive duration, as duplicate therapy, without adequate monitoring of efficacy and tolerance, or in the presence of adverse consequences.
Anderson
Karen Schendel
KS
Geriatrics, Health Partners, Minneapolis, MN, USA.
Bjorklund
Pamela
P
D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking; D016903:Drug Monitoring; D004358:Drug Therapy / Q000592:standards*; D064420:Drug-Related Side Effects and Adverse Reactions; D005161:Facility Regulation and Control / Q000458:organization & administration*; D035082:Federal Government; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000458:organization & administration*; D028701:Patient Rights / Q000331:legislation & jurisprudence; D018579:Patient Selection; D019338:Polypharmacy; D011600:Psychopharmacology / Q000458:organization & administration*; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use; D011787:Quality of Health Care / Q000458:organization & administration*; D014481:United States; D019564:Unnecessary Procedures
D011619:Psychotropic Drugs