Medications and the CMS Mega Rule

The CMS Final “Mega Rule” has some changes in store for long-term care pharmacy and medications, including how psychotropic drugs and antibiotics are administered and documented. While some of the changes won’t be implemented for a year or two, many of them went into effect at the end of November, said Todd King, PharmD, CGP, Senior Director of Clinical Services for Omnicare–A CVS Health Company, who summarized the coming changes in a recent IASC webinar.

Phase 1 of the new rule, which went into effect November 28, hammers out the grey areas in drug definitions and documentation practices. Facilities are required to create and implement policies and procedures for reviewing a resident’s medications on a monthly basis.

A psychotropic drug is defined as anything that affects mental processes and behaviors, including antianxiety and antidepressant medications. Any prescription viewed as unnecessary must be formally reviewed, and the actions must be documented in the medical record, whether the resident continues to take the medication or not. In Phase 2, a monthly review of each resident’s medical record will be required.

The CMS Final Rule also requires every skilled nursing facility to have an infection control and prevention program, ideally led by the medical director, the director of nursing and a consultant pharmacist. “Drug-resistant infections are rapidly outpacing the development of new antibiotics,” King said. “Nursing homes should be tracking infections, antibiotic prescribing patterns, duration of use, costs and outcomes on a monthly basis.”

The changes are slated to be implemented in three phases, one year apart, starting in November 2016.

Topics: Clinical , Infection control