04/28/2022

Survey Tip of the Week: Medication Errors

Medication administration review is a mandatory task within the Long-Term Care Survey Process (LTCSP). Medication administration citations within the prior two years can prevent a facility from being a medication aide training site for the clinical practice component within the Ohio medication aide program as outlined in the Ohio Administrative Code Rule 4723-27-07(C)(5). 

The LTCSP instructs surveyors to observe 25 medication opportunities across different units and shifts. The CMS-20056 Medication Administration Observation pathway provides a list of surveyor observations for oral or nasogastric tub administration, injection practices, topical, ophthalmic, and inhalation medications, and general medication administration observations. Examples of observations the surveyor will make includes:

• Hand hygiene was performed prior to handling medication(s) and after administering medication(s) if resident contact was necessary.
• The correct medication dose was administered to the resident.
• Medications administered before the expiration date on the label.
• Checked pulse and/or blood pressure prior to administering medications when indicated/ordered.
• Staff ensured medications were administered to the resident (e.g., left medications at bedside).
• Insulin suspensions − "mix" or “roll” the suspension without creating air bubbles.
• Shake a drug product that is labeled "shake well," such as Dilantin Elixir.
• Staff did not crush tablets or capsules that manufacturer states “do not crush,” such as enteric coated or time-released medications.
• Transdermal patch sites are rotated.

Facilities should identify if their pharmacy contract includes medication pass reviews. LeadingAge Ohio encourages facilities to utilize the LTCSP initial pool pathways to monitor for compliance. The survey pathways can be found on the CMS Nursing Home webpage, under the download section, and within the zip file called LTC Survey Pathways.

For more information about the citations occurring in Ohio, please join us on the monthly STAT: Survey Tips and Tactics call. Register now for the May 11 call at 10:00AM.

LeadingAge Ohio is sharing tips to assist members during the survey process. Send questions you’d like addressed in future Tips of the Week to Stephanie DeWees at sdewees@leadingageohio.org.