CMS Manual System - Louisiana Department of Health and Hospitals

NOTE: If a resident is receiving services from a dialysis provider, and the survey team
has concerns about the quality of care and services provided to the resident by
that provider, refer the concerns as a complaint to the State Agency
responsible for oversight of the dialysis provider, identifying the specific
resident(s) involved and the concerns identified.
Review of a Resident Who has Pain Symptoms, is being Treated for Pain, or Who
has the Potential for Pain Symptoms Related to Conditions or Treatments.
Recognition and Management of Pain - In order to help a resident attain or maintain his
or her highest practicable level of well-being and to prevent or manage pain, the facility,
to the extent possible:
Recognizes when the resident is experiencing pain and identifies circumstances
when pain can be anticipated;
Evaluates the existing pain and the cause(s), and
Manages or prevents pain, consistent with the comprehensive assessment and plan
of care, current clinical standards of practice, and the resident‘s goals and
preferences.
Definitions Related to Recognition and Management of Pain
―Addiction‖ is a primary, chronic, neurobiological disease, with genetic,
psychosocial, and environmental factors influencing its development and
manifestations. It is characterized by an overwhelming craving for medication or
behaviors that include one or more of the following: impaired control over drug
use, compulsive use, continued use despite harm, and craving .1
"Adjuvant Analgesics" describes any medication with a primary indication other
than pain management but with analgesic properties in some painful conditions. 2
―Adverse Consequence‖ is an unpleasant symptom or event that is due to or
associated with a medication, such as impairment or decline in a resident‘s mental
or physical condition or functional or psychosocial status. It may include various
types of adverse drug reactions and interactions (e.g., medication-medication,
medication-food, and medication-disease).
NOTE: Adverse drug reaction (ADR) is a form of adverse consequences. It
may be either a secondary effect of a medication that is usually
undesirable and different from the therapeutic effect of the
medication or any response to a medication that is noxious and
unintended and occurs in doses for prophylaxis, diagnosis, or
treatment. The term ―side effect‖ is often used interchangeably with
ADR; however, side effects are but one of five ADR categories, the