CMS Manual System - Louisiana Department of Health and Hospitals

errors, or other irregularities, and collaborating with other members of the
interdisciplinary team. 65
―Monitoring‖ is the ongoing collection and analysis of information (such as observations
and diagnostic test results) and comparison to baseline data in order to:
o Ascertain the individual’s response to treatment and care, including progress
or lack of progress toward a therapeutic goal;
o Detect any complications or adverse consequences of the condition or of the
treatments; and
o Support decisions about modifying, discontinuing, or continuing any
interventions.
―Pharmacy Assistant or Technician‖ refers to ancillary personnel who work under the
supervision and delegation of the pharmacist as consistent with state requirements.
OVERVIEW
Many nursing home residents require multiple medications to address their conditions, leading to
complex medication regimens. Medications are used for their therapeutic benefits in diagnosing,
managing, and treating acute and/or chronic conditions, for maintaining and/or improving a
resident‘s functional status, and for improving or sustaining the resident‘s quality of life. The
nursing home population may be quite diverse and may include geriatric residents as well as
individuals of any age with special needs, such as those who are immunocompromised or who
have end stage renal disease or spinal cord or closed head injuries. Regardless, this population
has been identified as being at high risk for adverse consequences related to medications. Some
adverse consequences may mimic symptoms of chronic conditions, the aging process, or a newly
emerging condition.
Transitions in care such as a move from home or hospital to the nursing home, or vice versa,
increases the risk of medication-related issues. Medications may be added, discontinued,
omitted, or changed. It is important, therefore, to review the medications. Currently, safeguards
to help identify medication issues include:
The physician providing and reviewing the orders and total program of care on admission
and the prescriber reviewing at each visit;
The nurse reviewing medications when transmitting the orders to the pharmacy and/or
prior to administering medications;
The interdisciplinary team reviewing the medications as part of the comprehensive
assessment for the Resident Assessment Instrument (RAI) and/or care plan;
The pharmacist reviewing the prescriptions prior to dispensing; and