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Holly I agree that
ensuring physician compliance regarding justification for psychotropic meds is
difficult. It’s not their top priority. It was wonderful when my Medical Director
was also my Psychiatrist. He was a man that was the DON’s best friend. He would
ensure whatever we needed we had. (He was very strict as well regarding his protocols
and expectations and had high standards and expectations.) However I have found
that many doctors lack the awareness of what is necessary per OBRA guidelines,
interpretations etc. I have found that a little information goes a long way. I have
provided quick reading literature, reminders that the meds may not be covered by
“ “ payment source if it lacks a justifiable and acceptable diagnosis, etc. It
is an ongoing battle. To have a policy not to initiate until appropriate diagnosis
is obtained, is sort of like saying “I can’t obtain an INFORMED consent unless I
know exactly why the resident is receiving this and what the anticipated effect
will be,” and therefore I can’t administer without informed consent. I guess I’d
look at whose feathers you want to ruffle and what’s the least painful way to go
about it. Good luck! -----Original
Message----- Very
true, Glo. And I am sorry if my original post sparked any
anti-surveyor sentiments. Once again, for the record, I was just trying to get
some confirmation about whether it is "acceptable" or
"legal" to have a policy of not initiating a new antipsychotic
medication until the MD has given an appropriate diagnosis. Our docs have
been using depression and agitation, and then get snarky with me when I try to
clarify. Seems as though it would be easier to have it on paper, saying,
"Dear Doctor. Your order for Risperdal for Resident Sally Swearsalot has
been noted. In order to begin this medication, please indicate the appropriate
diagnosis from the list below. Regulations require that one of these
diagnoses be present in order to justify use of this med." Thanks,
y'all, for bearing with me. I am just trying to understand this. Holly F. Sox,
RN, RAC-C -----
Original Message -----
Sent: Tuesday, December 16,
2003 9:27 PM Subject: Re:
Stop the Stereotypes It is true some surveyors are very and some are not. However, it
is my understanding that they are not allowed to give advice per the Federal
govt. I believe it is stated in the State operations manual. Gloglo |
- Re: Stop the Stereotypes/More Antipsych stuff Connie L. Frank
- Re: Stop the Stereotypes/More Antipsych stuff RRS2000
- Re: Stop the Stereotypes/More Antipsych stuf... Holly Sox, RN, RAC-C
