FAQ: Medication Errors in Nursing Homes

WHY DO SO MANY MEDICATION ERRORS OCCUR?

When you hear concerning data about the possibility of a loved one receiving incorrect medication, it is natural to wonder why. Below is a list of possible causes of medication errors in nursing homes:

• Basic Human Error
• Transcription Error
• Frequent Distractions/Care Changes
• Poor Communication
• Pharmacy Dispensing
• Medication Unavailable
• Medication Name Confusion
• Following Policies & Procedures
• Too Much Workload/Overtime
• Shift Change
• Product Labeling
• Pharmacy Delivered Wrong Medication
• Packaging Design
• Inadequate Information
• Improper Training
• Illegible Handwriting
• Short staffng
• Inadequately trained medical staff

WHO IS TO BLAME?

The medication your loved one receives most likely passes through many hands before it reaches them. There are many parties that may be liable for errors. If the nursing home does not have clearly stated procedures and comprehensive training for all their employees, they may be responsible for the error, in addition to the nurse or caretaker who administered the medication. The physician who prescribes the drug may be negligent if they fail to consider potential negative drug interactions. In some cases, pharmacists who make mistakes in measuring and distributing the medication may also be found negligent.

DO I HAVE ACCESS TO MY LOVED ONE’S MEDICAL RECORDS?

It is often a good idea to request copies of medical records when concerned with the treatment of a parent or other elderly relative. A resident and their representative have a right to view and receive copies of medical records. Authorized representatives of a resident will usually be established upon the resident’s entry into the nursing home, and each nursing home will have their own procedures and forms used to authorize representation.

Federal regulation Section 483.10 lays out basic rights of long term care facility residents. These include the following rights of a resident and their representative:

(i) Upon an oral or written request, to access all records pertaining to himself or herself including current clinical records within 24 hours (excluding weekends and holidays); and

(ii) After receipt of his or her records for inspection, to purchase at a cost not to exceed the community standard photocopies of the records or any portions of them upon request and 2 working days advance notice to the facility.

DOES THE NURSING HOME HAVE TO ALERT ME BEFORE THEY CHANGE MY LOVED ONE’S MEDICATION?

Yes, nursing homes should alert you when there are any changes to your relative’s condition, if you are their legal representative. In fact, nursing homes are legally obligated to alert the resident, a physician, and the legal representative or other family member for a variety of reasons including

• any accident involving the resident causing injury which might require medical attention
• significant changes in the resident’s physical, mental, or psychosocial state
• the need to alter treatment significantly; i.e. add or discontinue treatments
• the decision to transfer the resident to another facility

In addition, the nursing home should alert you if they decide to change your loved one’s room or roommate and if any of the laws governing their legal rights are altered.

IF I SUSPECT THAT THEY ARE MISMANAGING MY RELATIVE’S MEDICATION, WHO SHOULD I TALK TO?

There are many people you can approach about the problem, depending on the situation. If you trust your loved one’s physician or the nursing home supervisor, you can talk to them about the employees who manage your relative’s medication on a daily basis. If your relative is cognizant and aware, they may be able to give you information. Alternatively, you may file a complaint through the grievance system in place at any Medicare/Medicaid-certified nursing home or contact one of the many government agencies in place to protect elder home abuse victims such as Adult Protective Services who will assign a case manager. You may also call 911.