St. Josephs Place, a nursing home in Orange County, New York, received a deficient rating in several areas of care following an April, 2013 inspection by the Department of Health. Among these areas were a failure to keep residents’ drug regimens free from unnecessary drugs. Specifically, the facility failed to consider gradually reducing the dosage of psychoactive medications for a resident.
The resident in question suffered from several mental illnesses, including psychosis, dementia, and depression. These diagnoses required prescriptions for several medications, such as anti-psychotics and anti-depressants. Despite the resident’s stable behavior, there was no documentation that the physician considered reducing the dosage of these medications. The physician also seemed to ignore a recommendation from the resident’s pharmacist to lower the dosage.
A facility must make efforts to reduce the dosage of anti-psychotic medications prescribed to its residents. It must also conduct behavioral interventions in an effort to reduce or discontinue the usage of such prescriptions. Based on the DOH citation, it appears that St. Josephs did not make an effort in either of these areas.
St. Joseph’s also failed to provide proper fluid intake for one of its residents. Although upon admission to the facility this particular resident was deemed to be a dehydration risk, she was receiving only roughly 45% percent of the fluids called for in her care plan. Both the resident’s dietician and her charge nurse claimed that the other’s department was responsible for monitoring fluid intakes. The resident did not suffer any actual harm, but the potential for harm is always present when a facility fails to follow the regulation that it must provide adequate fluid intake to maintain hydration and health among its residents.
The rest of the Department of Health report on St. Joseph’s Place can be found on the DOH website.