Nursing home under investigation for overmedicating residents

Last week in Chapel Hill, North Carolina, local police announced that they had referred an investigation of nursing home abuse and neglect to the state police.  The investigation was sparked by a finding that several residents in a nursing home serving Alzheimer's patients were testing positive for powerful pain killers that had not been prescribed for them.  Three nursing home residents were admitted to the hospital after testing positive for the drugs, and one died shortly thereafter.

Many pain medications have the effect of sedating the person receiving them.  Using medications such as pain killers or anti-psychotic medications on nursing home residents for the purpose of sedating them is known as chemically restraining the resident.  Federal regulations prohibit this.

Besides the fact that using a chemical restraint on a nursing home resident is a form of nursing home abuse and neglect, there are a number of other troubling safety issues that are raised by this story:

• One thing that must be considered whenever a nursing home resident is being given prescription medications is whether there is potential for a drug interaction.  It is something that must be considered by the attending physician as well as during the monthly review of the resident's drug regimen.  If neither the doctor nor the pharmacist conducting the monthly review know that the resident is getting the pain killers, a drug interaction between the pain killer and the other medications that were actually prescribed is never given any consideration.  This greatly increases the chances of a nursing home prescription medication error.
• When nursing home residents are given pain killers for the purpose of sedating them, they become less active and less mobile.  Immobility is one of the things that sets nursing home residents up for developing pressure ulcers or bed sores.
• Over-medicating residents also increases the risk of of nursing home falls due to loss of balance and diminished alertness.  Falls are a major health risk for nursing home residents as multiple studies have shown that fractures, especially hip fractures, are a major cause of morbidity and mortality for senior citizens.

Obviously, one has to hope that the  perpetrator(s) of this scheme are identified and punished.  However, as an experienced Chicago nursing home lawyer, it seems to me that there are serious questions that have to be asked of the management and ownership of this nursing home.

Heavy duty pain killers are controlled substances, and the nursing home has to be accountable for the medications it has purchased.  If the pain medications were being dispense without a prescription, why wasn't anyone paying attention to the fact that the medications has gone missing?