Evaluation of neuroleptic drug use by nursing home elderly under proposed Medicare and Medicaid regulations.

ABSTRACT

KIE: Guidelines developed by the federal Health Care Financing Administration (HCFA) for the administration of drugs in Medicare- and Medicaid-certified nursing homes were recently implemented, marking the first time that the use of prescription drugs must be justified on the patient's medical chart. This study applied the HCFA guidelines on the administration of neuroleptic drugs to an existing set of data about medication use in nursing homes to estimate the potential impact of the federal regulations. Subjects, both randomly sampled admissions and residents, were followed through nursing and medical records for up to 24 months in 60 nursing homes in eight Western states. Comparison of the study data with the HCFA criteria revealed that one half of the neuroleptic use in each cohort was ineligible by federal standards. The authors discuss the implications that the implementation of the HCFA guidelines has for the care of the elderly.