CMS is failing to protect nursing home patients from bad care caused by the DEA

DEA issues in nursing homes and role of CMS:

-CMS is mandated to protect nursing home residents from neglect and substandard care, and yet for the past two years regulations by another government agency, the DEA, have resulted in a built-in delay in carrying out doctor orders when it comes to orders for narcotics and other scheduled drugs, such as benzodiazepines used for seizure or panic attacks. This delay is directly impacting quality of care of nursing home residents, as doctors orders can not be carried out immediately by the licensed nursing staff.

-Current DEA rules, prohibit nurses from carrying out doctor orders for scheduled drugs, unless they are coupled with a hard prescription, forcing a delay until the doctor has provided a written script or until the pharmacist confirmed the orders with the prescribing provider (as if the patient was at home, and not in a nursing home). All this involves or is followed by a complex paperwork process. Moreover, the nursing home nurses are not allowed to use the emergency kit in the facility to treat emergencies such as seizures, panic attacks, or pain control in dying patients, despite having a valid verbal order from a dully licensed attending physician in an inpatient nursing home setting. All this is done in the name of protecting all of us from drug diversion by healthcare professionals, at the expense of nursing home patients' suffering for an added 30 minutes or so each time a stat order is given. In case of seizures it is well established that any delay in treatment is potentially life threatening, but try telling that to the DEA.

-It is noteworthy that if facilities happen to document the above mentioned delays in medication administration, CMS can and does in fact hold the nursing homes, not the DEA, accountable for negligence and substandard care. There is no mention of the DEA in the CMS deficiency tags handed to offending nursing homes.

Why is CMS responsible?

. CMS is failing to live up to their own self-declared goals and obligations when it comes to preventing substandard care, simply because this substandard care happens to be caused by a powerful federal agency, the DEA. Instead of addressing the route cause of this particular problem, CMS is robotically holding local facilities accountable for something they have no control over and is a direct consequence of federal (DEA) mandates.