CMS Phase 2: Informational Update & Tools

Medication Crushing Requirements

The Nursing Home survey process is challenging. As we all try to navigate and follow the new regulations, we need all the tools and support available. Here are a few updates and resources to assist you and your team.

CMS released a Phase 2 revision on 11/22/17 about combining crushed medications.  

Crushed medications given via feeding tube must still be separated. To address concerns with physical and chemical incompatibility and complete dosing, best practice would be to separately crush each medication and separately administer each medication with food.

However, separating crushed medications may not be appropriate for all residents and is generally not counted as a medication error unless there are instructions not to crush the medication(s).

Communities should use a person-centered, individualized approach to administering all medications. If a surveyor identifies concerns related to crushing and combining oral medications, the surveyor should evaluate whether facility staff have worked with the resident/representative and appropriate clinicians (e.g., the consultant pharmacist, attending physician, medical director) to determine the most appropriate method for administering crushed medications which considers each resident’s safety, needs, medication schedule, preferences, and functional ability.

F-Tag List

Click here for the reviewed list of F-Tags.

Facility Assessment Tool

Nursing Homes are now required to conduct annual community-wide assessments on their resident population and the resources the facility needs to care for their residents (§483.70(e)). Please follow the link to download an assessment tool.