One big problem for Skilled Nursing Facilities (SNFs) is following new rules from the Centers for Medicare & Medicaid Services (CMS). Starting October 1, 2023, these rules became stricter. They affect how facilities report medication use and get paid through the Patient-Driven Payment Model (PDPM).
If SNFs don’t follow these rules, they might get paid less or face penalties. This is risky for facilities that don’t have good medication reconciliation processes. For people who run these facilities, meeting CMS rules is about money and keeping good care ratings. Good ratings help keep the facility’s reputation and trust from patients.
SNFs must make accurate, full, and clear medication lists during patient care changes to pass audits and bill correctly. This adds a lot of paperwork to nursing staff, who are already very busy in many SNFs around the United States.
Many SNFs struggle to keep enough nurses and nursing assistants. These workers do many different tasks, including medication reconciliation. The new CMS rules and more detailed medication checks make their work harder.
James Duke, PharmD, Vice President of Clinical Pharmacist Services at ActualMeds, said, “Their nursing resources are already stretched far too thin.” When nurses do complex medication checks by hand, mistakes can happen more often. This puts patient safety at risk.
When nurses spend much of their time on medication checks, they have less time for taking care of patients directly. This makes the job harder for staff and can affect how well patients do and how happy they are.
SNFs need to train their clinical staff to follow new medication reconciliation rules. Changing to new routines means staff must learn both new rules and how to use electronic health records (EHR) systems properly. Many SNFs have trouble giving ongoing training because of staff turnover, tight budgets, and busy schedules.
Staff must keep learning updated CMS rules and new technology or manual methods. This causes interruptions in daily work. Staff may get tired or unwilling to follow new steps. This can lead to inconsistent or incomplete medication lists.
Training problems also create risks for following rules. Wrong medication checks can cause missed dosage changes, drug problems, or delays in spotting bad effects. This is a concern for both patient care and legal reasons.
Good medication reconciliation relies on getting correct information about what medicines a patient takes. This information comes from many places: electronic records, pharmacy lists, and talking with patients or their caregivers. But during moves like admission or discharge, information can be lost or mixed up.
Manual typing and copying errors still happen often. Paper lists or EHR entries may not match what the patient really uses. Wrong medication lists can lead to harmful drug reactions, overdoses, or missed treatments.
Moving patients from hospital to SNF especially creates risks. Medication changes might not get shared correctly. To prevent this, staff need to make sure they have a full and checked list of a patient’s medicines throughout the whole care period.
Technology has helped medication checks but brings some problems too. Many SNFs use electronic health record (EHR) systems and pharmacy software. But these systems often don’t work well together. So, staff still must do some work by hand to match pharmacy and EHR data.
ActualMeds created the InConcert platform. It combines pharmacy and EHR data into one checked medication list covering patient admission to discharge. This helps reduce errors caused by typing and copying, as it collects data automatically from many sources.
Still, many facilities do not have access to tools like this. They must rely on separate systems and manual work that slow down the process.
Pharmacists play an important role in managing medicines in SNFs. Expert consultant pharmacists check medication orders, find any differences, and work with care teams to make clear, correct medication lists. These lists help with clinical decisions and tell patients what to keep taking or stop.
ActualMeds hires clinical pharmacists to help SNF teams by making discharge medication lists that are easy for patients and caregivers to understand. This helps meet CMS documentation rules and supports patients in taking the right medicines after leaving SNFs.
Having pharmacists involved also lowers the workload for nurses. Nurses can then spend more time on patient care.
Facilities with good medication reconciliation report better patient results and fewer hospital readmissions. Accurate medication lists help prevent bad drug events, which often cause harm after hospital care.
Using clinical pharmacists and technology helps patients understand their medicines better. ActualMeds says their patient-focused medication approach improves patient satisfaction and care quality scores.
Good medication reconciliation also lowers costs by avoiding errors and unnecessary hospital stays. This helps healthcare managers keep SNF budgets under control.
New technologies like artificial intelligence (AI) and workflow automation are becoming part of medication reconciliation in SNFs. AI can analyze large amounts of medication data, find differences, and spot possible mistakes faster than manual checks.
For example, AI can compare medication lists from pharmacies, EHRs, and old records. It points out differences that need clinical attention. Automation cuts down on manual typing and copying, common sources of error.
The ActualMeds InConcert platform uses both technology and pharmacist help. This model helps SNFs follow CMS rules without adding more work for staff.
Workflow automation tools guide the medication reconciliation steps, remind staff when tasks are due, and keep electronic records of what is done. This approach lowers missed tasks and helps with audits.
Automation and AI also improve communication across care providers. They make sure doctors, SNF staff, and pharmacists share up-to-date medication information when patients move or follow up. This helps care stay consistent when patients return home or go to other places.
In the US, SNFs must work within complex rules and payment systems that need very accurate documentation and medicine management. The challenges go beyond clinical care because not following rules can cut Medicare payments, a major income for many SNFs.
Small and medium-sized SNFs may struggle to buy advanced technology or hire more pharmacy staff. Cloud-based technology solutions are helpful by making medication checks more efficient.
Location and patient type also affect challenges. SNFs in rural or low-resource areas may have less access to pharmacists or technology, so they rely more on automation to support their staff.
As SNF patients get older and sicker, they need more careful medication checks. Facilities must get ready by using tools that handle many medicines and complex treatments often found in older patients.
Medication reconciliation remains a challenge for SNFs in the US due to changing rules, staff shortages, and technology issues. Safe, accurate, and patient-centered medication lists need new solutions that make nursing easier, improve clinical review, and cut costly mistakes.
Companies like ActualMeds created platforms and services to improve medication safety and work efficiency. Their mix of AI technology and pharmacist support could be a good model to fix current medication management issues in SNFs.
Healthcare managers, facility owners, and IT staff in SNFs need to understand these challenges and options to improve patient care and keep finances stable under new CMS rules.
By dealing with rules, staff limits, and technology challenges, SNFs can better handle medication reconciliation, helping patients stay safer and using resources more efficiently.
ActualMeds’ new solution is designed to help skilled nursing facilities (SNFs) comply with updated coding requirements from CMS that affect reimbursement, ensuring high-quality care and optimizing PDPM payments.
The InConcert platform provides a complete view of a patient’s validated medications, using historical drug data and new EHR orders to facilitate accurate medication reconciliation and safe patient discharges.
SNFs face challenges including stretched nursing resources, difficulties in training staff on new processes, and ensuring compliance with stringent CMS requirements, all while delivering quality care.
Integrating with the pharmacy and EHR systems minimizes manual data entry and transcription errors, ensuring that medication information is accurately updated and reconciled.
ActualMeds’ pharmacists create reconciled medication lists, review current orders, and collaborate with care teams to provide compliant discharge medication lists that enhance care continuity.
The solution relieves nursing staff from the burden of adapting to compliance requirements, allowing them to focus on patient care without the need to hire additional personnel.
Accurate discharge medication lists ensure that primary care physicians understand medication changes and provide clear instructions to patients and caregivers about ongoing medication management.
ActualMeds reports improved patient outcomes, higher satisfaction scores, reduced care management expenses, and overall lower costs of care due to their technology-enabled medication management.
The launch precedes important CMS updates effective October 1, 2023, at a time when SNFs are already understaffed and require immediate support for compliance.
ActualMeds aims to streamline medication management processes, enhance patient safety, ensure adherence, and reduce the risk of medication errors across post-acute care settings.
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