EmpRes PostAcute Rehabilitation was recently issued a Class A citation from the Dpeartment of Public Health for its part in heavily drugging a male resident with dementia. The resident was drugged with three antipsychotic drugs to restrain him from alleged physical aggression. Within days, he suffered a rapid decline, was no longer able to walk or talk, and required a mechanical lift to transfer from his bed to a wheelchair. The resident was drugged with Seroquel (the dosage increased over time), Risperdal (the dosage increased over time), and Zyprexa. The resident’s physician rebuffed a nurse practitioner’s recommendation to discontinue Zyprexa and another recommendation to reduce the Seroquel.
Multiple Parkinsonism symptoms were noted including tremors and immobile facial expressions but the drugging continued. A consultant pharmacist report recommended the physician justify the extreme drugging. The physician responded “no changes” to current plan. The facility’s staff asked the physician to approve a gradual reduction in the drugs to which the physician responded “no” without including a justification. Upon interview, the physician said he prescribed all three drugs to control the resident’s behaviors. The facility was cited for failing to implement its policies for decreasing or discontinuing antipsychotic drug usage in the presence of severe side effects.