Medication Errors

Medication Errors in Assisted Living Facilities

Assisted living facilities (ALFs) increasingly provide service to older adults who would have otherwise lived in skilled nursing facilities (SNFs), offering a more homelike and less restrictive residential option at more affordable costs. Due to multiple chronic health conditions, assisted living (AL) residents often need continuous monitoring and management. ALFs aim to provide their residents choice, privacy, autonomy, and the ability to age in place. Although ALFs are more affordable and their setting is less institutional, these qualities are compensated by less professional supervision and the possible risk for unfavorable health outcomes due to the need for more vigilant health monitoring. A crucial issue in ALFs is achieving the proper balance between freedoms and risks for residents, staff, and the residential settings themselves.

Frailty is prevalent among Assisted Living residents with various chronic health issues. Statistics show that over half are aged 85 and older, about 25% have significant cognitive impairment, and 77% need assistance with their medications. Moreover, several groups of high-risk medications in ALF’s (such as psychotropics, cardiovascular agents, and anticoagulants) are used prevalently. Unlike SNFs, where licensed nurses administer medication, medication management in ALFs are overseen by assistive personnel (UAP) who do not have a license, with little professional involvement. Exacerbating the problem are steep UAP turnover in assisted living settings and limited structures and processes to supervise quality in medication management. Medication management is one of the three most prominent quality of care concerns in ALFs.

The definition of a medication administration error is “any difference between what the patient received or was supposed to receive and what the prescriber intended in the original order.” There has been notable controversy in ALFs pertaining to medication administration because, in many cases, non-nurses are allowed to administer medications. Although the benefit of using these staff is that their services are less expensive than those of nurses, a potential negative consequence of using non-nurses to administer medications is that doing so could lead to more errors and jeopardize the health of already vulnerable Assisted Living residents. A recent study titled “We’ve Got Trouble: Medications in Assisted Living” revealed that, of 1,335 ALFs in Arizona surveyed in 2008, 62% were given a medication-related citation. The General Accounting Office reported medication administration to be the third most frequently cited problem in ALF’s and has voiced similar concerns.

A study that examined medication administration by nonurses in ALFs revealed an overall 28% error rate. Another recent study compared the rate of medication administration errors of licensed practical nurses (LPNs) and nonnurses working in ALFs. Nonnurses were regarded as medication aides (staff who completed a course, passed an examination, and was approved to administer medications) or others (who were differentiated by the amount of medication-related training they underwent). The results of the study had two major findings: (1) medication aides and LPNs have similar error rates, and (2) nonurses who are not medication aides perform significant medication administration, and make more errors than LPNs and medication aides. Errors were more prevalent among staff who went through less training. The results clearly show that all nonnurses who handle medications—even when assisting residents with self-administration—should be trained to the level of a medication aide.

In closing, ALFs are increasingly caring for frail and vulnerable older adults. Although these residents may not be as impaired as nursing home residents, they have multiple health conditions that require multiple routine medications (an average of ten medications), similar to nursing home residents. Furthermore, nursing home-eligible older adults who do not need skilled nursing services can often be served in ALFs and must receive the assistance they require with medication management. ALF staff who are given the responsibility to manage medications for residents must be trained, with an emphasized focus on medications likely to result in harm, to avoid medication errors that can threaten the quality of life and health of their residents.

If you believe that you or someone you love suffered or is suffering due to a medication error by assisted living facility staff, contact us today for a free consultation. We, at the Law Offices of Ben Yeroushalmi will fight to get you and your loved ones the justice you deserve. Not only will we advocate on your behalf, we will make sure that you do not have to handle this problem alone.

Client Reviews
★★★★★
Excellent staff and the epitome of genuine, honest, and beyond helpful. I was lost and running out of time until I found Yeroushalmi law office. I am beyond grateful and had the pleasure of working with such amazing people who look out for your best interest.
★★★★★
Ben Yeroushalmi accepted my case with much understanding and patience. He went above and beyond with the defense lawyers to reach a fair settlement. He explained the complete case process (as I had never filed a case with anyone) Ben kept my sister and I notified of every email or correspondence he had with the opposing council. Gloria
★★★★★
Ben is an outstanding litigator, and human being. He took on our case, as if it was his own. He paid close attention to details. His guidance was invaluable. He was very clear and concise, in explaining all potential scenarios to us. He spoke eloquently, and straight to the point at all times. Ben is a true professional, with a passion for his craft. Anonymous review
★★★★★
I had a heartfelt and memorable experience with Ben , very genuine and I can tell he loves what he does. His determination shows beautifully and it is amazing. In my opinion it is very rare you find people who love what they're doing and it shows. Not wanting to get religious on an review but, God introduced me to Ben for a reason. Summer
★★★★★
Ben was wonderful. He took our case when no one else was interested or wanted way to much money. We would highly recommend Ben because he really listens and takes your situation into consideration. We settled our case and we were only unhappy with one thing and that was the confidentiality clause but that was not Ben's fault it came with the deal. June
★★★★★
All around GREAT experienced under the circumstances. Special thanks to Devon Wright she did exceptional work for our case. Anonymous review
★★★★★
Mr Yeroushalmi was our lawyer for a case involving my mother who was a victim of elderly abuse while in a nursing home. He and his team did an excellent job. My mother was able to live comfortably for the remaining years of her life due to the results of our case. I highly recommend Mr Ben Yeroushalmi. Danny
★★★★★
Mr. Yeroushalmi had provided his legal services for my father's medical injury case. Through mr. Yeroushlmi's excellent services, my family could make informed decisions during the entire course of legal proceedings. Thanks for the professional and responsive services. I strongly recommend Mr. Yeroushimi as your legal advisior. He is the one you can rely on. Thanks. Samuel
★★★★★
Mr. Yeroushalmi provide excellent representation After my husband passed away from complications due to Alzheimer's. It was a complex case and I was always informed of the progression of the case. The office staff offers the personal touch and patience with my constant phone calls and questions. I highly recommend Ben and his staff if you are looking for an aggressive attorney with high ethics and great attention to details. Terry