F759 – Spotlight on CMS Pharmacy Deficiencies

F759 is a deficiency that long term care facilities can receive for a medication error rate of >5%.  Compared to F758 and some of the other pharmacy services deficiencies, this tag is rarely cited.

How Would F759 be Cited?

With the medication error rate deficiency, in the rare situations where I have seen it cited, the surveyor would typically watch medication administration.  If the surveyor deemed that the individual administer medications made multiple errors that equated to a rate of greater than 5%, the facility could be cited for this deficiency.  If the surveyor had concerns that a nurse administering medications, this may tip them off to watch a little closer and consider citing this tag.

What Medications Can be Cited Under F759?

This pharmacy services deficiency does not have to be in relation to prescription medications.  Any supplement or over-the-counter medication can be used in the calculation of the 5% medication error rate.

Example F759

The one…and only one example I definitively remember was with regards to a medication pass.  The error involved numerous medications which were being crushed and those medications should not have been.  Two specific medications I remember being cited in this tag was enteric coated aspirin being inappropriately crushed.  There were a few other errors with administration, but the other one that comes to mind was the use of an oral bisphosphonate that was being given with food.  These medications (alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel)) should not be given with other medications and should only be given with plain water.  This is due to the fact that they drug binds other nutrients and medications.  Therefore the drug is not adequately absorbed into the body and has no effect.  In a patient with osteoporosis, not getting benefit from the medication could be a significant concern.

Summing up F759. I doubt you will likely see this tag, but if there is a situation where numerous medication administration errors are made it is a possibility.  Training staff on appropriate medication administration and encouraging reporting of medication errors can help minimize the risk of frequent and substantial medication errors.

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