This week, DPH released an All-Facilities Letter (AFL) #14-05 to hospitals regarding nursing home obligations to verify informed consent for psych drugs before administering them. You may wonder: why would DPH send a letter to hospitals about nursing home responsibilities? The answer is that hospitals’ poor regard for informed consent requirements poses a major dilemma for nursing homes that admit residents from hospitals and contributes to the misuse of antipsychotics in long-term care.
It’s no secret that many, if not most, psych drug prescriptions for nursing home residents start in a hospital before the resident is admitted. In our experience, those hospital initiated prescriptions are often (perhaps usually) without any consent or even input from the patient. When those patients are transferred to a nursing home, the facility is required to verify informed consent for psych drugs. If the facility cannot verify informed consent, according to the AFL, it “must either refuse to admit the patient or suspend ordered treatment until consent can be obtained.”
The AFL strongly encourages hospitals to include informed consent verification as part of patient transfer summaries to minimize the burden on nursing homes that are admitting residents with psych drug orders.
This AFL should serve as a powerful reminder to hospitals that they have informed consent responsibilities to their patients when they administer psych drugs and that nursing homes rely on hospital compliance to ensure patients have smooth care transitions. DPH’s letter is a timely and important message in the ongoing campaign to end psychotropic drug misuse.