Board and Care Homes:

Elderly at Risk From Mishandled Medications

HRD-92-45: Published: Feb 7, 1992. Publicly Released: Mar 16, 1992.

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Pursuant to a congressional request, GAO reviewed the misuse and mismanagement of residents' medications in board and care homes for the elderly, focusing on whether: (1) staff who work in licensed board and care homes are knowledgeable about the proper handling of medications; (2) staff follow proper procedures for storing, supervising, and administering medications; and (3) residents receive the appropriate medications.

GAO found that: (1) because staff may not be properly trained or do not always follow state regulations, residents in board and care homes are at risk of being harmed by medication errors; (2) over one-third of the homes reviewed employed staff who did not meet state medication training requirements; (3) half of the homes reviewed violated medication-handling regulations for storing medications, supervising and assisting with residents' self-medication, and disposing of medications; and (4) the records for 20 of the 35 residents reviewed had sufficient medical information to indicate that medications were appropriately prescribed.

Status Legend:

More Info
  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: To minimize the risk of improper medication assistance to residents, the Secretary of Health and Human Services should direct the Department of Health and Human Services (HHS) to develop and disseminate to states guidelines for assisting with self-medication, storing and disposing of medications, and recordkeeping.

    Agency Affected: Department of Health and Human Services

    Status: Closed - Implemented

    Comments: HHS took alternative action. It performed and disseminated studies about the board and care industry that incorporated medication handling issues. The findings and conclusions were consistent with GAO's recommendation. However, an official in the Office of the Assistant Secretary for Planning and Evaluation stated that the agency does not have sufficient resources to take further action on the recommendation at this time.

    Recommendation: To minimize the risk of improper medication assistance to residents, the Secretary of Health and Human Services should direct HHS to develop and disseminate to states model classroom training programs for board and care home administrators, operators, staff, and state inspectors on such topics as medication types, proper storage, supervision and assistance, and adverse effects of medications.

    Agency Affected: Department of Health and Human Services

    Status: Closed - Implemented

    Comments: HHS took alternative action. It performed and disseminated studies about the board and care industry that incorporated medication handling issues. The findings and conclusions were consistent with GAO's recommendation. However, an official in the Office of the Assistant Secretary for Planning and Evaluation stated that the agency does not have sufficient resources to take further action on the recommendation at this time.

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