Board and Care Homes

Elderly at Risk From Mishandled Medications Gao ID: HRD-92-45 February 7, 1992

Board and care homes for the elderly are nonmedical, community-based facilities that provide room, meals, and some supervision of residents, including assistance with medications. In reviewing board and care homes in three states--California, Missouri, and Washington--GAO found that staff receive little medication training and often violate medication-handling regulations; state inspection procedures may not spot such violations; and staff frequently did not keep required resident records. While resident records supported the appropriateness of medications for about half of the 35 residents GAO reviewed, they were insufficient for GAO to judge the others. GAO concludes that residents in these homes are at risk of medication errors and that the Department of Health and Human Services should help states address these medication handling issues and develop training programs. GAO summarized this report in testimony before Congress; see: Board and Care Homes: Medication Mishandling Places Elderly at Risk, by Joseph F. Delfico, Director of Income Security Issues, before the Subcommittee on Health and Long-Term Care, House Select Committee on Aging. GAO/T-HRD-92-16, Mar. 13, 1992 (nine pages).

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.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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