CCP Long-Term Care Pharmacy Services Questions and Answers

Question 1

A consultant pharmacist is reviewing the medication regimen for a new 85-year-old resident admitted to a skilled nursing facility from a hospital.
The hospital discharge summary lists one set of medications, while the separate patient care referral form contains conflicting dosage instructions for the resident's anticoagulant.
Which of the following is the MOST critical initial action for the pharmacist to take?

Accepted Answer

Contact the discharging hospital's physician or pharmacist to clarify the correct and current medication orders.

Answer

Select the medication regimen that appears most clinically appropriate and document the decision.

Answer

Use the facility's standard protocol for anticoagulation until clarification can be obtained.

Answer

Interview the resident and their family to determine which medication list they believe is accurate.

Question 2

According to the Drug Enforcement Administration's (DEA) policy, controlled substances may be placed in an emergency drug kit at a Long-Term Care Facility (LTCF). Which statement accurately reflects the regulatory standing of these kits?

Accepted Answer

The kit is considered an extension of the servicing pharmacy, which is responsible for its control and accountability.

Answer

The emergency kit is considered a separate entity and must have its own DEA registration.

Answer

Only Schedule III-V controlled substances are permitted in the emergency kit, but not Schedule II.

Answer

A physician's verbal order is sufficient to authorize withdrawal and administration from the kit, with a written prescription to follow within 30 days.

Question 3

A consultant pharmacist is participating in a skilled nursing facility's quarterly Quality Assurance and Performance Improvement (QAPI) committee meeting. Beyond conducting individual Medication Regimen Reviews (MRRs), what is a key role for the pharmacist in this setting?

Accepted Answer

Analyzing aggregate drug-related data to identify trends and areas for system-level improvement.

Answer

Prescribing alternative medications directly when a physician is unavailable.

Answer

Disciplining nursing staff who have made medication administration errors.

Answer

Serving as the primary investigator for all resident grievances related to pharmacy services.

Question 4

An 88-year-old resident with a history of falls, dementia, and anxiety has a medication regimen that includes donepezil, sertraline, lorazepam 1mg as needed for agitation, and lisinopril. During the monthly Medication Regimen Review, which medication should the consultant pharmacist flag as MOST likely contributing to the resident's fall risk?

Accepted Answer

Lorazepam

Answer

Donepezil

Answer

Sertraline

Answer

Lisinopril

Question 5

Recent updates to the Centers for Medicare & Medicaid Services (CMS) State Operations Manual have revised the guidance for surveyors regarding unnecessary medications. Which of the following best describes a key change related to F-Tag F757 (Unnecessary Medications)?

Accepted Answer

The guidance for F-Tag F757 has been revised to focus exclusively on non-psychotropic medications.

Answer

F-Tag F757 has been expanded to include all instances of inappropriate psychotropic drug use.

Answer

The requirement for Gradual Dose Reductions (GDRs) has been moved from F-Tag F758 to F-Tag F757.

Answer

F-Tag F757 now requires facilities to obtain a pharmacist's approval before starting any new antibiotic.

Question 6

A consultant pharmacist identifies that a resident has been receiving an antibiotic for a urinary tract infection for 21 days, well beyond the facility's 10-day stop-order policy, without a documented reassessment or new indication. According to CMS criteria under 42 CFR §483.45, this situation would be classified as which type of 'unnecessary drug'?

Accepted Answer

Excessive duration

Answer

Excessive dose

Answer

Without adequate indication for use

Answer

In the presence of adverse consequences