Nursing Home Naloxone Policy and Procedure Toolkit

According to a CMS memo regarding Mental Health/Substance Use Disorder (SUD), CMS has identified a need to improve guidance related to meeting the unique health needs of residents with mental health diagnoses and SUD. CMS clarified that when facilities care for residents with these conditions, policies and practices must not conflict with resident rights or other requirements of participation. They further clarified that facility staff should have knowledge of signs and symptoms of possible substance use, and are prepared to address emergencies (e.g., an overdose) by increasing monitoring, administering naloxone, initiating cardiopulmonary resuscitation (CPR) as appropriate, and contacting emergency medical services.[1] This naloxone nursing home toolkit is intended to provide easy to adapt policies and procedures for nursing homes that need to implement or improve their emergency response to opioid overdose, which includes naloxone administration.

[1] Revised Long-Term Care Surveyor Guidance | CMS. www.cms.gov. Accessed January 17, 2023. (https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/revised-long-term-care-surveyor-guidance)

The Nursing Home Naloxone Policy & Procedure Toolkit PowerPoint

This is another resource, designed to be used as an introductory presentation. This slide deck contains an abridged version of the Toolkit and provides a general overview of the Toolkit contents. It includes select references to regulatory guidance, background, need assessment, features, and brief descriptions of the policies, procedures, and resources contained in the Toolkit.

Nursing Home Naloxone Policy & Procedure Toolkit Implementation Checklist

This resource was created to help facilities implement the Nursing Home Naloxone Policy & Procedure Toolkit. This checklist provides an overview for a process to successfully implement select toolkit contents.

Psychotropic Medication Tracking Form and Guide

The “Psychotropic Medication Tracking Form” was developed to assist facilities with a way to track the prescribing of psychotropic medications and any gradual dose reduction efforts. It maintains an active list of all psychotropic medication used in “real time” to include antidepressants, anti-anxiety medications, stimulants, antipsychotics, mood stabilizers and hypnotics. (See instructions below on how to download the tracking form resources.)

Complete this form to receive a link to download a zipped folder of the Psychotropic Medication Tracking Resources to include the Excel tracking form as well as a PDF instructional guide that explains the use of the tool.

For questions on the Psychotropic Medication Tracking Form and Guide, please contact us at QIN-QIOR2@ipro.org.

Staff Stability Toolkit

This Staff Stability Toolkit is an Excel file that contains individual worksheets focused on selected areas related to “staff stability”.

The tool is intended to offer a “snapshot” of your current staffing situation allowing you to collect and analyze areas for detailed and focused areas such as

  • Employment Status – The makeup of your current staffing situation as it relates to “full-time”, “part-time” and “per diem” employment status
  • Current Staff by Length of Service – Summarizing the current staff into Length of Service classifications across several categories from “< 6 months” through “10 Years or More”
  • Vacant Positions – Current vacant positions by FTEs across all departments and shifts
  • Turnover Rates – The calculation of turnover rates by “Overall Facility” with the opportunity to drill down by individual departments or groups
  • Cost of Turnover – The calculation of “Turnover Replacement Costs” to include recruitment, vacancy costs, and training/orientation costs based on current rate of terminations by position
  • Terminations by Length of Service – Collects both the number and percentage of terminations either by “Employee Choice” or “Employer Choice” across several Length of Service categories from “< 6 months” through “10 Years or More”
  • Absenteeism – The collection of Call-In Statistics by department and shift for categories to include “timely call-in”, “shift replaced”, “replaced with overtime”, “replaced with agency”, and any “incentives” that were paid for the replacement of the individual call-in. The categories are summarized and graphed by department and shift with the calculation of an overall call-in percentage related to scheduled shifts
  • Financial Incentives – The collection and summary of any incentive programs currently in place with an annual cost estimate

It is believed that by collecting and analyzing these focused “costs”, a facility will be better positioned to strategize and plan their approaches to improve and maintain the staffing stability within their individual facility.

Substance Use Disorder Treatment and Access Policy and Procedure Toolkit for Nursing Homes and Adult Care Facilities

This Substance Use Disorder (SUD) Treatment and Access Policy and Procedure Toolkit for Nursing Homes and Adult Care Facilities is intended to provide easy-to-adapt policies and procedures for facilities that wish to implement or improve their care for residents with SUD, which includes access to behavioral health resources, medications, telehealth, and referral networks. Most of the policies deal with opioid use disorder treatment, as this was the overarching need identified by nursing homes and adult care facilities; however, this toolkit was designed to be modified, and future updates will include additional substance use disorder policies.

Transfer Tracking Form and Guide

The Transfer Tracking Form was developed to provide facilities with a tool to track both their acute care and emergency department transfers over time. It maintains an active list of all transfers and any related aspects of each transfer in real time. (See instructions below on how to download the tracking form resources.)

Complete this form to receive a link to download a zipped folder of the Transfer Tracking Resources to include the Excel tracking form as well as a PDF instructional guide that explains the use of the tool.

For questions on the Transfer Tracking Form and Guide, please contact us at QIN-QIOR2@ipro.org.