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.

Naloxone Saves Lives: Information for patients, their families/care partners and pharmacists

This patient education document is available in both English and Spanish. It describes what naloxone is, how it works, why it is offered to individuals with an opioid prescription, and signs of opioid overdose.

Naloxone Saves Lives: English

Naloxone Saves Lives: Spanish

Naloxone Conversation Starters for Pharmacists

Reminders for Pharmacists When Offering Naloxone
• Offer a consultation about naloxone for opioid prescriptions.
• Be sure to advise patients that naloxone can be used to reverse any opioid overdose.
• Tell patients about available statewide programs that offer naloxone for free or at a lower cost.
• Patients may not be comfortable speaking about naloxone due to stigma associated with opioid use.

A list of multiple state naloxone resources is included.

MDS 3.0 Quality Measures

This manual is designed to assist organizations in identifying how a resident will “trigger” for a quality measure based on quality measure specifications and the coding of the MDS 3.0 Resident Assessment Instrument (RAI).

Complicated grief and related factors among nursing staff during the Covid-19 pandemic: a cross-sectional study

The challenging working conditions during the Covid-19 pandemic created a perfect storm that can seriously impact nurses’ physical and psychological well-being. Our study aimed to investigate complicated grief and its related factors among nursing staff during the Covid-19 pandemic.
Due to frequent exposure to patients’ deaths, healthcare providers are at increased risk of suffering from complicated grief during the Covid-19 and post-pandemic. If it remains unresolved, complicated grief can result in significant health problems and the experience of burnout among nurses. Governments, health authorities, and nursing managers should support nurses who work in Covid-19 settings to reduce the adverse impact of the pandemic
on nurses’ health and well-being.

Impact of COVID-19 pandemic on healthcare workers

The COVID-19 pandemic is a healthcare crisis that has led to unprecedented impact on healthcare services. At the heart of the unparalleled crisis, doctors face several challenges in treating patients with COVID-19. The psychological burden and overall wellness of healthcare workers (HCWs) have received heightened awareness, with research continuing to show high rates of burnout, psychological stress, and suicide. Detrimental effects include high rates of infection and death, excessive financial hardships, stress related to known and particularly unknown information, and fear of uncertainty regarding continued impact. Some researchers focused specifically on COVID-19’s impact on HCW sleep. Anxiety and stress were significantly increased, leading to negative impacts on both self-efficacy and sleep. Stress is an important factor in drug use. Efforts should be made to explore the factors that are associated with psychological distress, which may lead to symptoms of anxiety, depression, or provoke suicidal ideation, and efforts should be made to control the factors that are modifiable. There needs to be more awareness among doctors and further long-term studies focusing on their mental health as adverse mental health conditions will further affect them as the disease advances.