Category: Resource

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.

Advancing Anticoagulation Stewardship: A Playbook

The AC Forum, in partnership with FDA, identified seven Core Elements for improving systemic management of anticoagulants. The Playbook, developed with input from more than 30 experts, offers detailed strategies for each Core Element and is designed to be used by organizations establishing or considering Anticoagulation Stewardship programs, as well as those with existing programs in place. While all seven elements are important for implementation of a stewardship initiative, the first Core Element—securing the commitment of administrative leadership—is a foundational priority to ensure success and sustainability.

National Action Plan for ADE Prevention

The National Action Plan for Adverse Drug Event Prevention (ADE Action Plan) was established to address two key objectives: (1) identify common, preventable, and measurable adverse drug events (ADEs) that may result in significant patient harm; and (2) align the efforts of Federal health agencies to reduce patient harms from these specific ADEs nationally.

On the basis of national ADE data from inpatient and outpatient settings, three types of ADEs were considered to be common, clinically significant, preventable, and measurable, and were therefore selected as the high-priority targets of the ADE Action Plan.
The three initial targets of the ADE Action Plan are:
1. Anticoagulants (primary ADE of concern: bleeding)
2. Diabetes agents (primary ADE of concern: hypoglycemia)
3. Opioids (primary ADE of concern: accidental overdoses/over sedation /respiratory depression)


The ADE Action Plan suggests a four-pronged approach to reduce patient harms from these three ADEs: Surveillance, Prevention, Incentives and Oversight, and Research.

CMS Nursing Home Adverse Drug Event Trigger Tool

This tool was developed by CMS for use by nursing home surveyors and is a valuable resource for organizations that are focusing on preventing ADEs.

It was designed to help surveyors identify:

1. The extent to which facilities have identified resident-specific risk factors for adverse drug events

2. The extent to which facilities developed and implemented systems and processes to minimize risks associated with medications that are known to be high-risk and problem-prone

3. When a preventable adverse event has occurred, evaluate if the nursing home identified the issue and responded appropriately to mitigate harm to the individual and prevent recurrence.