From Polypharmacy To Clarity: Building A Culture Of Ongoing Med Rec

A single, accurate medication list can prevent harm, yet it’s often the messiest part of home visits. We unpack how to turn a kitchen-table pile of bottles into a clear, living record that protects patients, reduces polypharmacy, and keeps agencies compliant. Drawing on decades at the bedside and in surveys, we walk through the moments where discrepancies hide—transitions between providers, “as needed” meds, herbals and supplements, dose tweaks after a clinic visit—and show how to bring everything into alignment with orders and what’s actually in the home.

View CHAP's new resource: Medication Reconciliation in Home-Based Care

We get specific about what good medication reconciliation looks like in home health and hospice: verify at every visit, include non-covered and OTC products, and escalate discrepancies to the prescriber right away. You’ll hear why misalignment across the home list, the medication profile, and facility records is a top CMS deficiency and how it can escalate to immediate jeopardy when safety is at risk. We also dig into the April 2024 Home Health CoP interpretive update that lets agencies define who performs medication reviews based on scope and policy, while underscoring the nonnegotiable goal: a timely, accurate, and complete list.

Education and tools make the difference. We share practical strategies for teach-back, multilingual materials, and adapting for hearing or vision limits. We cover the Beers Criteria for older adults, ISMP resources, safe storage and disposal, and tech that improves adherence—delivery services, synchronized refills, pre-filled packs, and smart dispensers. Expect actionable checklists, questions to ask on every visit, and a reminder to have patients carry a current list to appointments and during any transition of care.

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Chapters

• 0:14 Welcome And Topic Set: Med Rec
• 1:00 Why Medication Reconciliation Matters
• 3:16 Real-World Risks And Survey Deficiencies
• 6:31 Building A Complete, Accurate Med List
• 8:53 Ongoing Process Beyond Admission
• 10:15 Older Adults, Polypharmacy, And Safety
• 12:39 Compliance, Alignment, And Immediate Jeopardy
• 15:19 Reconciling Across Settings And Substances
• 18:14 Every Visit Verification And Quality Of Life
• 20:48 Benefits For Home Health Outcomes
• 23:05 Resources, BEERS, And Practice Updates
• 25:50 Role Definition After 2024 COP Changes
• 27:33 Detecting Diversion And Red Flags