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Growing Trend Highlights Importance of Narcotics Control in In-Home Hospice

A recent article underwritten by The Gordon and Betty Moore Foundation, highlights the importance of the control of narcotics during in-home hospice care.  The article reports “As more people die at home on hospice, some of the powerful, addictive drugs they are prescribed are ending up in the wrong hands.”  The article provides examples of caregivers improperly using opioid prescriptions intended for the patient and instances where safeguarding powerful drugs like opioids may have prevented the abuse.  Understanding the importance of safeguarding drugs like this in the home, the CHAP hospice standards offer guidance at H1.5c and HII.5h:

HI.5c:  The CHAP hospice standards at H1.5c9: Medication Regime Management, require accredited hospices to have a policy and procedure to address the control of drugs and biologicals.  Our guidance suggests “Policies and procedures identify techniques to be used in the management and disposal of controlled drugs. (HII.5h).” The standards are also linked to the Medicare Condition of Participation 42 CFR 418.106 – Drugs and biologicals, medical supplies, and durable medical equipment. 

HII.5h The standards also require for the safe disposal of drugs and biologics after a patient’s death at HII.5h: Controlled substances are safeguarded in the home and disposed of in the home when such drugs are no longer needed by the patient. (418.106 € (2)):

1. Controlled drugs are those substances subject to the Controlled Substance Act of 1970 and are safeguarded in compliance with organizational policy.

2. Disposal of controlled drugs is accomplished in compliance with organizational policy and procedure and applicable state law

CHAP-accredited hospice providers who have questions or concerns about their approach to safeguarding powerful drugs like opioids should reach out to their Director of Accreditation for additional guidance.

“I think a key piece that folks in the hospice industry may miss is the requirement includes management and disposal, not just disposal.” CHAP Vice President of Accreditation, Fran Petrella, notes.  Agency policies may not address the management piece and it’s something that should be considered.