Form Cms-20056 - Medicare Adminstration Observation Page 3

ADVERTISEMENT

DEPARTMENT OF HEALTH AND HUMAN SERVICES
CENTERS FOR MEDICARE & MEDICAID SERVICES
Medication Administration Observation
Observation Findings
Calculations for Team’s Combined Medication Administration Observations
Combine all surveyor observations into one overall calculation for the facility. Record the Total Number of Errors. Record the number of
Step 1.
Opportunities for Errors (doses given plus doses ordered but not given).
Medication Administration Error Rate (%) = Number of Errors divided by Opportunities for Errors (doses given plus doses ordered but not
Step 2.
given) multiplied by 100.
After the overall error rate is determined, the team will determine whether a facility citation is appropriate during the team meetings. If the
Step 3.
Medication Administration Error Rate is 5% or greater, cite F332.
If any one medication error is determined to be significant, cite F333.
Total Number of Errors
Medication Administration Error Rate =
%
100:
*
Opportunities for Errors
1. Does the facility ensure that it is free of medication error rates of five percent or greater?
Yes
No
F332
2. Does the facility ensure that residents are free of any significant medication errors?
Yes
No
F333
3. Did the facility provide medications and/or biologicals and pharmaceutical services
to meet the needs of the resident?
Yes
No
F425
Notes:
3
FORM CMS–20056 (5/2013)

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Cms-20027 - Medicare Redetermination Request Form, Form Cms-20034 - Request For Medicare Hearing By An Administrative Law Judge Etc. Form Cms-20027 - Medicare Redetermination Request Form, Form Cms-20034 - Request For Medicare Hearing By An Administrative Law Judge Etc. Medical
Form Cms-855r - Medicare Enrollment Application - Reassignment Of Medicare Benefits Form Cms-855r - Medicare Enrollment Application - Reassignment Of Medicare Benefits Medical
Form Cms-838 Medicare Credit Balance Report Certification Page Form Cms-838 Medicare Credit Balance Report Certification Page Medical
Form Cms-460 - Medicare Participating Physician Or Supplier Agreement Form Cms-460 - Medicare Participating Physician Or Supplier Agreement Medical
Form Cms-46 - Medicare Participating Physician And Supplier Agreement Form Cms-46 - Medicare Participating Physician And Supplier Agreement Legal
Form Cms-8550 - Medicare Enrollment Application Form Cms-8550 - Medicare Enrollment Application Medical
Form Cms-20027 - Medicare Redetermination Request Form Cms-20027 - Medicare Redetermination Request Medical
Form Cms-855a - Medicare Enrollment Application - Institutional Providers Form Cms-855a - Medicare Enrollment Application - Institutional Providers Medical
Form Cms-855b - Medicare Enrollment Application - Clinics/group Practices And Certain Other Suppliers Form Cms-855b - Medicare Enrollment Application - Clinics/group Practices And Certain Other Suppliers Medical
Form Cms-855i - Medicare Enrollment Application - Physicians And Non-physician Practitioners Form Cms-855i - Medicare Enrollment Application - Physicians And Non-physician Practitioners Medical

Related Categories

Parent category: Medical
Download
Go
Page of 3