• F329 unnecessary drug;
  • federal nursing home regulation;
  • OBRA-87;
  • unnecessary medication

PURPOSE.  This paper attempts to demystify the federal regulations that govern the administration of medications to nursing home residents, describing the intent and correct implementation of F329 Unnecessary Drugs of the Omnibus Budget Reconciliation Act of 1987, most recently revised in 2006.

DESIGN AND METHODS.  Methods included a comprehensive review of the literature and cases from clinical practice.

FINDINGS AND PRACTICE IMPLICATIONS.  Although the regulatory language is complex, less so with each subsequent revision, its requirements nevertheless parallel good clinical practice and insure that vulnerable older adults have a quality of life that includes freedom from unnecessary medication—defined as any medication prescribed in a nursing home without adequate indication, in an excessive dose, for excessive duration, as duplicate therapy, without adequate monitoring of efficacy and tolerance, or in the presence of adverse consequences.