Run Medication Reconciliation and Drug Regimen Review (Home Health) — Free

Review Context and Medication Sources

Review type and timing documented critical (required)

Record the context for the medication review.

Note (optional)

Current medication sources reviewed critical (required)

Identify all sources used to build the best possible medication list.

Medication list is complete and current critical (required)

All active prescription, OTC, supplement, inhaled, topical, and PRN medications are captured.

Yes No N/A

High-risk medication changes since last review identified

Recent starts, stops, dose changes, or frequency changes that may affect safety were identified and documented.

Yes No N/A

Medication List Reconciliation

Prescription medications match current orders critical (required)

Each prescription medication name, dose, route, and frequency matches the most current order or discharge instruction.

Yes No N/A

Over-the-counter medications and supplements reviewed

OTC products, vitamins, herbal products, and nutritional supplements are included in the reconciliation.

Yes No N/A

PRN medications have clear indications and limits critical (required)

As-needed medications include a documented indication, maximum daily dose, and safe use instructions when applicable.

Yes No N/A

Duplicate therapy identified and addressed critical (required)

Potential duplicate therapy within the same class or with overlapping ingredients was checked and resolved or escalated.

Yes No N/A

Medication omissions or unintended discontinuations identified critical (required)

Any missing medications, unintended gaps, or stopped therapies were identified and communicated for follow-up.

Yes No N/A

Drug Regimen Review: Safety and Interaction Screening

Potential drug-drug interactions reviewed critical (required)

The regimen was screened for clinically significant interactions, including additive sedation, bleeding risk, QT prolongation, and CNS depression where relevant.

Yes No N/A

Potential drug-disease interactions reviewed critical (required)

The regimen was screened for conditions such as renal impairment, hepatic impairment, diabetes, heart failure, COPD, falls risk, or anticoagulation risk when applicable.

Yes No N/A

Adverse effects or toxicity signs assessed critical (required)

Symptoms, vitals, or observations suggestive of adverse drug effects were assessed and documented.

Yes No N/A

Medication allergies and intolerances verified critical (required)

Allergies, adverse reactions, and intolerances were reviewed against the current regimen.

Yes No N/A

Polypharmacy risk reviewed

The regimen was reviewed for medication burden, high-risk combinations, and opportunities to simplify therapy or reduce risk.

Yes No N/A

Adherence, Administration, and Patient Understanding

Patient/caregiver can describe how medications are taken critical (required)

The patient or caregiver can explain dose, route, timing, and purpose for key medications as appropriate.

Yes No N/A

Adherence barriers identified

Identify barriers that may affect safe adherence.

Medication administration technique observed or confirmed

Technique for inhalers, injections, eye drops, insulin, anticoagulants, or other special forms was observed or confirmed when applicable.

Yes No N/A

Medication organization supports safe use

Pillbox, blister packs, labels, schedules, or other supports are adequate for the patient’s regimen and abilities.

Yes No N/A

Communication, Escalation, and Follow-Up

Discrepancies communicated to prescriber or pharmacist critical (required)

Medication discrepancies, safety concerns, or unresolved questions were communicated to the appropriate licensed provider.

Yes No N/A

Follow-up plan documented critical (required)

A plan exists for clarifying orders, obtaining missing medications, monitoring adverse effects, or rechecking the regimen.

Yes No N/A

Patient/caregiver education provided

Education was provided on medication purpose, schedule, side effects, red flags, and when to seek help.

Yes No N/A

Urgent medication issue escalated immediately critical (required)

Any critical issue such as severe reaction, overdose risk, contraindicated combination, or missing life-sustaining medication was escalated without delay.

Yes No N/A

Documentation and Sign-Off

Medication reconciliation documentation is complete critical (required)

The chart includes the reconciled medication list, discrepancies, actions taken, and any unresolved items.

Yes No N/A

OASIS DRR findings documented in the record critical (required)

Drug regimen review findings are documented clearly enough to support OASIS Section N and clinical follow-up.

Yes No N/A

Inspector signature critical (required)

Signature of the clinician completing the review.

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Run: Medication Reconciliation and Drug Regimen Review (Home Health)

Review Context and Medication Sources

Medication List Reconciliation

Drug Regimen Review: Safety and Interaction Screening

Adherence, Administration, and Patient Understanding

Communication, Escalation, and Follow-Up

Documentation and Sign-Off

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