Standing with Residents: Preventing Medication Errors and Building Oversight

Medication use is one of the most common aspects of care across all settings—from hospitals and long-term care communities to private homes. When managed correctly, medications can control chronic conditions, relieve symptoms, and improve quality of life for residents. Yet mistakes—whether in timing, dosage, duplication, or drug interactions—can quickly turn helpful treatments into harmful events.

Because of this, medication oversight is not simply a matter of clinical precision; it’s an issue of safety, dignity, and rights. Residents have the federally protected right to be informed, involved, and respected in every decision about their care. This blog explores how medication oversight intersects with those rights and how Livindi’s technology helps residents, families, and care teams work together to reduce errors and strengthen accountability.

The Scope of the Problem: Medication Errors in the U.S.

Medication errors are among the most common preventable events in health care. In the United States, studies from the Institute of Medicine and the American Society of Health-System Pharmacists estimate that at least 1.5 million people are harmed by medication-related problems every year (AMCP, 2023). In hospital settings, analyses have found that roughly 4.8–5.3% of medication orders or administrations include an error, though most are intercepted before causing harm (PMC6371341). In home or long‑term care settings, error rates vary widely, with research citing anywhere from 2% to 33% depending on definitions and reporting methods (US Pharmacist, 2023).

According to the World Health Organization, medication errors cause at least one death every day and injure approximately 1.3 million people annually in the U.S. (WHO, 2017). The global cost of preventable medication harm is estimated at about $42 billion each year, nearly 1% of total health expenditure (WHO, 2024).

These figures illustrate a critical truth: medication safety is not optional. It is central to dignity, safety, and respect—the foundation of residents’ rights.

Residents’ Rights & Medication Oversight

Among the federally protected residents’ rights, the Right to Participate in One’s Own Care is central to medication management. This right ensures that every resident has a voice in treatment decisions, understands the purpose and risks of each prescription, and is empowered to make informed choices. Closely connected are companion rights that safeguard safe prescribing, clear communication, informed consent, and financial fairness. Together, they form the foundation of ethical medication oversight and ensure that residents remain informed, involved, and respected in every aspect of their care. Below, each relevant right is paired with how it connects to medication safety and oversight.

Right to Participate in One’s Own Care

Residents have the right to understand and engage in decisions about their medications—what they are for, how they work, and what alternatives exist. This participation helps ensure informed consent and builds trust between residents, families, and staff. 

Right to Receive Adequate and Appropriate Care

Medication oversight ensures that prescriptions are appropriate, doses correct, and side effects promptly addressed. Regular medication reviews and pharmacist consultations help safeguard this right.

Right to Be Informed of All Changes in Medical Condition

Any changes—new prescriptions, discontinued drugs, or lab result shifts—must be communicated clearly and promptly to residents and their families.

Right to Participate in Assessment, Care-Planning, Treatment, and Discharge

Including residents in medication decisions during care planning and discharge helps prevent duplications and ensures continuity of care.

Right to Refuse Medication and Treatment

Residents have the right to refuse medication—and those refusals must be documented and respected. Oversight systems should alert staff and prompt clinical review rather than override patient choice.

Right to Refuse Chemical and Physical Restraints

Psychotropic or sedative drugs must never be used as restraints without proper justification and consent. Oversight mechanisms can flag inappropriate prescribing and ensure accountability.

Right to Review One’s Medical Record

Residents should be able to view their medication list and updates. Transparent access reinforces trust and helps catch documentation errors early.

Right to Be Free from Charge for Services Covered by Medicaid or Medicare

Billing errors and duplicate prescriptions can unfairly burden residents. Oversight prevents unnecessary charges and ensures residents aren’t billed for covered medications.

The Cost of Medications: When Affordability Becomes a Safety Issue

For millions of older adults, medication safety isn’t only about accuracy, it’s also about affordability. Even when prescriptions are correct and available, rising drug costs means many residents face an impossible choice: pay for essentials or skip a dose.

According to the CDC, over 9 million U.S. adults reported skipping, delaying, or taking less medication than prescribed because of cost. Among adults sixty-five and older, 1 in 5 struggle with cost-related nonadherence — skipping refills or rationing doses to stretch prescriptions. The Kaiser Family Foundation found that 1 in 4 Medicare beneficiaries reports difficulty affording their medications, a number that rises sharply among those with chronic illnesses.

The consequences are serious. People who skip medications due to cost have 15–22% higher mortality rates from chronic conditions like diabetes, heart disease, and hypertension. What seems like the “lesser evil”—missing a pill today—often leads to hospitalizations, complications, and long-term decline that are far more costly later. Nationwide, the economic toll of medication nonadherence is estimated at up to $500 billion annually, or nearly 16% of total U.S. healthcare spending.

Almost 90% of older adults take at least one medication daily, and more than half take four or more. For many in long-term care, small copays add up to hundreds of dollars each month. Even with Medicare Part D and Medicaid coverage, formulary changes, prior authorizations, and out-of-pocket caps can create gaps that lead to skipped treatment.

Skipping medications isn’t a moral failing—it’s a systemic failure. When residents can’t afford the drugs they need, their right to receive adequate and appropriate care is compromised. Facilities and caregivers have an ethical duty to advocate for transparency, fair billing, and access to affordable options—and to document when cost, not choice, drives medication refusals.

Modern oversight tools like Livindi can help bridge this gap. By tracking adherence and flagging missed or delayed doses, Livindi makes it easier to identify when a resident may be rationing or avoiding a medication—and prompt follow-up before small omissions become health crises.

How Livindi Strengthens Medication Oversight

Livindi supports safer, more transparent medication management through its connected care ecosystem:

• Medication Reminders & Scheduling: Livindi displays daily medication reminders and schedules on its tablet, ensuring residents know what to take and when. 
  
• Alerts and Monitoring: Caregivers receive alerts through the Helper App if a dose is missed or delayed, allowing early intervention.
• Pattern Recognition: Livindi’s AI monitors changes in routines, identifying potential adherence problems or health issues before they escalate.
• Helper Portal Oversight: Family members and staff can view logs, confirm medication adherence, and communicate directly with residents through the Livindi system.
• Transparency & Records: Every interaction is timestamped and stored, creating a clear audit trail that reinforces the resident’s right to review their own medical record.
• Vital Signs Monitoring: Livindi’s monitoring tools can also track vital signs such as heart rate, blood pressure, and oxygen levels. This data can act an early warning system, helping caregivers identify potential medication-related issues—like adverse reactions or dosage problems—before they become serious.

Together, these tools protect residents’ rights by combining human compassion with technology-driven oversight. 

Documenting and Reporting Medication Concerns

When medication discrepancies or adverse effects are suspected, licensed nurses and medication aides are responsible for documenting the issue in the resident’s medical record and promptly notifying the attending physician, pharmacist, or facility administrator. Accurate documentation and communication ensure timely review and intervention.

For families, home health caregivers, or outside agencies who suspect noncompliance or unsafe medication practices, the first step is to report the concern to the facility’s management or the resident’s care team. If the issue remains unresolved, they can contact their state long-term care ombudsman, Adult Protective Services, or appropriate regulatory authority to file a formal complaint. Keeping written notes of observed issues, missed doses, or conversations helps create an accurate record for follow-up.

Clear documentation and open communication uphold residents’ rights by ensuring accountability, transparency, and swift corrective action when medication adherence or safety concerns arise.

Conclusion

Medication safety is not just a clinical issue—it is a rights issue. Preventing errors, reducing costs, and improving communication all serve the same purpose: protecting residents’ dignity, safety, and autonomy. With innovative tools like Livindi, families, caregivers, and facilities can work together to ensure that every resident receives the safe, informed, and affordable care they deserve.