Federal investigators are taking a closer look at how states monitor opioid use inside the nation’s nursing homes — a move that could reshape oversight of pharmacy services in long-term care.
The U.S. Department of Health and Human Services Office of Inspector General (OIG) announced Tuesday that it will examine whether state survey agencies are effectively overseeing nursing homes’ efforts to prevent opioid overuse, misuse and diversion. More than 150,000 residents in nursing facilities currently receive opioid medications, according to federal estimates.
The review comes amid findings that nearly half of the country’s approximately 15,000 certified nursing homes were recently cited for deficiencies related to pharmacy services during routine or complaint-based inspections.
Concerns Over Safeguards
In announcing the study, federal officials warned that more than 157,000 residents receiving opioids could face heightened risks if facilities lack strong systems to ensure safe medication use.
Federal rules require nursing homes to maintain procedures that guarantee accurate acquisition, dispensing and administration of drugs. Facilities must also store medications securely, limit access to authorized staff and maintain locked compartments for Schedule II controlled substances.
The opioid crisis has remained a declared public health emergency since 2017. Overdose deaths have claimed more than 700,000 lives nationwide, with millions more experiencing addiction or long-term disability — including older, medically fragile adults.
Industry Reaction
Some pharmacy leaders say the OIG review could help reinforce best practices rather than simply add regulatory pressure.
Lisa Morris, executive director of clinical services at medication management firm Consana Health Services, said the study highlights the critical role consultant pharmacists already play in safeguarding controlled substances.
Consultant pharmacists, she noted, oversee the medication-use process from procurement through disposal, helping facilities identify vulnerabilities and reduce risks of diversion or inappropriate prescribing.
While opioid prescribing in nursing homes has declined in recent years under federal scrutiny, experts say gaps remain — particularly in tracking opioid use among Medicare beneficiaries.
The OIG expects to complete its review in fiscal year 2028.
