Based on interview and record review, the facility failed to ensure non-pharmacological interventions (actions or treatments that do not include the use of medicine) were implemented for three of five sampled residents (Residents 1, 2 and 6) that had been given psychotropic medications (drugs that affects brain activities associated with mental processes and behavior) when: 1. Resident 6 was administered Seroquel (a medication for bipolar disorder, depression, and schizophrenia) without documented evidence for the implementation of non-pharmacological behavioral interventions. 2. Resident 1 was administered Seroquel (a medication for bipolar disorder, depression, and schizophrenia) without documented evidence for the implementation of non-pharmacological behavioral interventions. 3. Resident 2 was administered Ativan (a medication to treat anxiety) without documented evidence for the implementation of non-pharmacological resident-centered behavioral interventions. These failures had the potential to result in unnecessary psychotropic medications for Resident 1, 2, and 6, thus increasing the risk of breathing difficulties, sedation (severe sleepiness), anxiety (extreme uneasiness), agitation (extreme emotional disturbance) and memory loss. Findings: 1. During a review of Resident 6's admission Record, Resident 6 was re-admitted under Hospice Care to the facility on 4/4/22, with diagnoses that included but was not limited to stroke, severe vascular dementia (decline in brain function) with agitation, restlessness, and insomnia . Per Resident 6's Minimum Data Sheet Section C, dated 4/6/23, Resident 6 had a Brief Interview Mental Score (method of evaluating mental status) of 00, indicating severe mental impairment. Per Resident 6's physician order, on 10/26/23, Resident 6 was to receive Seroquel 25 mg amt ½ tab orally once an evening, for agitation with diagnosis: restlessness and agitation. During an interview, on 11/29/23 at 11:02 A.M., Licensed Nurse (LN) 3 stated Resident 6 was receiving Seroquel 12.5 mg for agitation. LN 3 further stated Resident 6's agitated behavior included refusing all care including any skin care or cleaning, striking at staff during care and becoming very upset while reaching for invisible objects. LN 3 stated if nurses attempted redirection this should be documented in Resident 6's medical record. During a concurrent interview and record review with LN 2, on 11/29/23 at 12:12 P.M., LN 2 stated Resident 6 had occasional episodes of confusion and agitation. LN 2 stated Resident 6 had been prescribed Seroquel for the agitation. LN 2 acknowledged it was important to ensure non-pharmacological interventions were documented to help prevent unnecessary use of psychotropic medications and their potentially dangerous side effects. On review of resident 6's medical record, LN 2 was unable to locate documentation of what non-pharmacological interventions had been done since Resident 6's admission. During a review of Resident 6's medical record, on 11/30/23, no documentation of non-pharmacological staff interventions related to the Seroquel administration was located. During a phone interview with the pharmacist (PH) on 11/30/23 at 10:38 A.M., PH reported she monitored Resident 6's physician order for Seroquel since this medication had potentially dangerous side effects. During an interview and record review on 11/30/23 at 10:00 A.M., the Director of Nursing (DON), confirmed non-pharmacological interventions for psychotropic medications should be documented in Resident 1, 2 and 6's medical record. She further acknowledged prior to 11/29/23 there was no documentation of these interventions being done. The DON agreed it is important to include non-pharmacological interventions to help decrease the use of unnecessary psychotropic medications . 2. A review of Resident 1's face sheet indicated Resident 1 was admitted from the memory care facility on 6/8/2021 with diagnoses that included dementia with behavioral disturbance (a group of thinking and social symptoms that interferes with daily functioning), anxiety disorder (a mental disorder characterized by feelings of worry, anxiety or fear) and major depressive disorder (persistently depressed mood or loss of interest in activities, causing significant impairment in daily life). During a joint observation and interview in the dining room on 11/28/2023, at 8:00 A.M., Resident 1 was sitting up in the wheelchair, assisted by Certified Nursing Assistant (CNA) 1. CNA 1 stated Resident 1 usually ate 50% of meals and was dependent with his care. CNA 1 stated Resident 1 liked to touch and grab things, and clapped his hands when awake. CNA 1 further stated she tried to keep Resident 1's hands occupied by giving Resident 1 something to hold on to. CNA 1 stated Resident 1 had episodes of agitation and struck out during care. During a joint interview and record review on 11/29/2023, at 11:24 A.M., with the Licensed nurse (LN) 3, LN 3 stated there was no documneted evidence of non-pharmacological interventions. 3. A review of Resident 2's face sheet indicated Resident 2 was admitted from home on 3/26/2021 with diagnoses that included major depressive disorder (persistently depressed mood or loss of interest in activities, causing significant impairment in daily life) and dementia with behavioral disturbance (a group of thinking and social symptoms that interferes with daily functioning). During an observation on 11/28/23, at 8:30 A.M., Resident 2 was sitting in the wheelchair in the dining room being assisted by Certified Nursing Assistant (CNA) 2. During a joint interview and record review on 11/29/2023, at 11:24 A.M., with the Licensed nurse (LN) 3, LN 3 stated the Medication Administration Record (MAR) and care plan did not have non-pharmacological interventions prior to use of Ativan (a medication used to treat anxiety). LN 3 stated non-pharmacological interventions should have been documnted as implemented prior to administration of Ativan. An interview with the Director of Nursing (DON) on 11/30/2023, at 9:42 A.M., the DON confirmed non-pharmacological interventions were not documented as implemented prior to administration of Ativan. A review of the facility policy and procedure titled Psychotropic Medication, dated 9/30/2015 was conducted. The policy indicated the facility was responsible to ensure the .Documentation of the specific type and frequency of medication, will be completed in the resident's care plan, nursing progress notes and added to the medication record .