**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on staff interviews, record review, and review of the facility policy titled, Monitoring of Antipsychotics, the facility failed to ensure that psychotropic medications were not ordered as needed (PRN) beyond 14 days and failed to document the reason for the extension or the period during which the extended order should be in effect for one of six residents (R) (R#17) reviewed for unnecessary medications. This failure had the potential for residents to experience excessive use and duration of psychotropic medication. Findings include: A review of the facility policy, Monitoring of Antipsychotics, revised [DATE], revealed as needed (PRN) orders for antipsychotic drugs are limited to 14 days and cannot be renewed unless the attending physician or prescribing practitioner evaluated the resident for the appropriateness of that medication. All PRN antipsychotic orders will be automatically stopped after 14 days. A review of the medical record for R#17 revealed a past medical history not inclusive of dementia without behavioral disturbances, and medical non-compliance. A review of the physician orders dated [DATE] revealed R#17 was prescribed lorazepam 2 Milligram (mg)/ Milliliter (mL), to give 0.5 mg via Intravenous (IV) once per day, as needed (PRN). A review of the Consultant Pharmacist Communication to Physician form, dated [DATE], revealed the following: RE: Resident has a PRN order for Lorazepam [Lorazepam INJ (injection) 2 mg/mL] According to the new CMS (Centers for Medicare and Medicaid) Mega rule (which goes into effect [DATE].2017). Residents are not to receive PRN orders for psychotropic drugs unless the drug is intended to treat a condition that is documented in the clinical record. PRN orders are limited to 14 days, unless the provider believes it is appropriate to extend the orders beyond 14 days and documents this in the clinical record. Please evaluate the current order: Resident is doing well on current order - May attach a 6 month stop date. MD Response: Neither box (I agree, or other) was checked. They physician/practitioner signed the order on [DATE]. Interview on [DATE] at 2:16 p.m. with the Director of Nursing (DON) confirmed R#17 had no end date for the as PRN order for Lorazepam. The DON explained the pharmacist was supposed to audit all medications and ensure end dates were within 14 days for all PRN psychotropic medications. The DON added that some residents had special orders to extend the medication end date. She further revealed R#17 had a special order for an extended period of six months written in [DATE], but the DON acknowledged the extension had expired in [DATE].