Final answer:
Nursing homes must comply with specific protocols, such as obtaining consent and maintaining records, when performing therapeutic substitutions under institutional formulary legislation to ensure patient safety and cost management.
Step-by-step explanation:
Under the institutional formularies and therapeutic substitution legislation, a nursing home must adhere to specific policies when substituting medications. These policies are designed to ensure the safety and efficacy of therapies while controlling costs. The nursing home's pharmacy and therapeutics committee usually manages the formulary, a list of approved medications for use within the institution.
Some states might also require that nursing homes report data on therapeutic substitutions to regulatory bodies to monitor the impact on patient care. By following these guidelines, nursing homes maintain a high standard of care and manage healthcare costs effectively in compliance with the law.