(a)  The facility shall obtain the services of a licensed pharmacist, prescribing practitioner or registered nurse for the provision of pharmaceutical care at least quarterly for residents or more frequently as determined by the Department, based on the documentation of significant medication problems identified during monitoring visits or other investigations in which the safety of the residents may be at risk. Pharmaceutical care involves the identification, prevention and resolution of medication related problems which includes at least the following:

(1)           an on-site medication review for each resident which includes at least the following:

(A)          the review of information in the resident’s record such as diagnoses, history and physical, discharge summary, vital signs, physician’s orders, progress notes, laboratory values and medication administration records, including current medication administration records, to determine that medications are administered as prescribed and ensure that any undesired side effects, potential and actual medication reactions or interactions, and medication errors are identified and reported to the appropriate prescribing practitioner; and,

(B)          making recommendations for change, if necessary, based on desired medication outcomes and ensuring that the appropriate prescribing practitioner is so informed; and,

(C)          documenting the results of the medication review in the resident’s record;

(2)           review of all aspects of medication administration including the observation or review of procedures for the administration of medications and inspection of medication storage areas;

(3)           review of the medication system utilized by the facility, including packaging, labeling and availability of medications;

(4)           review the facility’s procedures and records for the disposition of medications and provide assistance, if necessary;

(5)           provision of a written report of findings and any recommendations for change for Items (1) through (4) of Paragraph (a) of this Rule to the facility and the physician or appropriate health professional, when necessary;

(6)           conducting in-service programs as needed for facility staff on medication usage that includes, but not limited to the following:

(A)          potential or current medication related problems identified;

(B)          new medications;

(C)          side effects and medication interactions; and

(D)          policies and procedures.

(b)  The facility shall assure action is taken as needed in response to the medication review and documented, including that the physician or appropriate health professional has been informed of the findings when necessary.

(c)  The facility shall maintain the findings and reports resulting from the activities in Subparagraphs (1) through (6) of Paragraph (a) of this Rule in the facility, including action taken by the facility