Provision of Medication: Provision of medications may be provided by the assisted-living facility as requested by the resident and in accordance with licensed health care professional statutes and the statutes governing medication provision by unlicensed personnel.
4-006.09A Self-Administration of Medications: The following requirements apply in those instances when residents self-administer medications. Residents must:
- Be at least 19 years of age;
- Have cognitive capacity to make informed decision about taking medication;
- Be physically able to take or apply a dose of medication;
- Have capability and capacity to take or apply a dose of medication according to specific directions for prescribed medications or according to a recommended protocol for nonprescription medication; and
- Have capability and capacity to observe and take appropriate action regarding any desired effects, side effects, interactions, and contraindications associated with a dose of
4-006.09A1 In the event self-administration could potentially result in adverse health consequences, the facility must counsel the resident and the authorized representative, if applicable.
4-006.09A2 Medications may be stored in a resident’s room if the resident keeps the room locked when not present; or the medications are stored in a secure location or locked container.
4-006.09A3 Residents who self-medicate must be encouraged to have their medications reviewed on a regular basis by a licensed health care professional.
4-006.09B Administration of Medication: The assisted-living facility must establish and implement policies and procedures to ensure residents receive medications only as legally prescribed by a medical practitioner, in accordance with the Five Rights and prevailing professional standards. The assisted-living facility must ensure that a registered nurse reviews and documents the review of medication administration policies and procedures at least annually.
4-006.09B1 Methods of Administration: When the facility is responsible for the administration or provision of medications, it must be accomplished by the following methods:
4-006.09B1a Self-Administration of Medication: The facility must allow residents of the facility to self-administer medications, with or without supervision, when assessment determines resident is capable of doing so.
4-006.09B1b Licensed Health Care Professional: When the facility utilizes licensed health care professionals for whom medication administration is included in the scope of practice, the facility must ensure the medications are properly administered in accordance with prevailing professional standards.
4-006.09B1c Provision of Medication by a Person Other Than a Licensed Health Care Professional: When the facility utilizes persons other than a licensed health care professional in the provision of medications, the facility must follow 172 NAC 95 Regulations Governing the Provision of Medications by Medication Aides and Other Unlicensed Persons and 172 NAC 96 Regulations Governing the Medication Aide Registry. Each facility must establish and implement policies and procedures:
- To ensure that medication aides who provide medications are trained and have demonstrated the minimum competency standards specified in 172 NAC 95-004;
- To ensure that competency assessments and/or courses for medication aides have been completed in accordance with the provisions of 172 96-005;
- That specify how direction and monitoring will occur when the facility allows medication aides to perform the routine/acceptable activities authorized by 172 NAC 95-005 and as follows:
- Provide routine medication; and
- Provision of medications by the following routes:
- Oral, which includes any medication given by mouth including sublingual (placing under the tongue) and buccal (placing between the cheek and gum) routes and oral sprays;
- Inhalation, which includes inhalers and nebulizers, including oxygen given by inhalation;
- Topical application of sprays, creams, ointments, and lotions, and transdermal patches; and
- Instillation by drops, ointments, and sprays into the eyes, ears and
- That specify how direction and monitoring will occur when the assisted-living facility allows medication aides to perform the additional activities authorized by 172 NAC 95- 009, which include, but are not limited to:
- Provision of PRN medications;
- Provision of medications by additional routes, including, but not limited to, gastrostomy tube, rectal, and vaginal; and/or
- Participation in
- That specify how competency determinations will be made for medication aides to perform routine and additional activities pertaining to medication provision;
- That specify how written direction will be provided for medication aides to perform the additional activities authorized by 172 NAC 95-009;
- That specify how records of medication provision by medication aides will be recorded and maintained; and
- That specify how medication errors made by medication aides and adverse reactions to medications will be reported. The reporting must be:
- Made to the identified person responsible for direction and monitoring;
- Made immediately upon discovery; and
- Documented in resident medical
4-006.09C Handling of Medications: Each assisted-living facility must have procedures to ensure that residents receive medications as prescribed by a medical practitioner including a method for verifying the identity of each resident.
4-006.09C1 Medications sent with a resident for temporary absences from the assisted-living facility must be in containers identified for the resident.
4-006.09C2 Medications must be sent with a resident upon discharge upon resident request.
4-006.09C3 Medications authorized for one resident must not be used for another resident or staff.
4-006.09C4 Any errors in administration or provision of prescribed medications must be reported to the resident’s licensed health care professional in a timely manner upon discovery and a written report of the error prepared.
4-006.09C5 Any adverse reaction to a medication must be reported immediately upon discovery to the resident’s licensed health care professional and recorded in the resident’s record.
4-006.09D Medication Record: The assisted-living facility must maintain records in sufficient detail to assure that residents receive the medications authorized by a medical practitioner and maintain records to protect medications against theft and loss.
4-006.09D1 When facility staff administer or provide medication, each resident must have an individual medication administration record which includes:
- The identification of the resident;
- The name of the medication given;
- The date, time, dosage, method of administration or provision for each medication, the identification of the person who administered or provided the medication and any refusal by the resident; and
- The resident’s medication allergies and sensitivities, if
4-006.09E Storage: All medications must be stored in locked areas and stored in accordance with the manufacturer’s or dispensing pharmacist’s instructions for temperature, light, humidity, or other storage instructions. Only authorized personnel who are designated by the facility responsible for administration or provision of medications must have access to the medications.
4-006.09E1 Medications for external use must be stored separately from other medications.
4-006.09F Disposal of Medications: Medications that are discontinued by the medical practitioner, those medications leftover at the time of death or those medications which are beyond their expiration date, must be destroyed in accordance with facility policy.