37.106.2846 MEDICATIONS: STORAGE AND DISPOSAL (1) With the exception of resident medication organizers as discussed in ARM 37.106.2848, all medication must be stored in the container dispensed by the pharmacy or in the container in which it was purchased in the case of over-the-counter medication, with the label intact and clearly legible.

  • Medications that require refrigeration must be segregated from food items and stored within the temperature range specified by the
  • All medications administered by the facility shall be stored in locked containers in a secured environment such as a medication room or medication cart. Residents who are responsible for their own medication administration must be provided with a secure storage place within their room for their medications. If the resident is in a private room, locking the door when the resident leaves will
  • Over-the-counter medications or home remedies requested by the resident shall be reviewed by the resident’s practitioner or pharmacist as part of the development of a resident’s service


37.106. Subchapter 28 Residents may keep over-the-counter medications in their room with a written order by the residents’ practitioners.

  • The facility shall develop and implement a policy for lawful disposal of unused, outdated, discontinued or recalled resident The facility shall return a resident’s medication to the resident or resident’s legal representative upon discharge.




  • Medication and treatment orders shall be carried out as prescribed. The resident has the right to consent to or refuse medications and The practitioner shall be notified if a resident refuses consent to an order. Subsequent refusals to consent to an order shall be reported as required by the practitioner.
  • A prescription medication for which the dose or schedule has been changed by the practitioner must be noted in the resident’s medication administration record and the resident’s service or health care plan by an appropriate licensed health care



  • All category A facility residents must self-administer their Those category B facility residents that are capable of, and who wish to self-administer medications, shall be encouraged by facility staff to do so.
  • Any direct care staff member who is capable of reading medication labels may be made responsible for providing necessary assistance to any resident in taking their medication, as defined in ARM 106.2805.
  • Resident medication organizers may be prepared up to four weeks in advance and injectable medications as specified in (4)(c) by the following individuals:
  • a resident or a resident’s legal representative;
  • a resident’s family care giver, who is a person related to the resident by blood or marriage or who has full guardianship; or
  • as otherwise provided by
  • The individual referred to in (3) must adhere to the following protocol:
    • verify that all medications to be set up carry a practitioner’s current order;
    • set up medications only from prescriptions in labeled containers dispensed by a registered pharmacist or from over-the-counter drug containers with intact, clearly readable labels; and
    • set up injectable insulin up to seven days in advance by drawing insulin into syringes identified for content, date and Other injectable medications must be set up according to the recommendations provided by the pharmacy.
  • The facility may require residents to use a facility approved medication dispensing system or to establish medication set up criteria, but shall not require residents to purchase prescriptions from a specific
  • No resident or staff member may be permitted to use another resident’s



  • An accurate medication record for each resident shall be kept of all medications, including over-the-counter medications, for those residents whose self-administration of medication requires monitoring and/or assistance by the facility
  • The record shall include:
    • name of medication, reason for use, dosage, route and date and time given;
    • name of the prescribing practitioner and their telephone number;
    • any adverse reaction, unexpected effects of medication or medication error, which must also be reported to the resident’s practitioner;
    • allergies and sensitivities, if any;
    • resident specific parameters and instructions for PRN medications;
    • documentation of treatments with resident specific parameters;
    • documentation of doses missed or refused by resident and why;
    • initials of the person monitoring and/or assisting with self-administration of medication; and
    • review date and name of
  • The facility shall maintain legible signatures of staff who monitor and/or assist with the self- administration of medication, either on the medication administration record or on a separate signature
  • A medication record need not be kept for those residents for whom written authorization has been given by their practitioner to keep their medication in their rooms and to be fully responsible for taking the medication in the correct dosage and at the proper time. The authorization must be renewed on an annual
  • The facility shall maintain a record of all destroyed or returned medications in the resident’s record or closed resident file in the case of resident transfer or


37.106.2853 OXYGEN USE (1) A resident who requires the use of oxygen:

(a) shall be permitted to self-administer the oxygen if the resident is capable of:

  • determining their need for oxygen; and
  • administering the oxygen to themselves or with
  • The direct care staff employed by the facility shall monitor the ability of the resident to operate the equipment in accordance with the orders of the
  • The facility shall ensure that all direct care staff who may be required to assist resident’s with administration of oxygen have demonstrated the ability to properly operate the
  • The following rules must be followed when oxygen is in use:
    • oxygen tanks must be secured and properly stored at all times;
    • no smoking or open flames may be allowed in rooms in which oxygen is used or stored, and such rooms must be posted with a conspicuous “No Smoking, Oxygen in Use” sign;
    • a backup portable unit for the administration of oxygen shall be present in the facility at all times when a resident who requires oxygen is present in the facility, this includes when oxygen concentrators are used;
    • the equipment used to administer oxygen must be in good working condition; and
    • the equipment used to administer oxygen is removed from the facility when it is no longer needed by the