44-109.01. Responsibilities of the ALR personnel in medication management.

An ALA shall ensure that an initial assessment identifies whether a resident:
(1) Is capable of self-administering his or her own medications;
(2) Is capable of self-administering his or her own medication, but requires a reminder to take
medications or requires physical assistance with opening and removing medications from the
container, or both; or
(3) Requires that medications be administered by a THE or a licensed nurse.

44-109.02. Pre-Admission Medication. Management Assessment.
Within 30 days prior to admission, the ALR shall consult with the prospective resident’s
healthcare practitioner regarding:
(1) The prospective resident’s current medication profile, including a review of nonprescription
(2) Possible adverse interactions;
(3) Common expected or unexpected side effects; and
(4) The potential that such medications have to act as chemical restraints.

44-109.03. On-site medication review.

The ALR shall arrange for an on-site review by a registered nurse every 45 days to:
(1) Supervise the administration of medications by Trained Medication Employees;
(2) Assess the resident’s response to medication; and
(3) Assess the resident’s ability to continue to self-administer his or her medications.

44-109.04. Medication storage.

(a) The ALA shall provide a secured space for medication storage with access to a sink and
cold storage in the same area. Space for necessary medical supplies and equipment shall be
(b) The storage area shall be kept locked when not in use.
(c) The storage area shall be used only for storage of medications and medical supplies.
(d) The key to the storage area shall be kept on the person of the employee on duty who is
responsible for administering the medications.
(e)(1) All medications shall be kept in their original packaging and shall be properly labeled
and identified.
(2) The label of each resident’s prescription medication container shall be permanently affixed
and contain the resident’s full name, healthcare practitioner’s name, prescription number,
name and strength of drug, lot number, quantity, date of issue, expiration date,
manufacturer’s name, if generic, directions for use, and cautionary or accessory information.
Required information appearing on individually packaged drugs or within an alternate
medication delivery system need not be repeated on the label.
(3) All over-the-counter (OTC) medications repackaged by the pharmacy shall be labeled with
an expiration date, name and strength of the drug, lot number, date of issue, manufacturer’s
name if generic, and cautionary or accessory labels, in accordance with U.S.P. regulations.
Original manufacturer’s containers shall be labeled with at least the resident’s name. The
name label shall not obstruct any of the aforementioned information.
(4) In the “unit of use” distribution system, each dose of medication shall be individually
packaged in a hermetically sealed, tamper-proof container, and shall carry full manufacturer’s
disclosure information on each discrete dose. Disclosure information shall include product
name, strength, lot number, expiration date, and the manufacturer’s distributor’s name.
(5) Single use and disposable items shall not be reused.
(6) No stock supply of prescription medications shall be maintained, unless prior approval is
obtained from the Mayor.
(7) Discontinued or expired medications shall be destroyed within 30 days in the ALR, or, if
unopened and properly labeled, returned to the pharmacy. All medication destroyed in the ALR
shall be witnessed and documented by two persons, one of whom shall be the ALA or the ALA
(8) Residents who self-administer may keep and use prescription and nonprescription
medications in their units as long as they keep them secured from other residents