Section 164.139 - Safe Storage and Administration of Medications(A) Licensees providing medically managed or medically monitored detoxification services shall ensure that management, storage and administration of medication comply with requirements established by accreditation standards and by the United States Drug Enforcement Agency and Food and Drug Administration.(B) Licensees providing clinically managed detoxification services shall comply with the following: (1)Written Policy and Procedure: The licensee shall establish a written policy and procedure governing the storage and administration of patients' prescription medications.(2)Storage: All medications shall be maintained in a locked, secure cabinet, accessible only to designated staff positions. The titles of designated positions shall be posted on the cabinet. The licensee shall ensure that patients do not have direct access to the medication cabinet.(3)Approval of Medication: The licensee shall take possession of a patient's prescription and over-the-counter medication upon admission. The medical director shall assess such medication(s) in light of the medical examination and medical services to be provided to determine whether the patient should continue to take these medications.(4) Medications brought by patients to the program shall be stored in a locked, secure cabinet that is separate from the facility's supply, except that patients shall retain medications required to treat acute episodes, such as asthma attacks or allergic reactions. (a) If injectable drugs are used, licensees shall provide containers for safe storage, and proper disposal of sharps.(b) Medications requiring refrigeration shall be kept in a refrigerator in the same area where other medications are stored. Medications shall not be stored in kitchen refrigerators.(c) The licensee shall also establish a record of medications which remain in the possession of patients for treatment of acute episodes.(5) Prescription medication presented by a patient shall bear a pharmacy label, which shows the date of filling, the pharmacy name and address, the filling pharmacist's initials, the serial number of the prescription, the name of the patient, the name of the prescribing practitioner, the name of the prescribed medication, directions for use and cautionary statements, if any, contained in such prescription or required by law, and if tablets or capsules, the number in the container. All over-the-counter medications shall be kept in the original containers containing the original label, which shall include the directions for use.(6) Upon admission the licensee shall document in writing the number of tablets or capsules, or the approximate amount of liquid in each prescribed medication brought by the patient. The licensee shall ensure that a similar count is conducted by two staff persons at the beginning of each shift.(7) The licensee shall maintain documentation of all medications stored and disposed of.(8)Self-administration of Medications: Medications shall be self-administered by the patient, unless the licensee employs qualified health care professionals authorized to administer medications. Patients must be able to administer their own medications and, unless the licensee employs qualified health care professionals for this purpose, staff shall not administer medication to any patient. However, staff shall observe the patient ingesting the prescribed dose. Medications may not be provided to any patient if other patients are in the storage or office area. Licensees shall make provision to provide a supply of medications to patients who plan to be absent from the facility when they would normally take a medication. The licensee shall maintain documentation of all administrations of medication, which shall include: (a) Name of patient to whom medication was provided;(b) Name of staff person observing the patient take the medication, or providing needed supply;(c) Date and time medication was provided; and(d) Patient initials confirming that the medication was provided and taken.(9)Disposing of Medications: The licensee shall not permit expired medications, medications left behind by patients, or unused medications to accumulate in the storage area. The licensee shall establish policy and procedure for return of patient's medication upon discharge and for safe disposal of medications.(10)Improper Use: The licensee shall establish a policy regarding improper use of medication which: (a) may impose sanctions on patients who do not take medications in accordance with prescribed dose and frequency; and(b) shall impose sanctions on patients who illegally obtain and use prescription medications.