Section 164.406 - Safe Storage and Administration of MedicationsLicensed and Approved Providers shall comply with all federal and state laws and regulations relating to the procurement, storage, dispensing, administration, recording and disposal of medications and shall comply with the following:
(A)Written Policy and Procedure. The Licensed or Approved Provider shall establish a written policy and procedure governing the storage and administration of residents' prescription medications.(B)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 Licensed or Approved Provider shall ensure patients do not have direct access to the medication cabinet.(C) Medications brought by residents to the program shall be stored in a locked, secure cabinet that is separate from the facility's supply, except that residents shall retain medications required to treat acute episodes, such as asthma attacks or allergic reactions. (1) If injectable drugs are used, Licensed or Approved Providers shall provide containers for safe storage and proper disposal of sharps.(2) 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.(3) The Licensed or Approved Provider shall also establish a record of medications which remain in the possession of residents for treatment of acute episodes.(D) Prescription medication presented by residents 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 resident, 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.(E) The Licensed or Approved Provider shall maintain documentation of all medications stored and disposed of.(F) Upon admission the resident shall count, in the presence of staff, the number of tablets or capsules, or the approximate amount of liquid in each prescribed medication brought by the resident. The count shall be documented.(G)Self-administration of Medications. Medications shall be self-administered by the resident, unless the Licensed or Approved Provider employs qualified health care professionals authorized to administer medications. Adult residents must be able to administer their own medications, and, unless the Licensed or Approved Provider employs qualified health care professionals for this purpose, staff shall not administer medication to any resident or resident's child. Staff shall observe the resident ingesting the prescribed dose. For children younger than 18 years old residing with their parents or legal guardian, medication shall be administered by the child's resident parent or legal guardian. Medications may not be provided to any resident if other residents are in the storage or office area. The Licensed or Approved Provider may provide a supply of medications for any resident who will be absent from the program when he or she would normally take the medication. The Licensed or Approved Provider shall maintain documentation of all administrations of medication, which shall include:(1) Name of resident to whom medication was provided;(2) Name of staff person observing the resident take the medication, or providing the needed supply;(3) Date and time medication was provided; and(4) Resident initials confirming that the medication was provided and taken.(H)Disposing of Medications. Providers shall comply with all federal and state laws and regulations relating to the procurement, storage, dispensing, administration, recording and disposal of medications.(I)Improper Use. The Licensed or Approved Provider shall establish a policy regarding improper use of medication. Such policies:(1) may impose corrective actions on residents who do not take medications in accordance with prescribed dose and frequency; and(2) shall impose corrective actions on residents who illegally obtain and use prescription medications.Amended by Mass Register Issue 1482, eff. 11/11/2022.