Section R9-10-816. Medication Services

A.      A manager shall ensure that:

1.        Policies and procedures for medication services include:

a.         Procedures for preventing, responding to, and reporting a medication error;

b.        Procedures for responding to and reporting an unex- pected reaction to a medication;

c.         Procedures to ensure that a resident’s medication regimen and method of administration is reviewed by a medical practitioner to ensure the medication regimen meets the resident’s needs;

d.        Procedures for:

i.         Documenting, as applicable, medication administration and assistance in the self-admin- istration of medication; and

ii.        Monitoring a resident who self-administers medication;

e.         Procedures for assisting a resident in procuring med- ication; and

f.         If applicable, procedures for providing medication administration or assistance in the self-administra- tion of medication off the premises; and

2.        If a verbal order for a resident’s medication is received from a medical practitioner by the assisted living facility:

a.         The manager or a caregiver takes the verbal order from the medical practitioner,

b.        The verbal order is documented in the resident’s medical record, and

c.         A written order verifying the verbal order is obtained from the medical practitioner within 14 cal- endar days after receiving the verbal order.

B.       If an assisted living facility provides medication administra- tion, a manager shall ensure that:

1.        Medication is stored by the assisted living facility;

2.        Policies and procedures for medication administration:

a.         Are reviewed and approved by a medical practi- tioner, registered nurse, or pharmacist;

b.        Include a process for documenting an individual, authorized, according to the definition of “adminis- ter” in A.R.S. § 32-1901, by a medical practitioner to administer medication under the direction of the medical practitioner;

c.         Ensure that medication is administered to a resident only as prescribed; and

d.        Cover the documentation of a resident’s refusal to take prescribed medication in the resident’s medical record; and

3.        A medication administered to a resident:

a.         Is administered by an individual under direction of a medical practitioner,

b.        Is administered in compliance with a medication order, and

c.         Is documented in the resident’s medical record.

C.      If an assisted living facility provides assistance in the self- administration of medication, a manager shall ensure that:

1.        A resident’s medication is stored by the assisted living facility;

2.        The following assistance is provided to a resident:

a.         A reminder when it is time to take the medication;

b.        Opening the medication container or medication organizer for the resident;

c.         Observing the resident while the resident removes the medication  from the container or  medication organizer;

d.        Except when a resident uses a medication organizer, verifying that the medication is taken as ordered by the resident’s medical practitioner by confirming that:

i.         The resident taking the medication is the indi- vidual stated on the medication container label,

ii.        The resident is taking the dosage of the medica- tion stated on the medication container label or according to an order from a medical practi- tioner dated later than the date on the medica- tion container label, and

iii.      The resident is taking the medication at the time stated on the medication container label or according to an order from a medical practi- tioner dated later than the date on the medica- tion container label;

e.         For a resident using a medication organizer, verify- ing that the resident is taking the medication in the medication organizer according to the schedule specified on the medical practitioner’s order; or

f.         Observing the resident while the resident takes the medication;

3.        Policies and procedures for assistance in the self-adminis- tration of medication are reviewed and approved by a medical practitioner or nurse; and

4.        Assistance in the self-administration of medication pro- vided to a resident:

a.         Is in compliance with an order, and

b.        Is documented in the resident’s medical record.

D.      A manager shall ensure that:

1.        A current drug reference guide is available for use by per- sonnel members, and

2.        A current toxicology reference guide is available for use by personnel members.

E.       A manager shall ensure that a resident’s medication organizer is only filled by:

1.        The resident;

2.        The resident’s representative;

3.        A family member of the resident;

4.        A personnel member of a home health agency or hospice service agency; or

5.        The manager or a caregiver who has been designated and is under the direction of a medical practitioner, according to subsection (B)(2)(b).

F.       When medication is stored by an assisted living facility, a manager shall ensure that:

1.        Medication is stored in a separate locked room, closet, cabinet, or self-contained unit used only for medication storage;

2.        Medication is stored according to the instructions on the medication container; and

3.        Policies and procedures are established, documented, and implemented for:

a.         Receiving, storing, inventorying, tracking, dispens- ing, and discarding medication  including expired medication;

b.        Discarding or returning prepackaged and sample medication to the manufacturer if the manufacturer requests the discard or return of the medication;

c.         A medication  recall and notification of  residents who received recalled medication; and

d.        Storing, inventorying, and dispensing controlled substances.

G.      A manager shall ensure that a caregiver immediately reports a medication error or a resident’s unexpected reaction to a medi- cation to the medical practitioner who ordered the medication or, if the medical practitioner who ordered the medication is not available, another medical practitioner.

H.      If medication is stored by a resident in the resident’s bedroom or residential unit, a manager shall ensure that:

1.        The medication is stored according to the resident’s ser- vice plan; or

2.        If the medication is not being stored according to the resi- dent’s service plan, the resident’s service plan is updated to include how the medication is being stored by the resi- dent.

Historical Note

New Section made by final rulemaking at 9 A.A.R. 319, effective March 14, 2003 (Supp. 03-1). Section repealed; new Section made by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, pursuant to Laws 2013, Ch. 10, § 13; effective July 1, 2014 (Supp.

14-2). Amended by exempt rulemaking at 20 A.A.R. 1409, pursuant to Laws 2013, Ch. 10, § 13; effective July

1, 2014 (Supp. 14-2).