| (1) Administration. Medications must be
administered according to physician's orders. |
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(A) Residents who choose not to
or cannot self-administer their medications must have their
medications administered by a person who: |
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(i) holds a current license under state law
that authorizes the licensee to administer medication; or
(ii) holds a current medication aide permit and acts under
the authority of a person who holds a current nursing
license under state law that authorizes the licensee to
administer medication. A medication aide must function under
the direct supervision of a licensed nurse on duty or on
call by the facility; or
(iii) is an employee of the facility to whom the
administration of medication has been delegated by a
registered nurse, who has trained them to administer
medications or verified their training. The delegation of
the administration of medication is governed by 22 TAC
Chapter 225 (concerning RN Delegation to Unlicensed
Personnel and Tasks Not Requiring Delegation in Independent
Living Environments for Clients with Stable and Predictable
Conditions), which implements the Nursing Practice Act. |
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(B) All resident's prescribed
medication must be dispensed through a pharmacy or by the
resident's treating physician or dentist.
(C) Physician sample medications may be given to a resident
by the facility provided the medication has specific dosage
instructions for the individual resident.
(D) Each resident's medications must be listed on an
individual resident's medication profile record. The
recorded information obtained from the prescription label
must include, but is not limited to, the medication: |
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(i) name;
(ii) strength;
(iii) dosage;
(iv) amount received;
(v) directions for use;
(vi) route of administration;
(vii) prescription number;
(viii) pharmacy name; and
(ix) the date each medication was issued by the pharmacy. |
| (2) Supervision. Supervision of
a resident's medication regimen by facility staff may be
provided to residents who are incapable of
self-administering without assistance to include and limited
to: |
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(A) reminders to take their
medications at the prescribed time;
(B) opening containers or packages and replacing lids;
(C) pouring prescribed dosage according to medication
profile record;
(D) returning medications to the proper locked areas;
(E) obtaining medications from a pharmacy; and
(F) listing on an individual resident's medication profile
record the medication |
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(i) name;
(ii) strength;
(iii) dosage;
(iv) amount received;
(v) directions for use;
(vi) route of administration;
(vii) prescription number;
(viii) pharmacy name; and
(ix) the date each medication was issued by the pharmacy. |
| (3) Self-administration |
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(A) Residents who
self-administer their own medications and keep them locked
in their room must be counseled at least once a month by
facility staff to ascertain if the residents continue to be
capable of self-administering their medications/treatments
and if security of medications can continue to be
maintained. The facility must keep a written record of
counseling.
(B) Residents who choose to keep their medications locked in
the central medication storage area may be permitted
entrance or access to the area for the purpose of
self-administering their own medication/treatment regimen. A
facility staff member shall remain in or at the storage area
the entire time any resident is present. |
| (4) General |
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(A) Facility staff will
immediately report to the resident's physician and
responsible party any unusual reactions to medications or
treatments.
(B) When the facility supervises or administers the
medications, a written record must be kept when the resident
does not receive or take his/her medications/treatments as
prescribed. The documentation must include the date and time
the dose should have been taken, and the name and strength
of medication missed; however, the recording of missed doses
of medication does not apply when the resident is away from
the assisted living facility. |
| (5) Storage |
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(A) The facility must provide a
locked area for all medications. Examples of areas include,
but are not limited to: |
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(i) central storage area;
(ii) medication cart; and
(iii) resident room. |
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(B) Each resident's medication
must be stored separately from other resident's medications
within the storage area.
(C) A refrigerator must have a designated and locked storage
area for medications that require refrigeration, unless it
is inside a locked medication room.
(D) Poisonous substances and medications labeled for
"external use only" must be stored separately within the
locked medication area.
(E) If facilities store controlled drugs, facility policies
and procedures must address the prevention of the diversion
of the controlled drugs. |
| (6) Disposal |
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(A) Medications no longer being
used by the resident for the following reasons are to be
kept separate from current medications and are to be
disposed of by a registered pharmacist licensed in the State
of Texas: |
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(i) medications discontinued by order of the
physician;
(ii) medications that remain after a resident is deceased;
or
(iii) medications that have passed the expiration date. |
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(B) Needles and hypodermic
syringes with needles attached must be disposed as required
by 25 TAC §§1.131-1.137 (Definition, Treatment, and
Disposition of Special Waste from Health Care-Related
Facilities).
(C) Medications kept in a central storage area are released
to discharged residents when a receipt has been signed by
the resident or responsible party. |
