Current through Rules and Regulations filed through March 20, 2024
(1) All medications required by a resident in a Community Living Arrangement shall be administered appropriately and only in accordance with a physician's order. Where a resident does not have the capacity to self-administer the medications, a licensed nurse, physician's assistant, or other certified staff as determined by the Division of MHDDAD shall administer the medications.
(2) Notwithstanding other provisions of these rules to the contrary, a staff member who is not a licensed nurse or physician's assistant may appropriately administer epinephrine for analphylactic reaction, insulin required for diabetes, suppositories for ameliorating serious seizure activity, and medications through a nebulizer under the following conditions:
(a) The Community Living Arrangement shall have written protocol for the administration of the medication as ordered by a physician for a resident;
(b) The staff shall have been trained by a licensed nurse or physician's assistant in the written protocol and proper technique for the administration of the medication as ordered by a physician for a resident;
(c) The written protocol and staff training shall be updated annually; and
(d) A licensed nurse or physician's assistant shall verify the training and ability of the unlicensed staff member by signing and dating a copy of the written protocol. The signed and dated copy shall be kept in the file of the staff member.
(3) Responsibility for initial acquisition and refilling of prescribed medications shall be specifically assigned in the admission agreement to the resident, his or her representative or legal guardian, if any, or the Community Living Arrangement's designee.
(4) A resident who is not capable of fully independent self-administration of medication may be assisted and supervised in self-administration by staff to the following extent:
(a) He or she may be reminded of the time to take medication;
(b) The medication regimen as indicated by the physician's order or commercially labeled container may be read to him or her;
(c) The dosage he or she self-administers may be checked according to the physician's order or commercially labeled container; and
(d) He or she may be physically assisted in pouring medication.
(5) Over the counter drugs or dietary supplements, including vitamins and herbal supplements, shall be used by the resident under the following circumstances:
(a) Use of the drug is not contraindicated by allergies or sensitivities of the resident;
(b) Use of the drug is according to physician's order; and
(c) Use of the drug is documented on the medication administration record.
(6) All medication shall be administered solely for the purpose of providing effective treatment. Medications shall not be used as punishment or for the convenience of staff.
(7) Storage of medications. Medications shall be stored safely and appropriately monitored to prevent unauthorized use or access.
(a) Medications shall be stored under lock and key at all times whether kept by a resident or kept by the residence, except when required to be kept by the resident on his or her person due to need for frequent or emergency use, as determined by the physician. A key must be maintained within the residence and accessible to authorized staff at all times.
(b) Medication kept by a resident shall be stored in the resident's bedroom in a locked cabinet or other locked storage container, stored in a single-occupancy bedroom which is kept locked at all times, or stored in such a way as to make it inaccessible to others.
(c) Medications requiring refrigeration shall be stored separately from food. If a separate refrigerator is not available, these medications may be placed in a locked container in the same refrigerator in which food is stored. The temperature of the refrigerator shall be maintained between 36 degrees Fahrenheit and 41 degrees Fahrenheit.
(8) Medications shall be properly labeled and handled in accordance with current accepted standards of practice. Outdated, mislabeled, or otherwise unusable medications shall not be available for resident use.
(9) Staff members providing supervision of self-administration of medications shall be trained by a licensed nurse or physician's assistant prior to supervising self-administration of medications. Documented evidence of training shall be kept within the staff member's personnel file. Staff competencies related to the supervision of self-administration of medications shall be tested and documented annually.
(10) Staff training must include but may not be limited to:
(a) Purpose of a resident's medications, including risks and benefits;
(b) Identifying and responding appropriately to adverse reactions to medications;
(c) Following physician's orders, including rationale for ensuring timely receipt of medications;
(d) Documenting all medications, including vitamins and dietary and herbal supplements, taken by the resident on the Medication Administration Record (MAR);
(e) Documenting medications changed or discontinued by a physician;
(f) Proper storage of medication;
(g) Proper disposal of medication; and
(h) Information about medication errors, error-prone situations, and strategies to prevent such medication errors and instructions on proper documentation and reporting of medication errors.
(11) Community Living Arrangements shall have a written policy that specifies the procedures to be followed regarding oversight of medication. Such policy shall include but may not be limited to:
(a) Emergency procedures such as the employees to be notified, the local poison information center telephone number, the person responsible for decision making, and the physician, clinic, emergency room, or comparable medical personnel to be contacted in the event of a medication emergency;
(b) Procedures regarding management of medications including disposal of discontinued or out-of-date medications;
(c) Definitions and procedures for documenting and reporting medication errors;
(d) Procedures to flag allergies and other critical information; and
(e) Requirements for staff training.
O.C.G.A. Secs. 31-7-1et seq., 37-1-22.
