Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 07 - HOSPITALS
Chapter 10.07.02 - Nursing Homes
Section 10.07.02.26 - Pharmaceutical Services
Universal Citation: MD Code Reg 10.07.02.26
Current through Register Vol. 51, No. 19, September 20, 2024
A. Definition. In this regulation, the term committee means the pharmaceutical services committee.
B. Duties of the Nursing Home.
(1) The nursing home shall
provide appropriate methods and procedures for administering drugs and
biologicals to the nursing home's residents.
(2) The nursing home shall provide
pharmaceutical services in accordance with accepted professional standards and
related federal, State, and local laws.
C. Duties of the Pharmaceutical Services Committee.
(1) A pharmaceutical services
committee, or its equivalent, shall develop written policies and procedures for
safe and effective drug therapy, distribution, control, and use.
(2) The composition of the committee shall
include at least:
(a) The licensed
pharmacist;
(b) The director of
nursing;
(c) The consultant
dietitian-nutritionist;
(d) One
physician; and
(e) The
administrator.
(3) The
committee shall meet at least quarterly to establish policies and
procedures.
(4) There shall be an
agenda to guide meeting participants.
(5) All members of the committee shall review
revisions of policies and procedures before implementing any changes.
(6) The pharmaceutical services committee may
not develop policies and procedures that prohibit or restrict a resident from
receiving medications from the pharmacy of the resident's choice.
(7) In cases where the cost of any medication
obtained from the pharmacy selected by the resident exceeds the cost of the
same or equivalent medication available through a pharmacy that the nursing
home has contracted with to provide pharmaceutical services, the resident shall
be responsible for the additional amount.
(8) The committee may not require the
pharmacy to provide drugs by way of a specific drug distribution system such as
unit dose or use of a particular packaging system.
(9) The committee shall establish the
contents of sealed emergency drug kits.
(10) The committee shall oversee the accuracy
and adequacy of pharmaceutical services to the nursing home.
(11) The committee shall make recommendations
for improvements to pharmaceutical services.
(12) The committee shall document its actions
and recommendations.
D. Labeling.
(1) Medications shall be accurately
and plainly labeled. Except for those over-the-counter medications that the
Department may list as suitable for purchasing in bulk and dispensing as
needed, the labels for all medications shall bear at least:
(a) The resident's full name;
(b) The name of the drug;
(c) Strength;
(d) Original filling date and date refilled,
if applicable;
(e) Name of
authorized prescriber;
(f)
Expiration date of medication (month, year);
(g) Any special handling and storage
instructions;
(h) Name and address
of dispensing pharmacy;
(i)
Prescription number;
(j) Number of
tablets or capsules; and
(k)
Accessory federal labels.
(2) A nurse may not package, repackage,
bottle, or label any medication, in whole or in part, or alter any labeled
medication in any way.
E. Storage.
(1) The nursing home shall store medications
in a locked medication storage area that:
(a)
Is well lighted;
(b) Is located
where personnel preparing drugs for administration will not be
interrupted;
(c) Is spacious enough
to allow separate storage of external and internal medications;
(d) Is kept in a clean, orderly and
uncluttered manner; and
(e)
Contains a refrigerator to be used for medication storage only.
(2) The nursing home shall keep
poisons and medications marked for external use only separate from general
medications and Schedule II drugs.
F. Schedule II-IV Drugs.
(1) Schedule II drugs shall be kept in
separately locked, securely fixed boxes or drawers in the storage area, under
two locks. The lock on the door of a medication room shall be counted as one of
the two locks.
(2) A nurse and a
second staff member who is a nurse or an administrator may destroy controlled
dangerous substances in Schedules II-V on the premises of the nursing
home.
(3) If a controlled dangerous
substance is destroyed on the nursing home premises in accordance with
§F(2) of this regulation:
(a) A record of
the disposal, in addition to any other required records, shall be maintained in
the nursing home; and
(b) A copy of
the record of disposal shall be forwarded to the Office of Controlled
Substances Administration.
(4) A nursing home, whether or not operating
a licensed pharmacy, shall maintain a signed record of a Schedule II count at
each change of shift.
(5) A nursing
home that administers Schedule II drugs shall maintain a drug record that
documents:
(a) The name of the
resident;
(b) The date, time, kind,
dosage, and method of administration of all Schedule II drugs; and
(c) The name of the authorized prescriber who
prescribed the medication.
Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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