Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 07 - HOSPITALS
Chapter 10.07.02 - Nursing Homes
Section 10.07.02.27 - Pharmaceutical Management
Universal Citation: MD Code Reg 10.07.02.27
Current through Register Vol. 51, No. 19, September 20, 2024
A. Administration Procedures.
(1) Medications,
legend and non-legend, administered to residents shall be ordered in writing by
the resident's physician.
(2)
Medications shall be administered by:
(a)
Appropriately licensed personnel in accordance with laws and regulations
governing these acts; or
(b)
Certified graduates of a State-approved medicine aide course.
(3) The individual who prepares
medications shall give and record them.
(4) Medicine may not be returned to the
container. If the resident refuses the drug or if a mistake occurs:
(a) The drug shall be discarded;
and
(b) The occurrence shall be
documented in the resident's chart.
(5) Before invoking stop order policies, the
resident's attending physician shall be contacted for instructions so that
continuity of the resident's therapeutic regimen is not interrupted. If the
attending physician cannot be reached, the medical director shall be contacted
for instructions.
B. Pharmaceutical Services.
(1) The nursing home
shall arrange for pharmacies that provide medications for residents in the
nursing home. The pharmacy shall agree in writing to maintain at the pharmacy a
resident profile record system for each resident in the nursing home for whom
prescriptions are dispensed.
(2) If
the nursing home does not employ a licensed pharmacist, the nursing home shall
arrange by written contract for a pharmacy to provide consultation on
administering the pharmacy services in accordance with the policies and
procedures established by the pharmaceutical services committee. Pharmaceutical
services shall be under the general supervision of a licensed pharmacist who
shall:
(a) With the advice of the
pharmaceutical services committee, be responsible for developing, coordinating,
and supervising pharmaceutical services and provide in-service training at
least twice yearly;
(b) Visit the
nursing home frequently enough to ensure that policies and procedures
established by the pharmaceutical services committee are enforced;
(c) Notify the attending physician of any
potential drug problems found during the drug regimen review; and
(d) At least quarterly, submit a report to
the pharmaceutical services committee on the status of the nursing home's
pharmaceutical services and staff adherence to policies and
procedures.
C. Resident-Designated Pharmacy.
(1) The nursing home shall inform a
resident's designated pharmacy about the nursing home's written policies
concerning the provision of drugs.
(2) To provide services to the resident, a
designated pharmacy shall agree to comply with the nursing home's
policies.
(3) If the pharmacy fails
to comply with the policies, a representative of the nursing home shall discuss
the situation with the pharmacy and the resident, and if the pharmacy
subsequently refuses to follow the policies, the resident shall select another
pharmacy that agrees to comply.
(4)
The pharmacy shall have access to a copy of the written pharmaceutical care
policies.
(5) The pharmacy shall be
responsible for delivering medications to the nursing home. Members of the
resident's family or the responsible party for the resident may not deliver
medications to the resident or to the nursing home.
D. Medication Return and Disposal.
(1) The nursing home shall return all
prescribed medications, for residents who have been discharged or otherwise
departed, to the pharmacy in accordance with the nursing home's
policy.
(2) The nursing home shall
destroy adulterated, deteriorated, or outdated medications in the following
manner:
(a) Disposal shall occur in the
presence of two witnesses who are authorized by the nursing home; and
(b) The witnesses shall document the disposal
in the resident's chart.
(3) The nursing home shall only release
prescribed medications to residents at the time of discharge based on the
written authorization of the resident's authorized prescriber.
(4) Each month, the nursing home shall
perform a drug regimen review on each resident's records at the nursing home
and document the findings in the resident's medical record.
E. Administration of Medications for Leave of Absence of 24 Hours or Less.
(1)
A nursing home shall develop policies and procedures to ensure that a resident
or, if the resident lacks the capacity, the resident's family or other
individual accompanying the resident is informed, both orally and in writing,
on how the resident shall safely and correctly take the resident's medications
during a short-term leave of absence of 24 hours or less.
(2) In accordance with a nursing
home-developed procedure, a licensed nurse shall prepare medications to be sent
with a resident during a short-term leave of absence of 24 hours or
less.
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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