Current through Bulletin 2024-06, March 15, 2024
(1) The licensee
shall provide, or obtain by contract, routine and emergency drugs, biologicals,
and pharmaceutical services to meet each resident's physician's orders for
medications.
(2) The licensee shall
employ or obtain the services of a licensed pharmacist who:
(a) provides consultation on the pharmacy
services in the facility;
(b)
establishes a system of records of receipt and disposition of any controlled
substances that documents an accurate reconciliation; and
(c) determines that drug records are in order
and that an account of controlled substances is maintained and reconciled
monthly.
(3)
(a) A licensed pharmacist shall review the
drug regimen of each resident at least monthly.
(b) The pharmacist shall provide reports of
any drug regimen irregularities to the attending physician and the director of
nursing or health services supervisors.
(c) The physician and director of nursing or
health services supervisor shall indicate acceptance or rejection of the
pharmacist's irregularity report and document any action taken.
(4) Pharmacy personnel shall
ensure that labels on drugs and biologicals are in accordance with currently
accepted professional principles, and include the appropriate accessory and
cautionary instructions, and the expiration date.
(5)
(a) The
licensee shall store any drugs and biologicals in locked compartments under
proper temperature controls in accordance with Subsections
R432-150-18(5)(c)(iii) and
(iv), and permit only authorized personnel to
have access to the keys.
(b) The
licensee shall provide separately locked, permanently affixed compartments for
storage of controlled substances and other drugs subject to abuse, except when
the licensee uses single unit dose package drug distribution systems where the
quantity stored is minimal and a missing dose can be readily
detected.
(c) The licensee may not
store non-medication materials that are poisonous or caustic with
medications.
(d) The licensee shall
ensure:
(i) containers are clearly
labeled;
(ii) medication intended
for internal use is stored separately from medication intended for external
use;
(iii) medications stored at
room temperature are maintained within 59 and 80 degrees F; and
(iv) refrigerated medications are maintained
within 36 and 46 degrees F.
(6) The licensee shall maintain an emergency
drug supply and ensure emergency drug practices adhere to the following:
(a) emergency drug containers are sealed to
prevent unauthorized use;
(b)
contents of the emergency drug supply are listed on the outside of the
container and the use of contents is documented by the nursing staff;
(c) the emergency drug supply is stored and
located for access by the nursing staff;
(d) the pharmacist inventories the emergency
drug supply monthly; and
(e) used
or outdated items are replaced within 72 hours by the pharmacist.
(7) The licensee shall ensure that
the pharmacy dispenses drugs and biologicals on a timely basis.
(8) The licensee shall limit the duration of
a drug order in the absence of the prescriber's specific
instructions.
(9) The licensee
shall ensure drug references are available for any drugs used in the facility
and references include generic and brand names, available strength and dosage
forms, indications and side effects, and other pharmacological data.
(10) The licensee may send drugs with the
resident upon discharge, if ordered by the discharging physician provided that
a record of the drugs sent with the resident is documented in the resident's
health record.
(11) The licensee
shall ensure disposal of controlled substances are in accordance with the
Pharmacy Practice Act.
