Chapter 4723-27 Medication Administration by Certified Medication Aide

As used in this chapter:

(A) “Active certificate” means the certificate held by an individual who has fulfilled all the requirements of the board for initial certification or for certification renewal.

(B) “Approved drug” means a drug approved by the federal food and drug administration (FDA).

(C) “As-needed medication” means any medication that is not scheduled to be administered at a routine time, but is given in response to a resident’s complaint or expression of discomfort or other indication of a specified condition.

(D) “Board” means the Ohio board of nursing.

(E) “Board approved examination” means the written examination and clinical skills examination offered by a testing organization approved by the board.

(F) “Certificate” means the certificate issued to a medication aide by the board in accordance with section 4723.651 of the Revised Code.

(G) “Certified medication aide” means a person who holds a current, valid certificate as a medication aide issued by the board of nursing under section 4723.651 of the Revised Code.

(H) “Contact hour” means sixty minutes of continuing education, as provided in paragraph (B) of rule 4723-14-01 of the Administrative Code.

(I) “Curriculum” means the standard minimum curriculum to be used in a board-approved training program for medication aides in accordance with rule 4723-27-08 of the Administrative Code.

(J) “Delegation” means the transfer of responsibility for the administration of prescription medication from a registered nurse, or a licensed practical nurse acting at the direction of a registered nurse, to a certified medication aide.

(K) “Didactic” means the component of an educational program that includes lecture, verbal instruction, or other means of exchanging theoretical information between instructor and students, typically in a classroom setting.

(L) “Direction” means communicating a plan of care to a licensed practical nurse. Direction by a registered nurse is not meant to imply the registered nurse is supervising the licensed practical nurse in an employment context.

(M) “Gastrostomy tube” means a percutaneously inserted catheter that terminates in the stomach.

(N) “Inactive certificate” means the status of the certificate of an individual who has made a request in writing that the board place the certificate on inactive status and who has returned the certificate to the board. An individual with an inactive certificate does not hold a current, valid certificate.

(O) “Jejunostomy tube” means a percutaneously inserted catheter that terminates in the jejunum.

(P) “Laboratory experience” means a component of classroom instruction consisting of a simulated clinical experience, in which the student is provided the opportunity to practice skills in the administration of medication while observed by a nurse.

(Q) “Lapsed certificate” means a certified medication aide has failed to fulfill all requirements of certificate renewal and has not requested that the board place the certificate on inactive status.

(R) “Licensed practical nurse” or “L.P.N.” means an individual who holds a current, valid license issued under Chapter 4723. of the Revised Code that authorizes the practice of nursing as a licensed practical nurse.

(S) “Medication” means a drug as defined in division (E) of section 4729.01 of the Revised Code.

(T) “Medication aide training program” means the formal program of study approved by the board and required for certification as a medication aide in accordance with sections 4723.61 to 4723.69 of the Revised Code and this chapter.

(U) “Medication error” means a failure to follow the prescriber’s instructions when administering a prescription medication, including:

(1) Administration of an outdated medication;

(2) Administration of the wrong medication;

(3) Administration of the wrong dose of a medication;

(4) Failure to administer the medication as ordered;

(5) Administration of the medication by the wrong route;

(6) Administration of the medication to the wrong resident;

(7) Failure to prepare, store, or administer a medication in accordance with instructions of the manufacturer or the pharmacist;

(8) Administration of medication without nurse delegation or not in accordance with nurse delegation;

(9) Administration of medication using the wrong technique or method.

(V) “Nasogastric tube” means a tube that is passed through the nose and down through the nasopharynx and esophagus into the stomach.

(W) “Nurse” means a registered nurse or a licensed practical nurse.

(X) “Nursing home” means a home as defined by division (A)(6) of section 3721.01 of the Revised Code.

(Y) “Nursing home administrator” means the individual, licensed under Chapter 4751. of the Revised Code, who is responsible for planning, organizing, directing, and managing the operation of a nursing home.

(Z) “Oral gastric tube” means a tube that is passed through the mouth and down through the nasopharynx and esophagus into the stomach.

(AA) “Oral medication” means any medication that is prescribed to be taken by mouth.

(BB) “Pediatric” means a resident under eighteen years of age.

(CC) “Pharmacist” means an individual licensed under Chapter 4729. of the Revised Code to practice pharmacy.

(DD) “Physician” means an individual licensed under Chapter 4731. of the Revised Code to practice medicine and surgery, osteopathic medicine and surgery, or podiatry.

(EE) “Pilot program” means the pilot program authorized by section 4723.63 of the Revised Code for the use of certified medication aides in participating nursing homes and residential care facilities.

(FF) “Pilot program end date” means the day on and after which any nursing home or residential care facility may use one or more medication aides to administer prescription medication to its residents in accordance with section 4723.64 of the Revised Code.

(GG) “Professional boundaries” means the limits of the professional relationship that allow for a safe therapeutic relationship between the resident and the certified medication aide.

(HH) “Prescriber” has the same meaning as in division (I) of section 4729.01 of the Revised Code.

(II) “Prescription” means a written, electronic, or oral order, issued by a licensed health professional authorized to prescribe drugs, for any drug, including an over the counter drug to be used by a particular resident.

(JJ) “Rectal medication” means any medication that is prescribed to be administered by rectal insertion.

(KK) “Registered nurse” or “R.N.” means an individual who holds a current, valid license issued under Chapter 4723. of the Revised Code that authorizes the practice of nursing as a registered nurse.

(LL) “Representative of the board” means an employee or member of the board, or another individual designated by the board to act on its behalf.

(MM) “Resident” means an individual who lives in, and receives services from, a nursing home or residential care facility.

(NN) “Residential care facility” means a home as defined by division (A)(7) of section 3721.01 of the Revised Code.

(OO) “Residential care facility administrator” means the person responsible for the daily operation of a residential care facility.

(PP) “Site visit” means an announced or unannounced visit to a medication aide training program or a pilot program participant by a representative of the board to determine whether the program meets or maintains the minimum standards required by the board.

(QQ) “Standard blood and body fluid precautions” means practices used to minimize exposure to disease causing agents.

(RR) “Successful completion of a medication aide training program” means that a student has satisfactorily completed a board approved training program as set forth in rule 4723-27-08 of the Administrative Code, and has passed a board approved examination.

(SS) “Supervised clinical practice” means a task or activity planned to provide medication aide students with the opportunity to administer prescription medications in a nursing home or residential care facility setting in which the student is supervised by a nurse as part of a medication aide training program approved by the board under section 4723.66 of the Revised Code and this chapter.

(TT) “Telecommunication” means the process of transmitting or receiving information over a distance by any electronic or electromagnetic medium. Information may take the form of voice, video, or data.

(UU) “Topical medication” means any prescribed medication that is applied to intact skin.

(VV) “Vaginal medication” means any medication that is prescribed to be administered by vaginal insertion.

Effective: 02/01/2008

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/06 (Emer.), 5/1/06

(A) A certified medication aide shall administer prescription medications only at the delegation of a nurse in accordance with section 4723.67 of the Revised Code, Chapter 4723-13 of the Administrative Code, and this chapter, in the following settings:

(1) Prior to the pilot program end date, to residents of nursing homes and residential care facilities participating in the certified medication aide pilot program authorized under section 4723.63 of the Revised Code;

(2) On or after the pilot program end date, to residents of nursing homes and residential care facilities.

(B) Except as provided in paragraphs (C) and (D) of this rule, a certified medication aide to whom the task of medication administration is delegated, may administer the following types of prescription medications:

(1) Oral medications;

(2) Topical medications;

(3) Medications administered as nasal spray, or as drops, or ointment to a resident’s eye, ear, or nose;

(4) Rectal and vaginal medications; or

(5) Inhalants delivered by inhalers, nebulizers, or aerosols, that allow for a single dose of a fixed, pre-measured amount of medication.

(C) A certified medication aide shall not administer medications in the following categories:

(1) Medications containing a schedule II controlled substance, as defined in section 3719.01 of the Revised Code;

(2) Medications, including inhalants delivered by inhalers, nebulizers, or aerosols, requiring dosage calculations;

(3) Medications that are not approved drugs;

(4) Medications being administered as part of clinical research; or

(5) Oxygen.

(D) A certified medication aide shall not administer medications by any of the following methods:

(1) Injection;

(2) Intravenous therapy procedures;

(3) Splitting pills for purposes of changing the dose being given; or

(4) Through jejunostomy, gastrostomy, nasogastric, or oral gastric tubes.

(E) In addition to the prohibitions in paragraphs (C) and (D) of this rule, a certified medication aide shall not:

(1) Receive, transcribe or alter a medication order;

(2) Administer the initial dose of a medication ordered for a resident;

(3) Administer medications to a person other than a resident of a nursing home or residential care facility as provided in paragraph (A) of this rule;

(4) Administer any medication without the task having been delegated by a nurse;

(5) Administer medications to pediatric residents; or

(6) Access schedule II controlled substances.

(F) A certified medication aide shall maintain knowledge of the duties, responsibilities, and accountabilities of a certified medication aide and shall act in accordance with the laws pertaining to the administration of medication by a certified medication aide as set forth in Chapter 4723. of the Revised Code and the rules adopted under that chapter.

(G) A certified medication aide shall display the title “certified medication aide” at all times when administering medications to residents of a nursing home or residential care facility.

(H) A certified medication aide shall demonstrate competence and accountability in the task of medication administration, including appropriate recognition, referral, and consultation with the delegating nurse.

(I) Immediately after administering a medication, a certified medication aide shall accurately document in the resident’s record, the following information:

(1) The name of the medication and the dosage administered;

(2) The route of administration;

(3) The date and time of administration;

(4) The name of the certified medication aide administering the medication; and

(5) Refusal by a resident to comply with medication administration.

(J) A certified medication aide shall implement measures to promote a safe environment for nursing home or residential care facility residents.

(K) A certified medication aide shall take measures to ensure the safety of the resident including but not limited to:

(1) Reporting to a nurse in a timely manner all of the following:

(a) The potential need of a resident for the administration of an as-needed medication, as evidenced by an expression of discomfort from the resident or other indication;

(b) Refusal by a resident to comply with medication administration;

(c) Any deviation from the delegated medication administration;

(d) Any unanticipated reaction by the resident to the medication administration; or

(e) Anything about the condition of a resident that should cause concern to the certified medication aide.

(2) Preparing and storing medications in accordance with instructions of the manufacturer or the pharmacist;

(3) Removing medications only from a dispensed and properly labeled container that includes all of the following:

(a) Medication name;

(b) Medication dose;

(c) Name of the resident to whom the medication is dispensed, unless:

(i) The medication is a contingency drug stored and supplied in accordance with Chapter 4729-17 of the Administrative Code and is supplied to the certified medication aide by the delegating nurse; or

(ii) Medication that is available over the counter and bears the original manufacturer’s label and has been purchased and prescribed for the resident;

(d) Expiration date of the medication;

(4) Verifying the identity of the resident to whom the medication is to be administered;

(5) Witnessing the resident swallowing an oral medication that is to be ingested, or otherwise taking a medication in accordance with its prescribed route;

(6) Immediately documenting and reporting medication errors to a nurse;

(7) Utilizing only the medication delivery process currently in use in the nursing home or residential care facility; and

(8) Administering medications in accordance with standards set forth in the medication aide training curriculum established pursuant to division (B)(6) of section 4723.69 of the Revised Code and this chapter.

(L) A certified medication aide shall not accept a resident care assignment that would interrupt or conflict with the administration of medications or the performance of other tasks and activities that are directly related to the administration of medications. A certified medication aide may perform other resident care activities during such times that the certified medication aide is not engaged in, or scheduled to be engaged in, the administration of medications.

(M) A certified medication aide shall maintain the confidentiality of resident information obtained in the course of the certified medication aide’s duties and responsibilities.

(N) A certified medication aide to whom the administration of medication has been delegated shall not delegate the task of medication administration to any other person.

(O) A certified medication aide shall not falsify any resident record or any other document prepared or utilized in the course of, or in conjunction with, the administration of medications.

(P) A certified medication aide shall delineate, establish, and maintain professional boundaries with each resident.

(Q) At all times when a certified medication aide is administering medications to residents in a nursing home or residential care facility the certified medication aide shall:

(1) Take reasonable measures to assure the privacy of the resident; and

(2) Treat each resident with courtesy, respect, and with full recognition of dignity and individuality.

(R) A certified medication aide shall not:

(1) Engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a resident; or

(2) Engage in behavior toward a resident that may reasonably be interpreted as physical, verbal, mental, or emotional abuse.

(S) A certified medication aide shall not misappropriate a resident’s property or:

(1) Engage in behavior to seek or obtain personal gain at the expense of a resident or that may reasonably be interpreted as behavior to seek or obtain personal gain at the expense of a resident; or

(2) Engage in behavior that constitutes inappropriate involvement in the personal relationships of a resident or that may reasonably be interpreted as inappropriate involvement in the personal relationships of a resident.

For purposes of this paragraph, the resident is always presumed incapable of giving free, full, or informed consent to the behaviors by the certified medication aide set forth in this paragraph.

(T) A certified medication aide shall not:

(1) Engage in sexual conduct with a resident or conduct that may reasonably be interpreted as sexual; or

(2) Engage in any verbal behavior that is seductive or sexually demeaning to a resident, or that may reasonably be interpreted as seductive, or sexually demeaning to a resident.

For purposes of this paragraph, the resident is always presumed incapable of giving free, full, or informed consent to sexual activity with a certified medication aide.

(U) A certified medication aide shall not submit or cause to be submitted any false, misleading, or deceptive statements, information, or documentation to the board, to current employers, or to any future employers for positions requiring certification as a medication aide.

Effective: 02/01/2008

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/06 (Emer.), 5/1/06

(A) A registered nurse or a licensed practical nurse acting at the direction of a registered nurse, who provides nursing care to residents in nursing homes or residential care facilities, may delegate the task of medication administration to a certified medication aide in accordance with section 4723.67 of the Revised Code, Chapter 4723-13 of the Administrative Code, and this chapter.

(B) A registered nurse may delegate the administration of medications to a certified medication aide only if the registered nurse holds a current, valid license issued under Chapter 4723. of the Revised Code that is not subject to restrictions relating to the administration of medications imposed under section 4723.28 of the Revised Code, or imposed by agreement entered pursuant to sections 4723.282 or 4723.35 of the Revised Code.

(C) A licensed practical nurse, acting at the direction of a registered nurse, may delegate the administration of medications to a certified medication aide only if all of the following apply:

(1) The registered nurse at whose direction the licensed practical nurse is delegating the administration of medications is authorized to delegate the administration of medications to a certified medication aide in accordance with paragraph (B) of this rule;

(2) The licensed practical nurse is authorized to administer medications in accordance with division (F)(3) of section 4723.01 of the Revised Code; and

(3) The licensed practical nurse holds a current, valid license issued under Chapter 4723. of the Revised Code that is not subject to restrictions relating to the administration of medications imposed under section 4723.28 of the Revised Code, or imposed by agreement entered pursuant to sections 4723.282 or 4723.35 of the Revised Code.

(D) A nurse who delegates to a certified medication aide responsibility for the administration of prescription medications to residents in nursing homes or residential care facilities shall not withdraw the delegation on an arbitrary basis or for any purpose not related to resident safety.

(E) Prior to delegating the task of medication administration to a certified medication aide, a nurse shall evaluate the following:

(1) The resident and the medication needs of the resident, including:

(a) The resident’s mental and physical stability;

(b) The medication to be administered;

(c) The timeframe during which the medication is to be administered;

(d) The route or method by which the medication is to be administered; and

(2) The ability of the certified medication aide to safely administer the medication being delegated.

(F) When delegating the task of medication administration to a certified medication aide, the nurse shall communicate the following:

(1) The residents to whom the certified medication aide shall administer medications;

(2) The medications the certified medication aide shall administer;

(3) The timeframes during which the medications are to be administered; and

(4) Any special instructions concerning the administration of medications to specific residents.

(G) A nurse who is on site may delegate the administration of as-needed medications to a certified medication aide provided all of the following are satisfied:

(1) A registered nurse has completed a nursing assessment of the resident to whom the as-needed medication is to be administered;

(2) A nursing regimen based on the nursing assessment is established that contains interventions including the administration of the as-needed medication in accordance with the medication order;

(3) The nurse determines the resident’s need for the medication based on information collected from sources that include but are not limited to:

(a) Direct observation of the resident;

(b) The nursing regimen established for the resident;

(c) The resident’s record; and

(4) The nurse determines the as-needed medication may be safely administered by the certified medication aide.

(H) If a nurse is not on site, the nurse may delegate the administration of as-needed medications to a certified medication aide only if all of the following are satisfied:

(1) A registered nurse has completed a nursing assessment of the resident to whom the as-needed medication is to be administered;

(2) A nursing regimen based on the nursing assessment is established that contains interventions including the administration of the as-needed medication in accordance with the medication order;

(3) A nurse is immediately available by telecommunication and determines the resident’s need for the medication based on but not limited to the following:

(a) Current knowledge of the resident’s health status and the resident’s nursing regimen;

(b) The resident’s record; and

(c) Data conveyed by the certified medication aide who is directly engaged in the administration of medications to the resident.

(4) The as-needed medication is available for over the counter purchase;

(5) The nurse determines the as-needed medication may be safely administered by the certified medication aide.

(I) In a nursing home or residential care facility that utilizes certified medication aides, a nurse remains responsible for all of the following:

(1) Reviewing the medication delivery process to assure there have been no errors in stocking or preparing the medications;

(2) Accepting, transcribing, and reviewing resident medication orders;

(3) Monitoring residents to whom medications are administered for side effects or changes in health status; and

(4) Reviewing documentation completed by a certified medication aide, including the medication administration record.

(J) A nurse shall supervise the certified medication aides in accordance with the following:

(1) In a nursing home, a nurse shall provide on-site supervision of a certified medication aide;

(2) In a residential care facility, supervision of a certified medication aide shall be provided by a nurse who is either on-site or is immediately and continuously available through some form of telecommunication.

(K) A nurse may not delegate the administration of prescription medications in the following categories, by the following routes, or under the following circumstances, to a certified medication aide:

(1) Medications containing a schedule II controlled substance, as defined in section 3719.01 of the Revised Code;

(2) Medications, including inhalants delivered by inhalers, nebulizers, or aerosols, requiring dosage calculations;

(3) Medications that are not approved drugs;

(4) Medications being administered as part of clinical research;

(5) Administration of medications via injection;

(6) Administration of medications via intravenous therapy procedures;

(7) Administration of medications via splitting pills for purposes of changing the dose being given;

(8) Administration of medications through jejunostomy, gastrostomy, nasogastric, or oral gastric tubes;

(9) Administration of medications to pediatric residents;

(10) Administration of the initial dose of any medication ordered for a resident;

(11) Administration of oxygen.

(L) A registered nurse or a licensed practical nurse acting at the direction of a registered nurse, who delegates the administration of medications to a certified medication aide in accordance with section 4723.67 of the Revised Code and this chapter, shall not be liable in damages to any person or government entity in a civil action for injury, death, or loss to person or property that allegedly arises from an action or omission of the certified medication aide in the administration of the medications.

Replaces: 4723-27-03 (Emergency)

Effective: 05/01/2006

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/2006 (Emer.)

(A) For purposes of the pilot program authorized by section 4723.63 of the Revised Code, for the period beginning May 1, 2006 and ending on the pilot program end date, the board shall issue a pilot program medication aide certificate to qualified applicants.

(1) An applicant for a pilot program medication aide certificate shall satisfy all of the following:

(a) Be at least eighteen years of age;

(b) Have a high school diploma or a high school equivalence diploma as described in section 5107.40 of the Revised Code;

(c) If the applicant is to function as a certified medication aide in a nursing home, be a nurse aide who satisfies the requirements of division (A)(1), (A)(2), (A)(3), (A)(4), (A)(5), (A)(6), or (A)(8) of section 3721.32 of the Revised Code;

(d) If the applicant is to function as a certified medication aide in a residential care facility be either:

(i) A nurse aide who satisfies the requirements of division (A)(1), (A)(2), (A)(3), (A)(4), (A)(5), (A)(6), or (A)(8) of section 3721.32 of the Revised Code; or

(ii) Have at least one year of direct care experience in a residential care facility;

(e) Have submitted a completed application on the form specified by the board;

(f) The board has received the results of a criminal records check in accordance with division (B)(1) of section 4723.65 of the Revised Code, or has received a certified copy of the results of a records check conducted within five years prior to the date the application is submitted in accordance with division (B)(2) of section 4723.65 of the Revised Code, completed by the bureau of criminal identification and investigation. For applicants who have not lived in this state for at least five years, the check shall include a federal bureau of investigation records check. The records check required by this paragraph shall indicate that the applicant has not been convicted of, pleaded guilty to, or had a judicial finding of guilt for any violation referenced in division (A)(6) of section 4723.651 of the Revised Code;

(g) The board has received written verification that the applicant has successfully completed the approved medication aide training program, including a statement that the applicant has passed a board approved examination.

(2) The holder of a pilot program medication aide certificate is authorized to function as a certified medication aide only in those nursing homes or residential care facilities participating in the medication aide pilot program.

(3) The holder of a pilot program medication aide certificate who is not a state tested nurse aide but who qualifies for a pilot program medication aide certificate under paragraph (A)(1)(d)(ii) of this rule, may only function as a certified medication aide in residential care facilities participating in the pilot program.

(4) A pilot program medication aide certificate shall be valid, unless the certificate is made inactive or if disciplinary action has rendered it invalid, from the date of issuance until the pilot program end date at which time a certificate holder may apply for an interim certificate in accordance with paragraph (B) of this rule.

(B) For the period beginning on the pilot program end date and ending on April thirtieth of the next even numbered year, the board shall issue an interim medication aide certificate to qualified applicants.

(1) Applicants for an interim medication aide certificate shall satisfy the conditions for certification set forth in paragraph (A)(1) of this rule.

(2) If an applicant for an interim medication aide certificate previously held a pilot program medication aide certificate issued in accordance with paragraph (A) of this rule, the applicant is not required to obtain an additional criminal records check or a certified copy of the results of a records check, and the board will not require another statement verifying completion of a medication aide training program.

(3) In addition to a completed application for an interim medication aide certificate, an applicant shall submit to the board the fee required by paragraph (A)(1) of rule 4723-27-10 of the Administrative Code.

(4) The holder of an interim medication aide certificate who is not a state tested nurse aide but who qualifies for a medication aide certificate under paragraph (A)(1)(d)(ii) of this rule, may only function as a certified medication aide in residential care facilities.

(5) An interim medication aide certificate shall be valid, unless the certificate is made inactive or if disciplinary action has rendered it invalid, from the date on which it is issued until April thirtieth of the next even numbered year, at which time a holder may apply for a medication aide certificate in accordance with paragraph (C) of this rule.

(C) Beginning on May first of the next even numbered year following the pilot program end date, the board shall issue a medication aide certificate to qualified applicants.

(1) Applicants for a medication aide certificate shall satisfy the conditions for certification set forth in paragraph (A)(1) of this rule.

(2) If an applicant for a medication aide certificate previously held a pilot program medication aide certificate issued in accordance with paragraph (A) of this rule, or an interim medication aide certificate issued in accordance with paragraph (B) of this rule, the applicant is not required to obtain an additional criminal records check or a certified copy of the results of a records check, and the board will not require another statement verifying completion of a medication aide training program.

(3) In addition to a completed application for a medication aide certificate, an applicant shall submit to the board the fee for a medication aide certificate set forth in paragraph (A)(2) of rule 4723-27-10 of the Administrative Code.

(4) The holder of a medication aide certificate who is not a state tested nurse aide but who qualifies for a medication aide certificate under paragraph (A)(1)(d)(ii) of this rule, may only function as a certified medication aide in residential care facilities.

(5) Medication aide certificates shall be renewed biennially in accordance with rule 4723-27-05 of the Administrative Code, and shall be valid from May first of even numbered years until April thirtieth of the following even numbered year.

(6) If a medication aide certificate is issued by the board on or after February first of an even numbered year, the certificate shall be valid, unless the certificate is made inactive or if disciplinary action has rendered it invalid, through April thirtieth of the next even numbered year.

(D) Certification as a medication aide shall be evidenced by verification of certification on the board website.

(1) For applicants issued a pilot program medication aide certificate, the website verification and a wallet sized document issued by the board shall indicate that the holder is authorized to function as a certified medication aide only in facilities participating in the pilot program;

(2) For holders of a pilot program medication aide certificate issued in accordance with paragraph (A) of this rule, an interim medication aide certificate issued in accordance with paragraph (B) of this rule, or a medication aide certificate issued in accordance with paragraph (C) of this rule, who are authorized to function as a certified medication aide only in residential care facilities:

(a) The website verification and any wallet sized document issued by the board shall clearly indicate this limitation;

(b) If the certificate holder has, following certification, satisfied the requirements of division (A)(1), (A)(2), (A)(3), (A)(4), (A)(5), (A)(6), or (A)(8) of section 3721.32 of the Revised Code, the holder may submit documentation to the board and a written request that the holder’s certification be amended to allow the holder to function as a medication aide in nursing home facilities or residential care facilities.

If the board determines that the certificate holder has submitted valid documentation, the board shall amend website verification and any wallet sized card issued by the board to reflect the amended status of the certificate holder.

(E) An individual who holds a current, valid medication aide certificate issued by the board under section 4723.651 of the Revised Code and this chapter, may use the title “medication aide-certified” and the initials “MA-C.”

(F) If, through no fault of the board, an applicant for a medication aide certificate is not determined eligible for certification within one year of receipt of that application, the application shall be considered void and the fee forfeited.

(G) The board shall not endorse applicants who have been licensed or certified as medication aides in jurisdictions other than Ohio.

Effective: 02/01/2009

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/2006 (Emer.), 5/1/2006, 2/1/2008

(A) In accordance with division (C) of section 4723.651 of the Revised Code and except as otherwise provided in this chapter, medication aide certificates shall be renewed biennially on or before April thirtieth of even numbered years beginning with the certificates issued under paragraph (C) of rule 4723-27-04 of the Administrative Code.

(1) The board shall provide an application for renewal to every holder of a current, valid medication aide certificate, except when the board is aware that a certificate holder may be ineligible for certificate renewal for any reason, including but not limited to:

(a) The individual is subject to pending criminal charges in this state or another jurisdiction;

(b) Failure of the holder to comply with a disciplinary order from the board or terms of a consent agreement entered into with the board;

(c) Failure to pay fines or fees owed to the board; or

(d) Failure to provide documentation as requested by the board demonstrating compliance with the continuing education requirements specified in paragraph (C) of this rule.

(2) If the board provides a renewal application by mail, the application shall be addressed to the last known address of the holder and mailed prior to the date specified by the board. Failure of the holder to receive an application for renewal from the board does not excuse the holder from the requirements set forth in this rule.

(3) On or before the date specified, the certificate holder shall complete the renewal application and return it to the board with the renewal fee required by rule 4723-27-10 of the Administrative Code. The certificate holder shall report on the application any information requested by the board.

(4) On receipt of the renewal application, the board shall verify that the applicant meets the renewal requirements and shall renew the certificate for the following two-year period.

(B) A certified medication aide shall give written notice to the board of any change of name or address within thirty days of the change. The board shall require the holder to document a change of name in a manner acceptable to the board.

(C) During the two-year period for which a medication aide certificate is valid, the holder of the certificate shall meet the continuing education requirements set forth in rule 4723-27-06 of the Administrative Code.

(D) A certified medication aide who, at any time, does not wish to renew a medication aide certificate may request that the certificate be placed on inactive status by either of the following:

(1) At certificate renewal time, by checking the appropriate box on the renewal application provided by the board indicating that the holder wishes to place the certificate on inactive status; or

(2) At any other time, by submitting to the board the certificate holder’s current certificate and a written statement requesting that the certificate be placed on inactive status.

(E) If a medication aide certificate is not renewed by April thirtieth of each even numbered year and the certificate holder fails by that time to request that the certificate be placed on inactive status, the certificate shall be considered to have lapsed.

(F) If a medication aide certificate is inactive or lapsed for two years or less, the board may reactivate or reinstate the certificate if the individual submits to the board within two years from the date the certificate was made inactive or lapsed, all of the following:

(1) A completed application;

(2) The applicable fee set forth in paragraph (A) of rule 4723-27-10 of the Administrative Code; and

(3) Documentation of successful completion of the continuing education requirements for renewal of a certified medication aide as set forth in rule 4723-27-06 of the Administrative Code.

(G) If a medication aide certificate is inactive or lapsed for more than two years, it shall not be reactivated or reinstated unless the applicant submits to the board all of the following:

(1) A completed application;

(2) The applicable fee set forth in paragraph (A) of rule 4723-27-10 of the Administrative Code; and

(3) Written verification from an approved medication aide training program that the applicant has, within six months prior to submission of the application, successfully completed the medication aide training program.

(H) A certificate holder who has placed a medication aide certificate on inactive status is not required to pay a renewal fee unless or until the holder seeks to reactivate the certificate in accordance with paragraph (F) or (G) of this rule.

(I) During the time that an individual’s certification as a medication aide is either inactive or lapsed, the holder may not administer medications as a certified medication aide.

(J) An individual who administers medications as a certified medication aide or represents to the public that the individual holds a current valid medication aide certificate, who has failed to renew a medication aide certificate issued under this chapter, or while the certificate is under suspension, inactive or lapsed, may be subject to disciplinary action under rule 4723-27-09 of the Administrative Code.

(K) Notwithstanding the provisions of this rule, a medication aide whose certificate expired due to the holder’s service in the armed forces of the United States, or in the national guard or in a reserve component, shall be eligible for renewal and reinstatement without payment of the reinstatement fee specified in paragraph (A)(5) of rule 4723-27-10 of the Administrative Code, if the following conditions are met:

(1) The certificate holder presents the board with satisfactory evidence that not more than six months prior to the date the evidence is submitted to the board, the certificate holder was honorably discharged or separated under honorable conditions; and

(2) The certificate holder is not suffering a mental or physical impairment that may affect the individual’s ability to provide safe care.

Effective: 02/01/2009

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/2006 (Emer.), 5/1/2006, 2/1/2008

(A) During each certification period, a certified medication aide shall obtain fifteen approved contact hours of continuing education that includes the following:

(1) One hour of continuing education shall be directly related to Chapter 4723. of the Revised Code and the rules adopted under that chapter. To qualify, this continuing education must be approved by an OBN approver as defined in paragraph (I) of rule 4723-14-01 of the Administrative Code, or an OBN approved provider unit as defined in paragraph (M) of rule 4723-14-01 of the Administrative Code;

(2) One hour of continuing education shall be directly related to establishing and maintaining professional boundaries; and

(3) Ten hours of continuing education shall be related to medications or medication administration consistent with the function of the certified medication aide.

(B) Holders of interim certificates issued in accordance with paragraph (B) of rule 4723-27-04 of the Administrative Code who apply for a certificate under paragraph (C) of rule 4723-27-04 of the Administrative Code may be required to obtain up to eight approved contact hours of continuing education consistent with the function of the certified medication aide.

(C) When a medication aide certificate has been made inactive or has been allowed to lapse for two years or less, the applicant for reactivation or reinstatement of the certificate shall complete fifteen contact hours of continuing education as described in paragraph (A) of this rule within the twenty-four months immediately preceding the reactivation or reinstatement.

(D) When a medication aide certificate has been made inactive or has been allowed to lapse for greater than two years the applicant must complete a training program as set forth in rule 4723-27-07 of the Administrative Code.

(E) A certified medication aide shall verify completion of the continuing education required by this rule on the application for certificate renewal provided by the board, and at the discretion of the board, may be required to show proof of completion of the approved continuing education. Failure to so verify or provide such proof shall result in ineligibility to renew, reactivate, or reinstate a medication aide certificate until the continuing education requirements are met.

(F) A certified medication aide who earns in excess of the number of contact hours of continuing education for a single certification period shall not apply the excess hours to satisfy future continuing education requirements.

(G) A certified medication aide who is ineligible to renew, reactivate, or reinstate a medication aide certificate due to failure to meet the continuing education requirements, may be required to show completion of up to thirty contact hours of continuing education that meets the requirement of this rule, before being issued a current certificate by the board. The continuing education shall be obtained within the twenty-four months immediately preceding the renewal, reactivation, or reinstatement of the certificate.

(H) The calculation of contact hours based on credit hours earned in an academic institution shall be made in accordance with paragraph (B) of rule 4723-14-04 of the Administrative Code.

(I) Educational activities that satisfy the requirements of this rule are the same as set forth in rule 4723-14-05 of the Administrative Code.

(J) The board may conduct a retrospective audit of any holder of a medication aide certificate to determine compliance with this rule. The audit shall be conducted in accordance with rule 4723-14-07 of the Administrative Code. A certified medication aide shall retain proof of completion of approved continuing education for a period of six years.

(K) For purposes of determining whether continuing education requirements are met, the provisions of rule 4723-14-02 of the Administrative Code related to military duty are applicable.

Effective: 02/01/2009

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/2006 (Emer.), 5/1/2006, 2/1/2008

(A) An applicant seeking approval from the board to provide a medication aide training program shall submit an application for approval on the form specified by the board.

(1) Applications submitted on or after the pilot program end date shall be accompanied by the fee required by paragraph (A)(10) of rule 4723-27-10 of the Administrative Code.

(2) No applicant shall admit a student until the medication aide training program has been approved by the board.

(B) The application for approval of a medication aide training program shall contain the following information:

(1) The objectives and outcomes of the medication aide program;

(2) The program’s organizational chart;

(3) The name and credentials of the program’s registered nurse administrator;

(4) The name and credentials of all individuals serving as instructors in the program;

(5) A program curriculum that includes the number of hours to be spent on each topic area.

(C) To be approved by the board, a medication aide training program shall meet and maintain the following requirements:

(1) The medication aide training program shall include a minimum of one hundred twenty clock hours of instruction consisting of the following:

(a) Not less than eighty clock hours of didactic and laboratory instruction relating to medication administration and meeting the minimum curriculum requirements specified in rule 4723-27-08 of the Administrative Code; and

(b) Not less than forty clock hours of supervised clinical practice as set forth in rule 4723-27-08 of the Administrative Code.

(2) The medication aide training program shall employ or contract with one or more nurses who collectively shall satisfy all of the following requirements:

(a) A registered nurse who has held a current, valid Ohio license to practice registered nursing for a minimum of two years, to serve as the program administrator;

(b) A nurse who has had, within the past five years, at least one year of experience in providing nursing services as a registered nurse or licensed practical nurse in a nursing home or a residential care facility;

(c) A nurse with education or experience in adult instruction which may include completion of an approved train the trainer course or experience;

(d) A nurse who shall serve as supervisor of the clinical component; and

(e) A registered nurse who shall teach the didactic and laboratory component of the training program.

(3) The registered nurse program administrator shall direct and supervise all aspects of the training program and ensure that the program meets and maintains the requirements set forth in this rule, and rule 4723-27-08 of the Administrative Code.

(4) The program shall disclose to all applicants at the time of admission the program’s refund policy, the cost of the board approved medication aide examination, the qualifications for certification as a medication aide, as set forth in section 4723.651 of the Revised Code, and that in order to be certified as a medication aide, an applicant will be tested to determine whether the applicant’s reading, writing, and mathematical skills are sufficient to administer prescription medications safely.

(5) Prior to the pilot program end date, the supervised clinical practice component shall be provided in a nursing home or residential care facility that has been approved by the board to participate in the medication aide pilot program authorized under section 4723.63 of the Revised Code.

(6) On or after the pilot program end date, the supervised clinical practice component shall be provided in nursing homes that the Ohio department of health has found to be free from deficiencies related to the administration of medications in the two most recent annual surveys, or in residential care facilities that the Ohio department of health has found to be free from deficiencies, related to the administration of medications and the provision of skilled nursing care, in the two most recent annual surveys.

(7) A medication aide training program shall provide written certification, on a form specified by the board, to a board approved examination service provider of a student’s eligibility to take a board approved examination, in accordance with rule 4723-27-08 of the Administrative Code.

(8) A medication aide training program shall maintain records including results of a board approved examination for each student for a period of six years following the date the student enrolled in the program.

(9) A medication aide training program shall engage in program evaluation that includes, but is not limited to, obtaining feedback from students, instructors, and employers of individuals who have successfully completed the medication aide training program.

(10) A medication aide training program shall ensure an orderly transition between program administrators including providing written notification to the board within thirty days of the transition.

(11) A medication aide training program shall close a program, if necessary, in an orderly manner including providing thirty days advance written notice to the board, current students, and program applicants of the following:

(a) Tentative date of the closing;

(b) The location where the program’s student and other records will be retained; and

(c) The name, address, and other contact information of the custodian of all program records after the program is closed;

(12) A medication aide training program shall establish written policies and procedures to meet the requirements of this rule and other policies deemed necessary for the training program. Such policies and procedures shall be available for review by the board upon request.

(D) Approval of a medication aide training program shall be effective for a period of two years from the date of approval provided that the requirements set forth in this rule and rule 4723-27-08 of the Administrative Code are met and maintained throughout the two-year period.

(E) No later than ninety days prior to expiration of a medication aide training program approval period, a program seeking reapproval shall submit the following to the board:

(1) An application specified by the board which includes, but is not limited to, verification that the program meets and has maintained the requirements set forth in this rule and rule 4723-27-08 of the Administrative Code;

(2) Payment of a program reapproval fee as specified in paragraph (A)(11) of rule 4723-27-10 of the Administrative Code;

(3) Any other information requested by the board.

(F) The board may conduct site visits of a medication aide training program or program applicant. The board has all of the powers and duties conferred by sections 4723.28 and 4723.29 of the Revised Code with respect to evaluation of a medication aide training program or applicant.

(G) The board shall review completed applications for approval or reapproval of a medication aide training program during a regularly scheduled board meeting.

(H) The board may deny, suspend or revoke approval or reapproval of a medication aide training program or applicant, in accordance with Chapter 119. of the Revised Code, based upon the following:

(1) Failure to meet or maintain the requirements set forth in this rule and rule 4723-27-08 of the Administrative Code;

(2) Submitting false, misleading or deceptive statements, information or documentation to the board or its designees.

(I) If the board fails to act on a reapproval application prior to the expiration of the program’s current two-year approval period, the board shall consider the program’s current approval period effective until the board takes action with respect to the reapproval application.

Effective: 02/01/2008

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/06 (Emer.), 5/1/06

(A) The approved curriculum for a training program for certified medication aides shall be the standard minimum curriculum set forth in paragraph (C) of this rule, and shall include all of the following:

(1) Program objectives and outcomes, course objectives or outcomes, teaching strategies, and core competencies or other evaluation methods that are:

(a) Consistent with the law and rules applicable to certified medication aides, as set forth in Chapter 4723. of the Revised Code and this chapter;

(b) Internally consistent;

(c) Implemented as written; and

(d) Made available to students in medication aide training programs;

(2) A curriculum plan showing the sequence of courses, laboratory experiences, and the number of clock hours allotted to instruction and laboratory experience related to medication administration;

(3) A curriculum content that is a minimum of eighty clock hours of didactic classroom, including laboratory experience, allocated as specified in paragraph (C) of this rule, and an additional forty clock hours of supervised clinical practice;

(4) For purposes of paragraph (A)(3) of this rule:

(a) During the didactic and laboratory component, students and instructors must be present in the same location, and the instruction must be provided in person rather than exclusively by means of video, audio, computer, multimedia, or electronic communications;

(b) Students must satisfactorily complete the didactic and laboratory component prior to participating in the supervised clinical component of the certified medication aide training program.

(B) A medication aide training program and board approved medication aide examination shall be structured in the following manner:

(1) A class of students shall complete the program in no fewer than twenty business days and no more than ninety days;

(2) Within sixty days of satisfactorily completing the required classroom and supervised clinical practice components, the student shall take a board approved examination;

(3) The examination shall evaluate whether the student’s reading, writing, mathematical skills, and knowledge of the standard minimum curriculum are sufficient to administer prescription medications safely;

(4) A student who fails the examination may take the examination a second time within the six-month period immediately following notification of the examination results to the student and the training program;

(5) A student who fails the examination a second time must enroll or re-enroll, and satisfactorily complete, a board approved training program in order to be eligible to take the examination again.

(C) The standard minimum curriculum for certified medication aides shall include courses, content, and expected outcomes, relative to the defined role of the certified medication aide, in the following areas with the minimum number of course hours specified:

(1) Communication and interpersonal skills, four hours;

(2) Resident rights related to medication administration, including the right of a resident to refuse medications, one hour;

(3) The six rights of medication administration, three hours, including:

(a) The right person;

(b) The right drug;

(c) The right dose;

(d) The right time;

(e) The right route; and

(f) The right documentation.

(4) Drug terminology, storage and disposal, four hours, including:

(a) Medical terminology, symbols, accepted abbreviations;

(b) Dosage measurement;

(c) Reference resources;

(d) Principles of safe medication storage and disposal;

(5) Fundamentals of the following body systems, twenty hours, including:

(a) Gastrointestinal;

(b) Musculoskeletal;

(c) Nervous and sensory;

(d) Urinary/renal;

(e) Cardiovascular;

(f) Respiratory;

(g) Endocrine;

(h) Male and female reproductive; and

(i) Integumentary and mucous membranes;

(6) Basic pharmacology, drug classifications and medications affecting body systems, twelve hours, including:

(a) Purposes of various medications;

(b) Schedule III, IV, and V controlled substances;

(7) Safe administration of medications, twenty hours, including:

(a) Oral medications;

(b) Topical medications;

(c) Eye, ear, and nose medications;

(d) Vaginal medications;

(e) Rectal medications;

(f) Oral inhalants;

(g) Transdermal medications;

(h) Proper resident positioning;

(i) Measurement of apical pulse and blood pressure in association with routine medication administration;

(8) Principles of infection control and standard blood and body fluid precautions including those set forth in Chapter 4723-20 of the Administrative Code, two hours;

(9) Documentation of medications in residents’ clinical records, including as-needed medications, two hours;

(10) Circumstances in which a certified medication aide should report to, or consult with, a nurse concerning a resident or residents to whom medications are administered, four hours, including:

(a) The potential need of a resident for the administration of an as-needed medication, as evidenced by a resident’s expression of discomfort or other indication;

(b) A resident exercising the right to refuse medication administration;

(c) Any deviation from the delegation of medication administration instructions;

(d) Any observation about the condition of a resident that should cause concern to a certified medication aide.

(11) Medication errors, four hours, including:

(a) Error prevention through promotion of safe medication administration practices;

(b) Timeliness and manner of reporting medication errors;

(12) The role of the certified medication aide as set forth in Chapter 4723. of the Revised Code and this chapter, four hours, including:

(a) The fact that administration of medication is a nursing function that may only be performed by a certified medication aide when it has been delegated by a nurse in accordance with the provisions of this chapter;

(b) The settings in which medications may be administered by certified medication aides;

(c) The types of medications that may be administered by certified medication aides as well as those that a certified medication aide may not administer; and

(d) The activities associated with the administration of medications that are prohibited for a certified medication aide.

(D) The supervised clinical practice component of an approved medication aide training program shall be sufficient to assure that students are prepared to administer medications as a certified medication aide in a safe and effective manner, and shall satisfy the following:

(1) The supervised clinical practice component shall consist of not less than forty clock hours, including experience in tasks related to the administration of medication, and shall be conducted under the direction and supervision of a nurse.

(2) The supervised clinical practice component shall take place in a nursing home or residential care facility with which the training program has a written agreement to provide nurse supervision of the student in accordance with this rule;

(3) While engaged in medication administration, a student shall be under the one-on-one direction and supervision of a nurse.

(4) During the supervised clinical practice, the nurse supervising the medication aide student shall inform the registered nurse program administrator of the student’s progress in the supervised clinical practice.

(E) The minimum passing grade on the written component of a board-approved examination shall be 80 percent. A student must successfully complete each of the skills evaluation tasks included in the clinical component of a board-approved examination in order to pass.

(F) The training program shall assure that a medication skills checklist is maintained for each student to record performance during the supervised clinical practice and shall include the following:

(1) Each skill necessary to safely administer medications in accordance with this chapter;

(2) The date each skill is successfully demonstrated, or an indication that the student did not have an opportunity to perform the skill in a supervised clinical setting;

(3) The name and signature of the nurse who supervised the student’s successful performance of the skill.

(G) The training program shall provide a copy of the medication skills checklist, certified by the program to be true and accurate, to each student upon completion of the medication aide training program.

(H) If a student did not have an opportunity to perform a skill listed on the medication skills checklist during the supervised clinical component of the training program the student shall comply with all of the following:

(1) Upon employment as a certified medication aide, provide the employer with a certified copy of the medication skills checklist;

(2) Refrain from performing any unchecked medication skill as a certified medication aide without direct nurse supervision until a nurse has observed satisfactory performance of the skill; and

(3) Obtain the signature of the nurse who observed satisfactory performance of the skill by the certified medication aide on the date indicated on the medication skills checklist.

Replaces: 4723-27-08 (Emergency)

Effective: 05/01/2006

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/2006 (Emer.)

(A) The board, by a vote of a quorum, may revoke or may refuse to grant a medication aide certificate to a person found by the board to have committed fraud in passing an examination required to obtain the certificate or to have committed fraud, misrepresentation, or deception in applying for or securing a medication aide certificate issued by the board.

(B) The board, by a vote of a quorum, may impose one or more of the following sanctions: deny, revoke, suspend, or place restrictions on any medication aide certificate issued by the board; reprimand or otherwise discipline a holder of a medication aide certificate; or impose a fine of not more than five hundred dollars per violation. The sanctions may be imposed for any of the following:

(1) Denial, revocation, suspension, or restriction of authority to practice a health care occupation, in Ohio or another state or jurisdiction, including but not limited to nursing, practice as a dialysis technician, nurse aide, community health care worker or medication aide, for any reason other than a failure to renew;

(2) Administering medications as a certified medication aide, having failed to renew a medication aide certificate issued under this chapter, or while a medication aide certificate is under suspension or inactive;

(3) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for intervention in lieu of conviction for, of a misdemeanor committed in the course of practice;

(4) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for intervention in lieu of conviction for, any felony or of any crime involving gross immorality or moral turpitude;

(5) Selling, giving away, or administering drugs or therapeutic devices for other than legal and legitimate therapeutic purposes; or conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for intervention in lieu of conviction for, violating any municipal, state, county, or federal drug law;

(6) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for intervention in lieu of conviction for, an act in another jurisdiction that would constitute a felony or a crime of moral turpitude in Ohio;

(7) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for intervention in lieu of conviction for, an act in the course of practice in another jurisdiction that would constitute a misdemeanor in Ohio;

(8) Self-administering or otherwise taking into the body any dangerous drug, as defined in section 4729.01 of the Revised Code, in any way not in accordance with a legal, valid prescription issued for that individual;

(9) Habitual indulgence in the use of controlled substances, other habit-forming drugs, or alcohol or other chemical substances to an extent that impairs the ability to comply with standards of safe medication administration established in rule 4723-27-02 of the Administrative Code;

(10) Impairment of the ability to comply with standards of safe medication administration established in rule 4723-27-02 of the Administrative Code because of habitual or excessive use of drugs, alcohol, or other chemical substances that impair the ability to practice;

(11) Impairment of the ability to comply with standards of safe medication administration established in rule 4723-27-02 of the Administrative Code because of a physical or mental disability;

(12) Assaulting or causing harm to a resident or depriving a resident of the means to summon assistance;

(13) Obtaining or attempting to obtain money or anything of value by intentional misrepresentation or material deception in the course of practice;

(14) Adjudication by a probate court of being mentally ill or mentally incompetent. The board may restore the person’s medication aide certificate upon adjudication by a probate court of the person’s restoration to competency or upon submission to the board of other proof of competency;

(15) The suspension or termination of employment by the department of defense or the veterans administration of the United States for any act that violates or would violate this chapter;

(16) Violation of Chapter 4723. of the Revised Code or any rules adopted under it;

(17) Violation of any restrictions placed on a medication aide certificate by the board;

(18) Failure to use infection control and standard blood and body fluid precautions including those set forth in Chapter 4723-20 of the Administrative Code;

(19) Engaging in activities that exceed those permitted under sections 4723.61 to 4723.69 of the Revised Code or this chapter;

(20) Failure by a certified medication aide to conform to the standards of safe medication administration established in rule 4723-27-02 of the Administrative Code.

(21) Aiding and abetting a person in that person’s practice of nursing without a license, or practice as a dialysis technician or certified medication aide without a certificate issued under this chapter;

(22) Regardless of whether the contact or verbal behavior is consensual, engaging with a resident other than the spouse of the certified medication aide in any of the following:

(a) Sexual contact, as defined in section 2907.01 of the Revised Code;

(b) Verbal behavior that is sexually demeaning to the resident or may be reasonably interpreted by the resident as sexually demeaning.

(23) Assisting suicide as defined in section 2795.01 of the Revised Code.

(C) The hearings of the board shall be conducted in accordance with Chapter 119. of the Revised Code and Chapter 4723-16 of the Administrative Code. The board may appoint a hearing examiner, as provided in section 119.09 of the Revised Code, to conduct any hearing the board is authorized to hold under Chapter 119. of the Revised Code.

(D) In any instance in which the board is required under Chapter 119. of the Revised Code to give notice of an opportunity for a hearing and the applicant or certificate holder does not make a timely request for a hearing in accordance with section 119.07 of the Revised Code:

(1) The board is not required to hold a hearing, but may adopt, by a vote of a quorum, a final order that contains the board’s findings; and

(2) In the final order, the board may order any of the sanctions listed in paragraphs (A) or (B) of this rule.

(E) If a criminal action is brought against a certified medication aide for an act or crime described in paragraphs (B)(3) to (B)(7) of this rule and the action is dismissed by the trial court other than on the merits:

(1) The board shall conduct an adjudication to determine whether the certified medication aide committed the act upon which the action was based.

(2) If the board determines on the basis of the adjudication that the certified medication aide committed the act, or if the certified medication aide fails to participate in the adjudication, the board may take action as though the certified medication aide had been convicted of the act.

(F) If the board takes action on the basis of a conviction, plea, or a judicial finding as described in paragraphs (B)(3) to (B)(7) of this rule that is overturned on appeal, the certified medication aide may, on exhaustion of the appeal process, petition the board for reconsideration of its action.

(1) On receipt of the petition and supporting court documents, the board shall temporarily rescind its action.

(2) If the board determines that the decision on appeal was a decision on the merits, it shall permanently rescind its action.

(3) If the board determines that the decision on appeal was not a decision on the merits, it shall conduct an adjudication to determine whether the certified medication aide committed the act on which the original conviction, plea, or judicial finding was based.

(a) If the board determines on the basis of the adjudication that the certified medication aide committed such act, or if the certified medication aide does not request an adjudication, the board shall reinstate its action;

(b) If the board determines that the certified medication aide did not commit such act, the board shall permanently rescind its action.

(G) The board may investigate an individual’s criminal background in performing its duties under this rule and sections 4723.61 to 4723.69 of the Revised Code.

(H) During the course of an investigation authorized by section 4723.652 of the Revised Code, the board may compel any certified medication aide or applicant under sections 4723.61 to 4723.69 of the Revised Code to submit to a mental or physical examination, or both, as required by the board and at the expense of the individual, if the board finds reason to believe that the individual under investigation may have a physical or mental impairment that may affect the individual’s ability to safely administer prescribed medication. Failure of any individual to submit to a mental or physical examination when directed constitutes an admission of the allegations, unless the failure is due to circumstances beyond the individual’s control, and a default and final order may be entered without the taking of testimony or presentation of evidence.

(I) If the board finds that an individual is impaired in accordance with paragraph (H) of this rule, the board shall require the individual to submit to care, counseling, or treatment approved or designated by the board, as a condition for initial, continued, reinstated, or renewed certificate to administer prescribed medication.

(1) The individual shall be afforded an opportunity to demonstrate to the board that the individual can begin or resume the administration of prescribed medication in accordance with the standards established under rule 4723-27-02 of the Administrative Code.

(2) For purposes of this paragraph, any certified medication aide or applicant under this rule shall be deemed to have given consent to submit to a mental or physical examination when directed to do so in writing by the board, and to have waived all objections to the admissibility of testimony or examination reports that constitute a privileged communication.

(J) The provisions of division (I) of section 4723.28 of the Revised Code apply to information, investigations and adjudications involving certified medication aides or applicants under sections 4723.61 to 4723.69 of the Revised Code and this chapter.

(K) The provisions of section 4723.29 of the Revised Code apply with respect to any matter that the board has authority to investigate, inquire into, or hear under sections 4723.61 to 4723.69 of the Revised Code and this chapter.

(L) When the board refuses to grant a medication aide certificate to an applicant, revokes a certificate, or refuses to reinstate a certificate, the board may specify that its action is permanent. An individual subject to permanent action taken by the board is forever ineligible to hold a medication aide certificate and the board shall not accept from the individual an application for reinstatement of the certificate or for a new certificate.

(M) No unilateral surrender of a medication aide certificate issued under Chapter 4723. of the Revised Code shall be effective unless accepted by majority vote of the board. No application for a medication aide certificate issued under Chapter 4723. of the Revised Code may be withdrawn without a majority vote of the board. The board’s jurisdiction to take disciplinary action is not removed or limited when an individual has a certificate classified as inactive or fails to renew a certificate.

Replaces: 4723-27-09 (Emergency)

Effective: 05/01/2006

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/2006 (Emer.)

(A) The board may impose fees in accordance with division (B)(1) of section 4723.69 of the Revised Code, including the following:

(1) For applications to obtain an interim medication aide certificate for the period beginning the pilot program end date and ending April thirtieth of the next even numbered year, fifteen dollars;

(2) For applications to obtain a medication aide certificate on or after May first of the even numbered year following the pilot program end date, fifty dollars;

(3) For biennial renewal of a medication aide certificate submitted on or before March first of even numbered years, fifty dollars;

(4) For biennial renewal of a medication aide certificate submitted after March first and before May first of even numbered years, one-hundred dollars;

(5) Except as provided in section 5903.10 of the Revised Code, for reinstatement of a lapsed medication aide certificate, one hundred and fifty dollars;

(6) For reactivation of an inactive medication aide certificate, fifty dollars;

(7) For verification of a medication aide certificate to another jurisdiction, fifteen dollars;

(8) For providing a replacement copy of a medication aide certificate card, twenty-five dollars;

(9) For applications for approval to participate in the medication aide pilot program, one thousand nine hundred and thirty-five dollars, due to the board within ten business days of notice by the board that the applicant has been approved;

(10) For applications for approval to operate a medication aide training program on or after the pilot program end date, one thousand dollars;

(11) For applications for re-approval of a medication aide training program, five hundred dollars;

(12) For processing a check returned to the board by a financial institution for insufficient funds, twenty-five dollars;

(B) All payments of fees shall be in the form as specified by the board.

(C) Except for duplicate payments, all fees are nonrefundable.

(D) An applicant whose initial payment is returned to the board before the renewal deadline may reissue payment to the board without jeopardizing the status of the applicant’s certificate.

(E) An applicant whose initial payment is returned to the board after the renewal deadline will be deemed to have failed to fulfill a renewal requirement set forth in rule 4723-27-05 of the Administrative Code. If the board does not receive the reissued payment and applicable penalties within the thirty-day period, the applicant’s certificate shall be considered to have lapsed.

Effective: 02/01/2009

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/2006 (Emer.), 5/1/2006, 2/1/2008

(A) The board of nursing shall conduct a pilot program for the utilization of certified medication aides in participating nursing homes and residential care facilities in accordance with sections 4723.61 to 4723.69 of the Revised Code and this chapter.

(B) The medication aide pilot program shall commence no later than May 1, 2006 and shall terminate on the thirty-first day after the report required by division (F)(2) of section 4723.63 of the Revised Code is submitted by the board in accordance with that division.

(C) An individual holding a medication aide certificate issued by the board after May 1, 2006 and prior to the pilot program end date may provide services as a certified medication aide only in those nursing homes and residential care facilities that are selected by the board to participate in the medication aide pilot program.

(D) The medication aide pilot program shall consist of not more than eighty nursing homes and forty residential care facilities that are selected by the board to participate in the program in accordance with the selection standards and criteria set forth in section 4723.63 of the Revised Code and this chapter.

(E) The board shall make available information relating to the application process and selection criteria for the medication aide pilot program in the following manner:

(1) By posting the information on the official board of nursing website;

(2) By distributing the information by electronic mail to individuals or entities on the board’s electronic mail subscriber list; and

(3) By mailing information through the United States postal service to individuals or entities that have requested the board provide them with medication aide pilot program information by postal mail.

(F) In accordance with division (C)(2) of section 4723.63 of the Revised Code, a nursing home is only eligible to be considered for participation in the medication aide pilot program if the Ohio department of health found that the nursing home was free from deficiencies related to the administration of medications in its most recent annual survey or inspection.

(G) In accordance with division (C)(2) of section 4723.63 of the Revised Code, a residential care facility is only eligible to be considered for participation in the medication aide pilot program if, in the most recent annual survey or inspection, the Ohio department of health found that the facility was free from deficiencies related to:

(1) The provision of skilled nursing care; and

(2) The administration of medications.

(H) In addition to the eligibility criteria set forth in paragraphs (F) and (G) of this rule, the board may consider the following factors in selecting nursing homes and residential care facilities to participate in the medication aide pilot program:

(1) Geographic location of a nursing home or residential care facility;

(2) Number of beds for which a nursing home or residential care facility is licensed;

(3) Number of years that a nursing home or residential care facility has been licensed;

(4) Compliance and safety history of a nursing home or residential care facility as evidenced by the survey or inspection report submitted with a pilot program application;

(5) Whether or not a residential care facility is affiliated with a nursing home through common corporate ownership, shared physical facilities, or other means;

(6) Whether or not a nursing home or residential care facility is owned by an individual or entity that owns or operates additional nursing homes or residential care facilities;

(7) Date on which a pilot program application is received by the board; and

(8) Any other factors determined appropriate by the board.

(I) Nursing homes and residential care facilities that are selected to participate in the medication aide pilot program shall submit to the board the participation fee as set forth in rule 4723-27-10 of the Administrative Code.

(J) The board may terminate the participation of a nursing home or residential care facility in the medication aide pilot program for any of the following:

(1) Failure to submit the required pilot program participation fee by the date specified by the board;

(2) Failure to allow representatives of the board to conduct site visits or to provide resident records, data, information, or reports to the board in accordance with this chapter, and as agreed to in the pilot program application;

(3) Failure to adhere to the plan set forth in the application submitted by the nursing home or residential care facility relating to the preservation of residents’ rights and the protection of human dignity;

(4) Failure to assure that medication aides administering prescription medications in the nursing home or residential care facility hold a certificate issued under section 4723.651 of the Revised Code and this chapter;

(5) Failure to assure that certified medication aides administering prescription medications in the nursing home or residential care facility act in accordance with the standards set forth in section 4723.67 of the Revised Code and this chapter;

(6) Failure to assure that certified medication aides do not have access to schedule II controlled substances; or

(7) In accordance with division (E) of section 4723.63 of the Revised Code, a determination by the board that continued participation by the nursing home or residential care facility poses an imminent danger or risk of serious harm or jeopardy to the residents of the nursing home or residential care facility.

(K) A nursing home or residential care facility whose participation in the pilot program is terminated by the board in accordance with paragraph (J) of this rule shall comply with all of the following:

(1) Provide immediate written notice to certified medication aides administering prescription medications in the nursing home or residential care facility that they are no longer authorized to administer prescription medications in that nursing home or residential care facility;

(2) Immediately cease using certified medication aides to administer prescription medications in the nursing home or residential care facility;

(3) Submit to the board all data and information necessary to satisfy reporting requirements imposed by rules 4723-27-13 and 4723-27-14 of the Administrative Code for the period of time during which the nursing home or residential care facility was a participant in the pilot program.

(L) A nursing home or residential care facility that voluntarily withdraws from participation in the pilot program shall comply with all of the following:

(1) Provide immediate written notice to the board that the nursing home or residential care facility is withdrawing from participation in the pilot program;

(2) Provide immediate written notice to certified medication aides administering prescription medications in the nursing home or residential care facility that they are no longer authorized to administer prescription medications in that nursing home or residential care facility;

(3) Immediately cease using certified medication aides to administer prescription medications in the nursing home or residential care facility;

(4) Submit to the board all data and information necessary to satisfy reporting requirements imposed by rules 4723-27-13 and 4723-27-14 of the Administrative Code for the period of time during which the nursing home or residential care facility was a participant in the pilot program.

(M) During the pilot program, representatives of the board may conduct announced or unannounced site visits of participating nursing homes and residential care facilities so that the board may assess whether the nursing home or residential care facility is complying with the terms of the pilot program, as set forth in sections 4723.61 to 4723.69 of the Revised Code and this chapter, including but not limited to the following:

(1) Evaluating whether certified medication aides are able to administer prescription medications safely to residents as provided in division (F)(1)(a) of section 4723.63 of the Revised Code;

(2) Determining whether continued participation in the pilot program by a nursing home or residential care facility poses an imminent danger, risk of serious harm, or jeopardy to a resident as provided in division (E) of section 4723.63 of the Revised Code; or

(3) Investigating medication errors or other acts or omissions required to be reported to the board in accordance with rules 4723-27-13 and 4723-27-14 of the Administrative Code.

(N) In conducting site visits of participating nursing homes or residential care facilities, representatives of the board may observe the administration of medications by certified medication aides and shall have access to nursing home or residential care facility records as provided in the pilot program application.

(O) A nursing home or residential care facility shall make records available to representatives of the board during site visits and shall provide to the board certified copies of resident records within ten business days of the date requested.

(P) Chapter 4723. of the Revised Code does not require that the board afford an adjudication to a nursing home or residential care facility in either of the following situations:

(1) The nursing home or residential care facility was not selected by the board to participate in the medication aide pilot program; or

(2) Participation by the nursing home or residential care facility in the medication aide pilot program was terminated in accordance with paragraph (J) of this rule.

Effective: 02/01/2008

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/06 (Emer.), 5/1/06

(A) Nursing homes and residential care facilities that seek to participate in the medication aide pilot program shall submit an application to the board, on a form provided by the board, that includes but is not limited to, the following information:

(1) The name, address, and telephone number for the nursing home or residential care facility where the certified medication aides will administer prescription medications;

(2) If the nursing home or residential care facility is operated for profit, a statement of ownership and contact information for the owner or the owner’s representative;

(3) If the nursing home or residential care facility is a not-for-profit, information regarding membership of the governing board and contact information for a representative of the governing board;

(4) The name, address, and telephone number of the licensed nursing home administrator if the applicant is a nursing home, or the residential care facility administrator if the applicant is a residential care facility;

(5) The name, address, and telephone number of the registered nurse who is responsible for oversight of nursing care in the nursing home or residential care facility;

(6) The licensed capacity of the nursing home or residential care facility, its average annual census, any special populations it serves, and the general acuity level of its residents;

(7) In accordance with division (C)(2) of section 4723.63 of the Revised Code, a copy of the most recent annual survey or inspection of the nursing home or residential care facility conducted by the department of health;

(8) The estimated number of certified medication aides who will be authorized to administer prescription medications in the nursing home or residential care facility, and the estimated number of residents for whom each certified medication aide is expected to have medication administration responsibilities;

(B) In addition to the information set forth in paragraph (A) of this rule, a nursing home or residential care facility that submits an application to participate in the medication aide pilot program shall include with the application a plan to utilize certified medication aides in a manner that assures that the rights of residents are preserved, and human dignity is protected. Such plan shall include but need not be limited to:

(1) Providing written notice that the nursing home or residential care facility will be participating in the medication aide pilot program and intends to utilize certified medication aides to administer prescription medications to residents of the nursing home or residential care facility;

(2) Making available to residents information regarding the following:

(a) The education and training necessary to qualify an individual to receive a medication aide certificate from the board of nursing;

(b) The types of prescription medications that can be administered by a certified medication aide;

(c) The manner in which a nurse delegates the administration of medications to a certified medication aide who is administering prescription medications;

(d) The right of the resident to refuse to have prescription medications administered by a certified medication aide without fear of reprisals by the nursing home or residential care facility.

(3) Obtaining written informed consent from each resident for the administration of prescription medications by a certified medication aide during the pilot program.

(C) Nursing homes and residential care facilities submitting applications for participation in the medication aide pilot program shall include an attestation signed by an individual authorized to sign contracts or other legal documents on behalf of the nursing home or residential care facility that includes the following:

(1) Consent by the applicant to site visits, whether announced or unannounced, by representatives of the board which may include review of resident records; and

(2) Agreement to comply with all requirements of the medication aide pilot program as set forth in sections 4723.61 to 4723.69 of the Revised Code and this chapter.

Effective: 02/01/2008

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/06 (Emer.), 5/1/06

(A) Beginning on May 1, 2006 and extending through the pilot program end date, nursing homes and residential care facilities that are participants in the medication aide pilot program may utilize medication aides certified under section 4723.651 of the Revised Code and this chapter, to administer prescription medications to residents of the nursing home or residential care facility in accordance with section 4723.67 of the Revised Code.

(B) Nursing homes and residential care facilities participating in the pilot program shall take necessary measures to protect the health and welfare of the residents to whom certified medication aides administer medications. These measures shall include, but are not limited to, the following:

(1) Verifying that medication aides hold a current, valid certificate issued by the board in accordance with section 4723.651 of the Revised Code;

(2) Informing nurses and other staff that the nursing home or residential care facility is participating in the pilot program to utilize certified medication aides and the respective roles and responsibilities of different staff;

(3) Ensuring that certified medication aides are not assigned resident care activities that are not directly related to medication administration during the times that the certified medication aide is engaged in, or scheduled to be engaged in, the administration of medications;

(4) Orienting certified medication aides to the process of medication storage and distribution utilized by the nursing home or residential care facility;

(5) Orienting certified medication aides to the medication administration documentation system used by the nursing home or residential care facility and the documentation requirements in section 4723.67 of the Revised Code and this chapter;

(6) Utilizing appropriate medication storage and distribution systems to ensure that certified medication aides do not have access to schedule II controlled substances as defined in section 3719.01 of the Revised Code;

(7) Ensuring that certified medication aides administer only the following types of prescription medications:

(a) Oral medications;

(b) Topical medications;

(c) Medications administered as nasal spray, or as drops, or ointment to a resident’s eye, ear, or nose;

(d) Rectal and vaginal medications; and

(e) Inhalants delivered by inhalers, nebulizers, or aerosols that allow for a single dose of a fixed, pre-measured amount of medication.

(8) Ensuring that certified medication aides do not administer medications in the following categories:

(a) Medications containing a scheduled II controlled substance as defined in section 3719.01 of the Revised Code;

(b) Medications, including inhalants delivered by inhalers, nebulizers, or aerosols, that require dosage calculations;

(c) Medications that are not approved drugs;

(d) Medications administered as part of clinical research; or

(e) Oxygen.

(9) Ensuring that certified medication aides do not administer medications through the following routes or methods:

(a) Injection;

(b) Intravenous therapy procedures;

(c) Splitting pills for purposes of changing the dose being given; or

(d) Through jejunostomy, gastrostomy, nasogastric, or oral gastric tubes;

(10) Ensuring that certified medication aides do not:

(a) Receive, transcribe or alter a medication order;

(b) Administer the initial dose of a medication ordered for a resident;

(c) Administer medications to a person other than a resident of the nursing home or residential care facility participating in the pilot program;

(d) Administer any medication without the task being delegated by a nurse;

(e) Administer any medications to pediatric residents; or

(f) Access schedule II controlled substances.

(11) Ensuring that a nursing assessment of a resident has been completed at the nursing home or residential care facility prior to a nurse delegating to a certified medication aide the administration of as-needed medications to that resident;

(12) Requiring that certified medication aides clarify, inform, or otherwise consult with a nurse in a timely manner and in accordance with the standards of safe medication administration set forth in rule 4723-27-02 of the Administrative Code;

(13) Ensuring timely documentation and reporting of medication errors to the board and ensuring timely documentation and reporting to the board of other acts or omissions that constitute a failure of a certified medication aide to comply with section 4723.67 of the Revised Code and this chapter; and

(14) Ensuring that the informed consent of residents to administration of medications by certified medication aides during the pilot program has been obtained.

(C) A nursing home or residential care facility participating in the pilot program shall establish written policies and procedures addressing the measures set forth in paragraph (B) of this rule and other measures deemed necessary for the health and welfare of its residents. Such policies and procedures shall be available for review by the board upon request.

(D) A nursing home or residential care facility participating in the pilot program shall conduct job performance evaluations of certified medication aides and provide ongoing education and skills review as necessary to promote resident safety.

(E) During the medication aide pilot program conducted pursuant to section 4723.63 of the Revised Code, nursing homes and residential care facilities participating in the pilot program shall report to the board the name of any current or former certified medication aide working in the nursing home or residential care facility who has engaged in conduct that would be grounds for disciplinary action by the board under section 4723.652 of the Revised Code and this rule. The nursing home or residential care facility shall report the conduct to the board within five business days of the date the conduct occurred, including providing the following:

(1) The date, time and place the incident occurred;

(2) A narrative description of the incident;

(3) The name of the medication aide or aides and any other staff involved in the incident;

(4) The name, address, telephone number, and written statements provided by each witness to the incident;

(5) The name, address, telephone number, and written statements provided by the medication aide or aides and any other staff involved in the incident;

(6) The name of the resident or residents involved;

(7) The outcome for the resident involved, including whether:

(a) The resident required transfer to an acute care facility;

(b) The resident required additional monitoring, medication, intervention or treatment at the nursing home or residential care facility; or

(c) The resident expired.

(8) A certified copy of the following records, if in the possession of the nursing home or residential care facility:

(a) The resident’s demographic information record;

(b) The resident’s clinical record covering the time period during which the incident occurred, including care plan, minimum data set and assessment protocols, care team notes and nurse’s notes, physician progress notes and orders, medication administration records, controlled drug records;

(c) The resident’s laboratory reports;

(d) The certified medication aide’s laboratory or alcohol/drug screen reports.

(9) A description of any disciplinary action taken by the nursing home or residential care facility with respect to the certified medication aide and any other staff.

Effective: 02/01/2008

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/06 (Emer.), 5/1/06

(A) The board shall evaluate data received from nursing homes and residential care facilities participating in the pilot program to assess whether or not certified medication aides are able to administer prescription medications safely to nursing home and residential care facility residents.

(B) Nursing homes and residential care facilities participating in the pilot program shall report on the form specified by the board the following data regarding a medication error involving a certified medication aide within five business days of the date on which the medication error occurred:

(1) The proprietary and generic name of the medication prescribed, and the name of the medication that was administered;

(2) The dosage of the medication prescribed, and the dosage of the medication that was administered;

(3) The time the medication was prescribed to be administered, and the time it was administered;

(4) The route the medication was prescribed to be administered, and the route it was administered;

(5) Whether the medication administered was outdated or expired according to the manufacturer label;

(6) Whether the medication was improperly prepared or stored;

(7) An identified individual or individuals who made the error, perpetuated the error and detected the error;

(8) The technique appropriate for the medication administration if the proper technique was not used;

(9) Whether the medication was administered to the wrong patient;

(10) Whether the task of administering the medication was not delegated or was improperly delegated to the certified medication aide;

(11) Whether the certified medication aide involved in the medication error performed other tasks or activities not directly related to the administration of medication during the shift in which the error occurred;

(12) The number of residents to whom the certified medication aide was delegated the task of medication administration at the time the medication error occurred;

(13) The number of certified medication aides the delegating nurse involved in the medication error was supervising at the time the medication error occurred;

(14) The number of certified medication aides administering medications at the nursing home or residential care facility at the time the medication error occurred;

(15) The date and time the medication error occurred;

(16) The number of hours that the certified medication aide involved in the medication error worked during the twenty-four hour time period immediately prior to the time the error occurred;

(17) A description of the medication dispensing, storage and administration system utilized by the nursing home or residential care facility;

(18) The cause of the error as determined by the reporting nursing home or residential care facility which may include but not be limited to the following:

(a) Verbal miscommunication;

(b) Written miscommunication;

(c) Misinterpretation of medication order;

(d) Misinterpretation of delegation directions;

(e) Proprietary medication name confusion;

(f) Generic medication name confusion; and

(19) The outcome for the resident involved in the medication error, including whether:

(a) The resident required transfer to an acute care facility;

(b) The resident required additional monitoring, medication, intervention or treatment at the nursing home or residential care facility; or

(c) The resident expired.

(C) In addition to the data reported in accordance with paragraph (B) of this rule, the nursing home or residential care facility shall:

(1) Submit a personal written statement from the certified medication aide involved in the medication error;

(2) Submit a personal written statement from the delegating nurse involved in the medication error;

(3) Provide an opportunity for a resident or other appropriate party to provide a personal statement relating to the medication error.

(D) Participating nursing homes and residential care facilities shall prepare and submit to the board not later than the thirty-first day after the board requests it under division (F)(1)(a) of section 4723.63 of the Revised Code, on a form specified by the board, all of the following:

(1) Data collected as of sixty days immediately prior to the date on which the report is to be submitted to the board in accordance with division (F)(1)(a) of section 4723.63 of the Revised Code, regarding costs and other financial matters pertaining to the use of certified medication aides at each nursing home or residential care facility participating in the pilot program;

(2) A summary prepared by a certified public accountant or the nursing home or residential care facility’s financial officer familiar with the facility’s accounting system that explains the financial implications of the reported costs and financial data as determined by the facility;

(3) A summary of the nursing home or residential care facility’s experience in utilizing certified medication aides, including but not limited to benefits, challenges and recommendations associated with the use of certified medication aides; and

(4) A statement by the nursing home or residential care facility regarding its perception of the quality and nature of the training received by the certified medication aides utilized in the facility.

(E) Not later than the one hundred eighty-first day after the day on which the board issues a medication aide certificate under section 4723.651 of the Revised Code to the seventy-fifth individual, the board, upon the advice of the medication aide advisory council, shall prepare and submit a report of its findings and recommendations derived from the evaluation of the reported data to the following entities:

(1) The governor;

(2) The president and minority leader of the senate;

(3) The speaker and minority leader of the house of representatives; and

(4) The director of health.

(F) The provisions of division (I) of section 4723.28 of the Revised Code apply to information received by the board in the course of evaluating and assessing the medication aide pilot program pursuant to section 4723.63 of the Revised Code. The board has all of the powers and duties conferred by sections 4723.28 and 4723.29 of the Revised Code with respect to the evaluation and assessment of the medication aide pilot program.

Effective: 02/01/2008

R.C. 119.032 review dates: 05/01/2011

Promulgated Under: 119.03

Statutory Authority: 4723.69

Rule Amplifies: 4723.61 to 4723.69

Prior Effective Dates: 2/1/06 (Emer.), 5/1/06