4723-27-13 Utilization of certified medication aides by pilot program participants.

(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;

(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;

(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;

(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

(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;

(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