Nevada Licensed Residential Facility for Groups compliance with NAC 449.2742 – Administration of Medications
The purpose of this informational memorandum is to help ensure facilities are in compliance with NAC 449.2742 (6) and to ensure residents get their medications in an effective and timely manner. NAC 449.2742 (6) requires (except as otherwise provided in this subsection) a medication prescribed by a physician to be administered as prescribed by the physician. Part of ensuring a medication is administered, as prescribed by a physician, is ensuring new medications and changes to medications are administered without any unnecessary delays.
The following scenarios are being presented to help a facility in carrying out the provisions of NAC 449.2742 (6).
If a resident goes to a doctor’s appointment or to the hospital and returns with discharge instructions which notes any new medications the resident is to take and the facility receives the prescription bottle with the resident’s name, the ordering prescribers name, the dose and frequency of the new medication, this would be considered a medication prescribed by a physician. There is no requirement for an actual physician’s signature in order to begin administering the medications. This will ensure that residents receive their medications in a timely manner, as ordered by the physician, and avoids delay in the administration of medications to residents.
A prescription bottle for a new medication is considered a prescription for the purposes of NAC 449.2742 (6). If there is no supporting documentation to support the new prescription besides the prescription bottle, the facility must call the ordering prescriber in which the prescription was filled and confirm the prescription was issued to the resident. Document this confirmation in the resident’s medication administration record. Again, an actual physician’s signature is not required in this case.
If a physician orders a change in the amount or times medication is to be administered to a resident, the facility has, within 5 days after the change is ordered, to obtain a copy of the order or prescription signed by the physician to be included in the resident’s medication administration record. This does not prevent a resident from having the new prescription with the change filled and having the facility administer the medication to the resident prior to the 5 days. The facility may call the ordering prescriber or pharmacy to confirm the prescription was issued to the resident. This allows a facility, within 5 days, to obtain a copy of the order or prescription signed by the physician without delaying the administration of medications to residents.
If you have any questions related to this informational memorandum you may call 775-684-1045 or 702-486-6515 and ask to speak with an inspection manager or supervisor.
REFERENCE
NAC 449.2742 Administration of medication: Responsibilities of administrator, caregivers and employees of facility. (NRS 439.200, 449.0302, 449.0304)
6. Except as otherwise provided in this subsection, a medication prescribed by a physician must be administered as prescribed by the physician. If a physician orders a change in the amount or times medication is to be administered to a resident:
(a) The caregiver responsible for assisting in the administration of the medication shall:
(1) Comply with the order;
(2) Indicate on the container of the medication that a change has occurred; and
(3) Note the change in the record maintained pursuant to paragraph (b) of subsection 1 of NAC 449.2744;
(b) Within 5 days after the change is ordered, a copy of the order or prescription signed by the physician must be included in the record maintained pursuant to paragraph (b) of subsection 1 of NAC 449.2744; and
(c) If the label prepared by a pharmacist does not match the order or prescription written by a physician, the physician, registered nurse or pharmacist must interpret that order or prescription and, within 5 days after the change is ordered, the interpretation must be included in the record maintained pursuant to paragraph (b) of subsection 1 of NAC 449.2744.