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Medication Management for Licensed Health Facilities
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General Information
What is medication management?
Medication management in a residential facility for groups (RFG) of any size is an organized process of ordering, administering, reconciling, monitoring and tracking each resident’s medications to ensure the medications are administered according to doctor’s order and avoid potentially dangerous drug interactions and complications. Medication, by definition, includes prescription medications, over-the-counter medications, nutritional supplements, and vitamins. Where can I obtain a current list of approved medication management programs and trainers?
A list of approved Medication Management curricula and instructors will be found on the HCQC Training and Education web page under the "Medication Management" bullet. The Medication Management team will update the list as new or existing programs are approved/re-approved. Which Nevada Revised Statutes (NRS) and Nevada Administrative Code (NAC) regulate medication management training?
NAC 449.196(3)(a)-(d), derived from NRS 449.037(6)(e), authorizes HCQC to approve Medication Management curricula and instructors for the purpose of providing training for caregivers working in residential facilities for groups and administer medications to residents. Are there medication management courses taught in languages other than English?
No, the medication management training is taught in English only. NAC 449.196(1)(d) requires caregivers to read, write, speak and understand English. It is important for the caregiver/medication technician to learn and understand medication management in English to ensure they can follow doctor’s orders and coordinate care with healthcare professionals from outside agencies such as home health and hospice. What are the requirements to become a medication technician?
Per NAC 449.196 Qualifications and training of caregivers. (NRS 449.0302)
3. If a caregiver assists a resident of a residential facility in the administration of any medication, including, without limitation, an over-the-counter medication or dietary supplement, the caregiver must:
(a) Before assisting a resident in the administration of a medication, receive the training required pursuant to paragraph (e) of subsection 6 of NRS 449.0302, which must include at least 16 hours of training in the management of medication consisting of not less than 12 hours of classroom training and not less than 4 hours of practical training, and obtain a certificate acknowledging the completion of such training; (and)
(b) Receive annually at least 8 hours of training in the management of medication and provide the residential facility with satisfactory evidence of the content of the training and his or her attendance at the training.
What are the main topics covered in an initial 16-hour medication management class? Why is 16 hours necessary?
The main topics include: NRS and NAC related to medication management; general information about the facility’s medication plan, medication types, commonly prescribed controlled substances, different routes, forms and packaging types of medications, allergic reactions; how to read the labels on medications; doctor’s orders; medication administration; medication administration record (MAR); documentation of medications administered as needed, caring for residents with special needs as related to medications and hands-on competency demonstration. Per regulation, the class should consist of 12 hours of classroom training and not less than 4 hours of practical hands-on training. If I am a RN, LPN, DO or MD, do I have to take medication management training if I plan to administer medications to residents in an RFG?
Yes, licensed healthcare professionals who assist residents with their medications are required to take the medication management course to ensure they understand the medication-related regulations for residential facilities for groups because they are different from hospitals, skilled nursing facilities and other medical facilities. The medication management regulations for RFGs are thorough because medication technicians are not medically trained. Where can I report instructors who are not following the regulations or who are not providing the information as they appear on the class outline, or who are not completing the required number of hours of training?
Whom do I contact for more medication management information?
FAQs for Instructors/Course Coordinators
How can I be approved to provide the medication management training?
How do I apply for curriculum approval?
Request medication management course/instructor application forms by sending email to medmgt@health.nv.gov. What are the main topics needed for an acceptable medication management curriculum?
The main topics include:
- NRS and NAC related to medication management
- General information about the facility’s medication plan, medication types, commonly prescribed controlled substances, different routes, forms and packaging types of medications, allergic reactions
- How to read the labels on medications
- Doctor’s orders
- Medication administration
- Medication administration record (MAR) and other medication documentation
- Caring for residents with special needs as related to medications
- Hands-on competency demonstration
The application packet provides a more detailed list of topics required for the curriculum.
Who will review my curriculum or training materials?
The Medication Management Team will review your training materials to ensure all required topics are covered and are understandable to RFG employees. How long is the curriculum approval or certification valid?
The curriculum approval is valid for two years. Why does an instructor need to be certified?
An instructor needs to be certified by HCQC to ensure employees of a residential facility for groups are provided the complete and accurate information about medication management and provide guidance to employees in performing their medication-related tasks. How do I apply for certification to teach medication management?
What are the qualifications to become a medication management instructor?
Any individual applying for instructor certification to teach medication management must meet all of the following requirements:
- Be in good standing with any applicable licensing boards.
- Own or have authorized use of an approved medication management curriculum.
- Have completed the 16 hours and/or 8 hours of Medication Management class in the past 12 months and can provide evidence of completion.
- Have the ability to speak, read, write and teach the entire course in English.
Medication management instructors also must:
- Be a licensed healthcare professional (MD, DO, PA, NP, RN, LPN); or
- Have three years verifiable experience administering medications and/or supervising medication administration in a medical or non-medical facility.
Does the course coordinator have to be an approved medication management instructor?
No, however the course coordinator is responsible for the training provided by the instructors approved to teach under the course coordinator’s approved curriculum. For how long is my instructor certification valid?
The instructor certification is valid for two years. The exception is if an instructor applies and is approved under an existing curriculum. In this instance, the certification expires the same date as the curriculum. What happens if my instructor certification expires?
The instructor must re-apply for certification. In the meantime, the instructor cannot provide medication management training. How will others know I have been certified to teach medication management?
A list of approved Medication Management curricula and instructors will be found on the HCQC Training and Education web page under the “Medication Management” bullet. The Medication Management Team will update the list as new or existing programs are approved/re-approved. What is the purpose of the Ethical Obligations, Professional Expectations and Acknowledgements for Certified Medication Management Instructors document?
This document explains the instructor’s role, responsibilities and accountabilities. It is also a commitment by the instructor to provide the best medication management education to employees of RFGs. Why is an in-person interview required as part of the medication management instructor application process?
The personal or video interview is the final step for instructor certification. In the interview, the instructor applicant is evaluated on their knowledge of the medication regulations and their curriculum. In addition, the instructor is evaluated on their ability to present accurate, clear and complete information to their audience. What happens if I do not pass the requirements for the medication management instructor interview?
If the instructor applicant does not pass the first interview, the applicant will be offered up to two chances to pass the interview requirement. Once I become certified as a medication management instructor, can my certification be suspended or revoked?
Yes, if the instructor is found to have violated or have been non-compliant with the stipulations on the Ethical Obligations, Professional Expectations and Acknowledgements for Certified Medication Management Instructors. The instructor certification may also be suspended or revoked if HCQC determines, after a thorough investigation, the employee(s) were misinformed by a specific instructor and therefore were not in compliance with the regulations. What happens if I, as the administrator of an RFG and medication management instructor, receive disciplinary actions from BELTCA, the Nursing Board or Board of Medical Examiners?
As an instructor, am I allowed to teach the medication management course in another language?
No, NAC 449.196(1)(d) requires caregivers to read, write, speak and understand the English language. It is important for the caregiver/medication technician to learn and understand medication management in English to ensure they have the ability to follow doctor’s orders and coordinate care with healthcare professionals from outside agencies such as home health and hospice. As a course coordinator/instructor, can I use my own exams for my participants?
No, the HCQC medication management program requires approved medication management instructors to use the examinations approved and provided by HCQC. Once an instructor is approved to teach the course(s), HCQC will provide the examinations to utilize. Can I give an open book exam to my participants?
As a course coordinator/instructor, can I use my own certificates for my participants?
No, you will be provided with a standard certificate to issue after the participants complete the training and pass the test. There will be a certificate for 16-hour training, 8-hour training, exam only and remedial training. Can the instructor edit the medication management training certificates to include a photo?
We discourage reformatting the certificate templates. Adding of a photo or any other information on the certificate template will not be possible because some of the fields are protected. Identification checks must be completed as participants check-in for the class. As an approved medication management instructor or course coordinator, can I certify myself for the annual medication management training?
No, you will have to take a class with another instructor. It will give you the opportunity to learn from other programs – the information provided and how they are presented. Can HCQC attend the classes I teach?
Yes. An HCQC representative may attend the training on a day that has been published online, to verify the training is being presented as approved. For classes in various facilities or smaller groups exclusive to a specific facility, HCQC may ask the course coordinator or instructor for their next scheduled training. The HCQC representative will present a DPBH ID badge. What will surveyors look for during a survey as it pertains to medication management?
Surveyors look for proper training of any caregiver administering medications to residents. Evidence of training includes certificates that contain the name of participant, date of training and expiration date, hours of training, course ID number, instructor ID number and instructor signature.
Surveyors will make sure:
- All medications prescribed by the resident’s physician are available on site.
- Medications are given following doctor’s order.
- Documentation is complete and accurate for both routine and “as needed” medications.
- The resident or responsible party signed an ultimate user agreement.
- The physician/pharmacist/registered nurse reviewed the resident’s medications for accuracy and appropriateness at least once every six months.
- Make sure medications are secured.
- Ensure residents who receive medication assistance do not keep medications in their bedroom.
- All over-the-counter medications and dietary supplements have doctor’s order and are labeled with resident’s name and prescribing physician.
Can the instructor use someone else’s medication management curriculum to teach their course?
Yes, provided the owner of the curriculum grants authorization to the instructor. The instructor must be certified or approved under the owner of the curriculum or the course coordinator. If you are a certified instructor and would like to use another course, please notify the medication management team so that we can revise your certificate templates with the correct course ID. What is the Nevada Commission on Post-Ssecondary Education (CPE)?
The Commission on Postsecondary Education (CPE) is the predominant licensing authority charged by the Nevada Legislature for the oversight of private postsecondary educational institutions operating in Nevada. Before you can operate in Nevada, you must either be licensed or exempted by the CPE. For more information go to http://cpe.nv.gov/Licensure/Licensure_Home/. What authority does the Nevada CPE have in relation to medication management training?
Do all medication management training programs need licensure from the Nevada CPE?
No, if you provide the 16-hour initial medication management training to persons other than your own employees and you charge a fee, you will need to obtain licensure from CPE. However, if you provide only the 8-hour medication management refresher course to persons other than your own employees, you will not need CPE licensure. How do I know if my medication management training program needs Nevada CPE licensure to teach medication management?
You can submit an Evaluation Form to CPE. Based on the information you provided, you will then receive a response stating whether your program needs CPE licensure or exempt from licensure. The evaluation form is found in dpbh.nv.gov – Health Facilities – Training & Education – Medication Management If I am only providing instruction to my employees, do I have to be licensed by the Nevada CPE?
If you provide medication management training to your employees only and do not charge a fee, you may be exempted from CPE licensure. However, it is necessary to submit the CPE Evaluation Form to obtain the exemption. What is the course coordinator responsible for?
Responsibilities of the course coordinator include:
- Ensure all topics in the approved curriculum are covered.
- Maintaining attendance records for the course for at least two years after the final date on which the course took place; and provide those records to the Division of Public and Behavioral Health/Bureau of Health Care Quality and Compliance upon request.
- Ensure instructors use the correct post-training examinations (four versions) and preserve the integrity of the examination.
- Ensure instructors monitor the participants while they are taking the examination.
- Ensure instructors follow the Ethical Obligations, Professional Responsibilities and Acknowledgments.
What happens if my medication management Course ID number expires?
About 90 days before your Course ID number expires, the Medication Management Team will send you a reminder for re-certification. However, if you want to start the re-certification process earlier, please let us know by emailing medmgt@health.nv.gov. How will others know my course curriculum/medication management program has been approved?
A list of approved Medication Management curricula and instructors will be found on the Training and Education web page under the “Medication Management” bullet.
The Medication Management Team will update the list as new or existing programs are approved/re-approved.