This regulation establishes medication administration and drug control requirements for licensed behavioral health residential programs in Minnesota. License holders must ensure that non-licensed staff who administer or assist with medications are properly trained and supervised by a registered nurse. Written policies and procedures—developed by a registered nurse—must govern medication recording, delegation limits, drug storage (including separately locked compartments for Schedule II substances), shift-by-shift accounting of scheduled drugs, and procedures for handling discontinued or outdated medications.
View official source9530.6555 MEDICATIONS. § Subpart 1. Administration of medications. A license holder must meet the requirements in items A and B if services include medication administration. § A. A staff member other than a licensed practitioner or nurse who is delegated by a licensed practitioner or a registered nurse the tasks of administration of medications or assistance with self-medications by a licensed practitioner or a registered nurse must: § (1) document that the staff member has successfully completed a medication administration training program through an accredited, Minnesota postsecondary educational institution. Completion of the course must be documented and placed in the staff member's personnel records; § (2) be trained according to a formalized training program offered by the license holder that is taught by a registered nurse. Completion of the course must be documented and placed in the staff member's personnel records; or § (3) demonstrate to a registered nurse competency to perform the delegated activity. § B. A registered nurse must be employed or contracted to develop the policies and procedures for medication administration. A registered nurse must provide supervision as defined in part 6321.0100 . The registered nurse supervision must include on-site supervision at least monthly or more often as warranted by the health needs of the client. The policies and procedures must include: § (1) a requirement that delegations of administration of medication are limited to administration of those medications which are oral, suppository, eye drops, ear drops, inhalant, or topical; § (2) a provision that clients may carry emergency medication such as nitroglycerin as instructed by their physician; § (3) requirements for recording the client's use of medication, including staff signatures with date and time; § (4) guidelines regarding when to inform a registered nurse of problems with medication administration, including failure to administer, client refusal of a medication, adverse reactions, or errors; and § (5) procedures for acceptance, documentation, and implementation of prescriptions, whether written, verbal, telephonic, or electronic. § Subp. 2. Control of drugs. A license holder must have in place and implement written policies and procedures developed by a registered nurse that contain the following provisions: § A. a requirement that all drugs must be stored in a locked compartment. Schedule II drugs, as defined by Minnesota Statutes, section 152.02 , subdivision 3, must be stored in a separately locked compartment, permanently affixed to the physical plant or medication cart; § B. a system for accounting for all scheduled drugs each shift; § C. a procedure for recording the client's use of medication, including staff signatures with time and date; § D. a procedure for destruction of discontinued, outdated, or deteriorated medications; § E. a statement that only authorized personnel are permitted to have access to the keys to the locked drug compartments; and § F. a statement that no legend drug supply for one client may be given to another client.