Ariz. Admin. Code § R4-23-701 - Long-term Care Facilities Pharmacy Services: Consultant Pharmacist

A.The long-term care consultant pharmacist as defined in R4-23-110 shall:

1. Possess a valid Arizona pharmacist license issued by the Board;

2. Ensure the provision of pharmaceutical patient care services as defined in R4-23-110;

3. Review the distribution and storage of drugs and devices and assist the facility in establishing policies and procedures for the distribution and storage of drugs and devices;

a. Specification for the storage, distribution, and procurement of drugs and biologicals;

b. Resident evaluation programs that relate to monitoring the therapeutic response and use of all drugs and biologi-cals prescribed or administered to residents, using as guidelines the most current indicators established by the Centers for Medicare and Medicaid Services, United States Department of Health and Human Services as required in 42 CFR 483.60, published October 1, 2001, and no future amendments or editions, incorporated by reference and on file with the Board and the Office of the Secretary of State.

c. Pharmacist assistance in drug-related emergency situations on a 24-hour basis;

d. Controlled substance accountability including:

i. Date and time of administration,

ii. Name of the person who administers the controlled substance,

iii. Documenting and verifying of any wasted or partial doses, and

iv. Exception reports for refused doses;

e. Prescription order requirements;

f. Approved abbreviations;

g. Stop-order procedures;

h. Pass and discharge prescription order procedures;

i. Emergency drug supply unit procedures;

j. Formulary procedures, including development, review, modification, use, and documentation, if applicable;

k. Security and temperature control procedures for all drugs and biologicals;

l. Disposal procedures that comply with subsection (D) for discontinued or outdated, prescription-only drugs or containers with illegible or missing labels; and

m. Procedures for identifying and reporting to proper authorities drug irregularities and dispensing errors.

4. Provide resident evaluation programs that relate to monitoring the therapeutic response and utilization of all drugs and devices prescribed or administered to residents, using as guidelines the most current indicators established by the Centers for Medicare and Medicaid Services, United States Department of Health and Human Services as required in 42 CFR 483.60 (revised October 1, 2010, incorporated by reference and on file with the Board. This incorporated material contains no future editions or amendments.).

5. Serve as a resource for pharmacy-related education services within the facility;

6. Participate in quality management of resident care in the facility; and

7. Communicate with the provider pharmacy regarding areas of mutual concern and resolution.

B.A long-term care consultant pharmacist shall ensure that:

1. A pharmacist evaluates and verifies a prescription order of a long-term care facility resident in compliance with R4-23-402(A)(5) and (6) ;

2. The prescription order of a long-term care facility resident contains:

a. Resident's name;

b. Facility name or address;

c. Drug name, strength, and dosage form;

d. Directions for use;

e. Date issued; and

f. Name of prescriber;

3. 1. When a provider pharmacy is not open for business, arrangements are made in advance by the long-term care consultant pharmacist, in cooperation with the pharmacist-in-charge of the provider pharmacy and the director of nursing and medical staff of the long-term care facility, for providing emergency drugs for the licensed nursing staff to administer to the residents of the facility using an emergency drug supply unit located at the facility;

4. 2. The label and packaging of prescription-only and nonprescription drugs intended for use within a long-term care facility complies with state and federal law; and

5. 3. The long-term care facility:

a. Stores controlled substances listed in A.R.S. § 36-2513 in a separately locked and permanently affixed compartment, unless the facility uses a single-unit package medication distribution system; and

b. Maintains accurate records of controlled substance administration or ultimate disposition.

C.The long-term care consultant pharmacist shall:

1. Ensure availability of records and reports designed to provide the data necessary to evaluate the drug use of each long-term care facility resident that include the following:

1. a. Provider pharmacy patient profiles and long-term care facility medication administration records;

2. b. Reports of suspected adverse drug reactions;

3. c. Inspection reports of drug storage areas with emphasis on detecting outdated drugs; and

4. d. Accountability reports, that include:

i. Date and time of administration,

ii. Name of the person who administered the drug,

iii. Documentation and verification of any wasted or partial doses,

iv. Exception reports for refused doses, and

v. All drug destruction forms; and

2. Identify and report drug irregularities and dispensing errors to the prescriber, the director of nursing of the facility, and the provider pharmacy.

D.A long-term care consultant pharmacist or pharmacist-in-charge of a provider pharmacy shall ensure that:

1. Discontinued or outdated drugs, including controlled substances, are destroyed or disposed of in a timely manner using methods consistent with federal, state, and local requirements and subject to review by the Board or its staff; and

a. Under the supervision of either a long-term care consultant pharmacist or a pharmacist employed by a provider pharmacy and witnessed by the long-term care facility administrator or the administrator's designee;

b. List by drug name, strength, dosage form, and quantity; and

2. Drug containers with illegible or missing labels are:

a. Identified; and

b. Replaced or relabeled by a pharmacist employed by the pharmacy that dispensed the prescription medication.

Notes

Ariz. Admin. Code § R4-23-701

Former Rules 6.8110, 6.8120, 6.8130, 6.8140, 6.8150, 6.8160, and 6.8170; Amended effective Aug. 10, 1978 (Supp. 78-4). Section repealed, new Section adopted effective December 18, 1992 (Supp. 92-4). Amended by final rulemaking at 9 A.A.R. 1064, effective May 4, 2003 (Supp. 03-1). Amended by final rulemaking at 12 A.A.R. 3032, effective October 1, 2006 (Supp. 06-3). Amended by final rulemaking at 19 A.A.R. 2894, effective November 10, 2013.