{"ref":"DC-HSP-MED-02","title":"Controlled Substances in the Home: Management and Disposal","category":"Clinical tasks","summary":"Sets the Agency’s written procedures for managing and disposing of controlled drugs in the patient’s home: what staff give and explain to the patient, representative and family when a controlled drug is first ordered, how controlled drugs are kept safe at home, when hospice employees may dispose of them under 21 U.S.C. §822(g)(5) (after death, when expired, or by a registered hospice physician when the plan of care changes), how disposal is done and recorded, what happens when a family declines, patients in facilities, and suspected loss or diversion.","inShort":["When the first controlled drug is ordered, give the family Form DC-HSP-MED-02-A, explain it and record that you did.","Teach the family to keep controlled drugs out of reach and never share them.","Nurses may dispose of controlled drugs only after death or when they are expired. Never take drugs out of the home.","Dispose on site with a witness and record drug, dose, route, amount, time, date and method.","If the family says no, do not insist. Explain safe options and record it.","Aides and homemakers never handle controlled drugs. Report any missing drugs to the nurse."],"primaryCitation":"42 CFR §418.106(e)(2)","citations":["D.C. Code §48-901.02 et seq.","D.C. Code §5-1406(a)"],"federalCitations":["42 CFR §418.106(e)(2)","42 CFR §418.106(c)(2), (e)(3)","21 U.S.C. §822(g)(1), (4), (5)","21 CFR Part 1317","42 CFR §418.112(c)"],"surveyorAsks":["Show me where this record documents that the controlled substance policy was given to and discussed with the family when the first controlled drug was ordered.","What do your nurses do with the patient’s controlled drugs after a death?"],"forms":[{"ref":"DC-HSP-MED-02-A","title":"Managing and Disposing of Controlled Medicines at Home"},{"ref":"DC-HSP-MED-02-B","title":"Controlled Substance Disposal Record"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.106(e)(2)(i))","5. When a Controlled Drug Is First Ordered","6. Keeping Controlled Drugs Safe in the Home","7. When Agency Staff May Dispose of Controlled Drugs","8. How Disposal Is Done","9. When Disposal Is Prevented or Declined","10. Patients in Facilities","11. Suspected Loss, Misuse or Diversion","12. Disposal Training","13. Responsibilities","14. Records and Compliance Monitoring","15. Staff Training","16. References","17. Related Policies and Forms","18. Approval","19. Revision History"],"version":"1.0","sample":false,"pack":"dc-hospice","state":"Washington, DC","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}