Controlled Substances in the Home: Delivery Records, Misuse and Disposal
Sets out how the Agency manages controlled substances in the patient's home: the written policy given to and discussed with the patient and family when a controlled substance is first ordered, the delivery record (date, patient, medication name and strength, quantity on the container and two signatures) when staff deliver, safe storage and counts, identifying and documenting misuse and notifying the prescriber, the Missouri rule that staff never remove medications from the residence, and on-site disposal by trained hospice nurses after death or expiry under the federal SUPPORT Act provision, with information to families on disposal when medications are no longer needed.
- Policy number
- MO-HSP-MED-02
- Version
- 1.0
- Main rule
- 19 CSR 30-35.010(2)(H)12
- Library
- Missouri hospice · 59 policies
- Category
- Clinical tasks
- Sections
- 21
In short
- When the first controlled substance is ordered, give the family Form MO-HSP-MED-02-B, talk it through, and record that you did.
- If you deliver a controlled substance, record the date, patient, drug and strength, quantity on the container, and get your signature and the receiver's.
- Count controlled substances at each nursing visit. Report a wrong count or any sign of misuse to the case manager RN the same day; the prescriber is told.
- Never take medications out of a patient's home, for any reason.
- Only trained nurses dispose of controlled substances on site, after a death or when expired, with a witness, and record what was destroyed.
What's inside
21 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (19 CSR 30-35.010(2)(H)12; 42 CFR §418.106(e)(2)(i))
- 5. When a Controlled Substance Is First Ordered
- 6. Delivery by Staff (19 CSR 30-35.010(2)(H)5)
- 7. Keeping Controlled Substances Safe in the Home
- 8. Misuse and Diversion (19 CSR 30-35.010(2)(H)6)
- 9. Disposal When Medications Are No Longer Needed
- 9.1 How on-site disposal is done
- 10. Patients in Facilities
- 11. State Rules to Check
- 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
An inspector may ask
- Show me where this family was given and talked through your controlled substance disposal policy when the first controlled substance was ordered.
- When your staff delivered this controlled substance, where is the record with both signatures?
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