This week’s “Ftag of the Week” is F554, which is the regulation for the resident’s right to self-administer medications if the IDT has determined that it is clinically appropriate and safe for the resident to do so.
Per the Interpretive Guidance (IG), the following considerations must be addressed and documented in the medical record and care plan:
- Which meds are appropriate/safe for self-administration
- Physical capabilities of the resident, such as swallowing without difficulty and opening medication bottles
- Cognitive status – specifically if residents can correctly name their medications and know what conditions they are taking them for
- Capacity to follow directions and to tell time
- Capacity to ensure that medication is safely and securely stored
- Comprehension of instructions for administration – dose, timing, side effects, when to report issues to staff
- Ability to understand what refusals of medications are
- How staff address resident medication refusals and what education is provided
Facilities must have a process in place to show via medical record documentation how the IDT made the decision that the resident is capable of self-administration. A process also needs to be in place that validates that the resident has taken the self-administered medication as well. Self-administration med errors are not counted in the facility’s med error rate, but if an issue is identified, the IDT may need to reevaluate the resident’s continued ability to self-administer his/her medications. If a resident wishes to actively participate in med administration but the IDT has determined this is not safe, alternate arrangements for participation should be made as possible, such as getting medications from a nurse at a designated location to self-administer instead of keeping a locked box in his/her room.