D. Centrally Stored Medications

  1. Medications must be centrally stored if:
  • The facility administers the medication;
  • The resident requests that the facility store his/her medications;
  • A health care provider documents that it would be hazardous to the resident to keep the medication in his/her personal possession;
  • The resident does not keep it in a secure place or keep his/her room locked when absent;
  • The facility determines that because of physical arrangements and the conditions or habits of residents that the resident keeping his/her medication poses a safety hazard to other residents;
  • Facility policy requires all residents to centrally store their medications.

NOTE: An ALF may require all residents to “centrally store” their medications. However, if an ALF has such a policy, the facility must provide this information to all residents prior to admission.

2. All medications which are centrally stored, must be:

  • Kept in a locked cabinet, locked cart, or other locked storage receptacle, room, or area at all times; and
  • Located in an area free of dampness and at normal temperature level, unless the medication is required to be refrigerated.
  • If required to be refrigerated, must be kept in locked container in the refrigerator, or the refrigerator must be locked or the room or area where the refrigerator is located must be locked.
  • Must be kept in their legally dispensed, labeled package, and kept separately from the medication of other residents. Weekly pill organizers cannot be centrally stored without a proper label.
  • Staff trained to assist with or licensed to administer medications must have access to keys to the medication storage area or container at all times.

3. Medication Storage Tips:

The medication storage area should be well organized to reduce the risk of errors and to help save time when assisting with medications. Place medications in a systematic order; for example, in alphabetical order by resident name.

  • Always store medications in their labeled containers. If, for example, a tube of medication arrives in a box labeled by the pharmacy, the medication must be stored in the labeled box.
  • Do not expose medications to extremes in temperature or moisture, unless medications are supposed to be refrigerated.
  • Store medications for the eye, ear, nose and throat separately. For example, in different drawers of a medication cart, or by using drawers of a medication cart, or by using drawer dividers.
  • Store discontinued medications separately from medications being used currently. This will prevent you from continuing to give a medication which is no longer prescribed.
  • Ask a pharmacist to help you set up a system and organize your storage area. Occasionally ask a pharmacist to spot check your storage area and make recommendations for changes or improvements.
  • Medication containers must be properly closed or sealed so that medications do not become loose and get mixed together.

4. Storage of Over-the-Counter (OTC) Medication

An ALF can not have a “stock supply” of over-the-counter medication. Bottles of aspirin, Maalox, etc. may not be kept for use by multiple residents. However, individual residents may have their own OTC medications.

Residents may be allowed to keep over the counter medications in their rooms if they self-administer their medications, with or without assistance. If the resident requires medication to be administered, he/she should not store OTC medications in his/her room.

An ALF may centrally store OTC medications for residents. If you are storing OTC medications for residents that have not been prescribed by the health care provider, they must be labeled with the resident’s name, and the manufacturer’s instructions for use must be kept with the medication.

When an OTC medication is prescribed by a health care provider, the medication must be stored in the same manner as prescription medication and managed according to the prescription label/instructions just like prescribed medication.