HJNO Jan/Feb 2023

HEALTHCARE JOURNAL OF NEW ORLEANS I  JAN / FEB 2023 51 Daphne H. Dominguez, EdD Assisted Living Administrator Lambeth House how busy doctors are, physician follow- up is extremely important to the delivery of care. Oftentimes, residents feel they can self-administer or perhaps just need a re- minder; however, a resident who lives in assisted living, according to regulations, must understand what medications they are taking, what it is for and the need for the medication, and must always maintain safety with their medications. Managing medications, no matter where you live, can be tricky for any person no matter their age. Prescreening or inquiring about how individuals manage their medications is beneficial to the provider. This allows for the provider to learn early on how the indi- vidual manages their medications at home and also lets the provider prepare the new resident for the fact that an assessment is done for anyone moving into assisted liv- ing. Residents and family members should be informed that medications include all medications — prescriptions, over-the- counter medications, inhalers, eyedrops, patches, etc. If a resident is going to par- ticipate in the medication administration program, their physician must provide an order for each medication prescribed no matter what it is. It is important that providers under- stand the regulations because it is the law. As challenging as it might be to retain staff to carry out medication administration programs, the law must be followed. Per the Louisiana Department of Health (LDH) Minimum Licensing Standards, currently, the only person who can administer medi- cations in assisted living is an individual “who is currently licensed to practice medicine or osteopathy by the appropri- ate licensing agency for the state, or by an individual who is currently licensed as an RN or LPN by the appropriate state agency.” 1 Although LDH is working to ex- tend medication administration allow- ance to medication technicians, this is not the current law. If this rule is accepted in the near future, it is still the responsibil- ity of the provider to understand the laws around that type of administration. Best practices for medication manage- ment in assisted living: • ALCs should have an assessment tool in place to determine which level of administration each resident may need. • Providers must comply with the du- ties assigned for a registered nurse and pharmacist review of the medi- cation administration program. • Family members should inquire about medication services offered prior to filling out any paperwork for admission. If medication administra- tion is necessary, talk to the facility in detail about what is necessary to en- roll in such a program. • Families of residents should ask what pharmacies are suggested for medi- cation administration. Best practice is to have medications individually packaged. • Understand that if medications will be administered, each medication, whether over-the-counter or not, must have an order from the resi- dent’s doctor with specific time and dose of the medication. • Communication is key! n REFERENCES 1 .. https://ldh.la.gov/assets/medicaid/hss/docs/ ARCP/ARCP_LAC481_Chapter68updated04. 26.22.pdf It is imperative for physicians, providers, employees, and family members to under- stand the rules about medication adminis- tration if you are connected with a resident in assisted living because, simply, things may be different from what you might be used to. Many physicians are more famil- iar with nursing home procedures than those in assisted living. In nursing homes, medications are administered by licensed professionals regardless of whether a resident has the ability to take their own medications; it’s the law. In assisted liv- ing, residents have options. One option in particular is “assistance with self-adminis- tration,” but this option can sometimes be vague compared with “administration.” It is important to understand the regulatory definition of “assistance,”which is outlined in the ARCP Health Care Standards.1 Phy- sicians should realize that providers need their support to determine which option is appropriate. Physician services vary in assisted living when compared to a nursing care commu- nity. ALCs tend to have more physicians involved because the setting is similar to a resident living at home. In nursing care, the attending physicians are required to be available to respond to medical issues involving their patient; therefore, there are fewer physicians willing to practice in nursing care communities and less doc- tors to have to communicate to. Having to communicate to so many physicians can be a challenge for the ALC staff, which can sometimes delay a medication ad- ministration service. Alexis Birden, Lam- beth House’s assisted living nurse states, “Communication from physicians is key to the operation of the entire medication program.” Although nurses understand