DHS 132.65(4)(a)(a) A facility may have one or more emergency medication kits. All emergency medication kits shall be under the control of a pharmacist.

DHS 132.65(5)(a)(a) Maintenance. A facility may have a contingency supply of medications not to exceed 10 units of any medication. Any contingency supply of medications must be under the control of a pharmacist.

DHS 132.65(5)(b)(b) Storage. Contingency drugs shall be stored at a nursing unit, except that those medications requiring refrigeration shall be stored in a refrigerator.

DHS 132.65(5)(c)(c) Single units. Contingency medications shall be stored in single unit containers, a unit being a single capsule, tablet, ampule, tubex, or suppository.

DHS 132.65(5)(d)(d) Committee authorization. The quality assessment and assurance committee shall determine which medications and strengths of medications are to be stocked in the contingency storage unit and the procedures for use and re-stocking of the medications.

DHS 132.65(5)(e)(e) Control. Unless controlled by a “proof-of-use” system, as provided by sub. (6) (e), a copy of the pharmacy communication order shall be placed in the contingency storage unit when any medication is removed.

DHS 132.65(6)(b)(b) Storing and labeling medications. Unless exempted under par. (f), all medications shall be handled in accordance with the following provisions:

DHS 132.65(6)(b)1.1. ‘Storage.’ Medications shall be stored near nurse’s stations, in locked cabinets, closets or rooms, conveniently located, well lighted, and kept at a temperature of no more than 85° F. (29° C.).

DHS 132.65(6)(b)2.2. ‘Transfer between containers.’ Medications shall be stored in their original containers, and not transferred between containers, except by a physician or pharmacist.

DHS 132.65(6)(b)3.3. ‘Controlled substances.’ Separately locked and securely fastened boxes or drawers, or permanently affixed compartments, within the locked medication area shall be provided for storage of schedule II drugs, subject to 21 USC ch. 13, and Wisconsin’s uniform controlled substance act, ch. 961, Stats.

DHS 132.65(6)(b)4.4. ‘Separation of medications.’ Medications packaged for individual residents shall be kept physically separated.

DHS 132.65(6)(b)5.5. ‘Refrigeration.’ Medications requiring refrigeration shall be kept in a separate covered container and locked, unless the refrigeration is available in a locked drug room.

DHS 132.65(6)(b)6.6. ‘External use of medications.’ Poisons and medications for external use only shall be kept in a locked cabinet and separate from other medications, except that time-released transdermal drug delivery systems, including nitroglycerin ointments, may be kept with internal medications.

DHS 132.65(6)(b)7.7. ‘Accessibility to drugs.’ Medications shall be accessible only to the registered nurse or designee. In facilities where no registered nurse is required, the medications shall be accessible only to the administrator or designee. The key shall be in the possession of the person who is on duty and assigned to administer the medications.

DHS 132.65(6)(b)8.8. ‘Labeling medications.’ Prescription medications shall be labeled with the expiration date and as required by s. 450.11 (4), Stats. Non-prescription medications shall be labeled with the name of the medication, directions for use, the expiration date and the name of the resident taking the medication.

DHS 132.65(6)(c)1.1. ‘Time limit.’ Unless otherwise ordered by a physician, a resident’s medication not returned to the pharmacy for credit shall be destroyed within 72 hours of a physician’s order discontinuing its use, the resident’s discharge, the resident’s death or passage of its expiration date. No resident’s medication may be held in the facility for more than 30 days unless an order is written every 30 days to hold the medication.

DHS 132.65(6)(c)2.2. ‘Procedure.’ Records shall be kept of all medication returned for credit. Any medication not returned for credit shall be destroyed in the facility and a record of the destruction shall be witnessed, signed and dated by 2 or more personnel licensed or registered in the health field.

DHS 132.65(6)(d)1.1. ‘Receipt of medications.’ The administrator or a physician, nurse, pharmacist, or the designee of any of these may be an agent of the resident for the receipt of medications.

DHS 132.65(6)(d)2.2. ‘Signatures.’ When the medication is received by the facility, the person completing the control record shall sign the record indicating the amount received.

DHS 132.65(6)(d)3.3. ‘Discontinuance of schedule II drugs.’ The use of schedule II drugs shall be discontinued after 72 hours unless the original order specifies a greater period of time not to exceed 60 days.

DHS 132.65(6)(e)1.1. For schedule II drugs, a proof-of-use record shall be maintained which lists, on separate proof-of-use sheets for each type and strength of schedule II drug, the date and time administered, resident’s name, physician’s name, dose, signature of the person administering dose, and balance.

DHS 132.65(6)(e)2.2. Proof-of-use records shall be audited daily by the registered nurse or designee, except that in facilities in which a registered nurse is not required, the administrator or designee shall perform the audit of proof-of-use records daily.

DHS 132.65(6)(f)(f) Resident control and use of medications. Medications which, if ingested or brought into contact with the nasal or eye mucosa, would produce toxic or irritant effects shall be stored and used only in accordance with the health, safety, and welfare of all residents.