DHS 83.37(1)(i)2.2. The administrator or qualified designee shall monitor at least monthly for the inappropriate use of PRN psychotropic medication, including but not limited to, use contrary to the individual service plan, presence of significant adverse side effects, use for discipline or staff convenience, or contrary to the intended use. DHS 83.37(1)(i)3.3. Documentation in the resident’s record shall include the rationale for use, description of behaviors requiring the PRN psychotropic medication, the effectiveness of the medication, the presence of any side effects, and monitoring for inappropriate use for each PRN psychotropic medication given. DHS 83.37(1)(j)(j) Proof-of-use record. The CBRF shall maintain a proof-of-use record for schedule II drugs, subject to 21 USC 812 (c), and Wisconsin’s uniform controlled substances act, ch. 961, Stats., that contains the date and time administered, the resident’s name, the practitioner’s name, dose, signature of the person administering the dose, and the remaining balance of the drug. The administrator or designee shall audit, sign and date the proof-of-use records on a daily basis. DHS 83.37(1)(k)1.1. The CBRF shall document in the resident’s record any error in the administration of prescription or over-the-counter medication, known adverse drug reaction or resident refusal to take medication. DHS 83.37(1)(k)2.2. The CBRF shall report all errors in the administration of medication and any adverse drug reactions to a licensed practitioner, supervising nurse or pharmacist immediately. Unless otherwise directed by the prescribing practitioner, the CBRF shall report to the prescribing practitioner, supervising nurse or pharmacist as soon as possible after the resident refuses a medication for 2 consecutive days. DHS 83.37(1)(L)(L) Medication information. The CBRF shall make available written information to resident care staff on the purpose and side effects of medications taken by residents. DHS 83.37(2)(a)1.1. The resident shall self-administer prescribed and over-the-counter medications and dietary supplements, unless the resident has been found incompetent under ch. 54, Stats., or does not have the physical or mental capacity to self-administer as determined by the resident’s physician, or the resident requests in writing that CBRF employees manage and administer medication. DHS 83.37(2)(a)2.2. Except as specified under sub. (4), when a resident self-administers medications, prescribed and over-the-counter medications and dietary supplements shall remain under the control of the resident. The CBRF shall provide a secure place for the storage of medications in the resident’s room. DHS 83.37(2)(a)3.3. A resident with the mental and physical capacity to develop increased independence in medication administration shall receive self-administration instruction. DHS 83.37(2)(b)(b) Medication administration supervised by a registered nurse, practitioner or pharmacist. When medication administration is supervised by a registered nurse, practitioner or pharmacist, the CBRF shall ensure all of the following: DHS 83.37(2)(b)1.1. The registered nurse, practitioner or pharmacist coordinates, directs and inspects the administration of medications and the medication administration system. DHS 83.37(2)(b)2.2. The registered nurse, practitioner or pharmacist participates in the resident’s assessment under s. DHS 83.35 (1) and development and review of the individual service plan under s. DHS 83.35 (3) regarding the resident’s medical condition and the goals of the medication regimen. DHS 83.37(2)(c)(c) Medication administration not supervised by a registered nurse, practitioner or pharmacist. When medication administration is not supervised by a registered nurse, practitioner or pharmacist, the CBRF shall arrange for a pharmacist to package and label a resident’s prescription medications in unit dose. Medications available over-the-counter may be excluded from unit dose packaging requirements, unless the physician specifies unit dose. DHS 83.37(2)(d)(d) Documentation of medication administration. As required under s. DHS 83.42 (1) (o), at the time of medication administration, the person administering the medication or treatment shall document in the resident record the name, dosage, date and time of medication taken or treatments performed and initial the medication administration record. Any side effects observed by the employee or symptoms reported by the resident shall be documented. The need for any PRN medication and the resident’s response shall be documented. DHS 83.37(2)(e)(e) Other administration. Injectables, nebulizers, stomal and enteral medications, and medications, treatments or preparations delivered vaginally or rectally shall be administered by a registered nurse or by a licensed practical nurse within the scope of their license. Medication administration described under sub. (2) (e) may be delegated to non-licensed employees pursuant to s. N 6.03 (3). DHS 83.37(3)(a)(a) Original containers. The CBRF shall keep medications in the original containers and not transfer medications to another container, unless the CBRF complies with all of the following: DHS 83.37(3)(a)1.1. Transfer of medications from the original container to another container shall be done by a practitioner, registered nurse, or pharmacist. Transfer of medication to another container may be delegated to other personnel by a practitioner, registered nurse or pharmacist. DHS 83.37(3)(a)2.2. If a medication is administered by CBRF employees and the medication is transferred from the original container by a registered nurse, or practitioner or other personnel who were delegated the task, the CBRF shall have a legible label on the new container that includes, at a minimum, the resident’s name, medication name, dose and instructions for use. The CBRF shall maintain the original pharmacy container until the transferred medication is gone. DHS 83.37(3)(b)(b) Unit dose packaging. For use during unplanned or non-routine events or activities, employees who have completed medication administration training as required in s. DHS 83.20 (2) (d) may transfer unit doses of medications into packages for the resident. DHS 83.37(3)(c)(c) Administered by facility. The CBRF shall keep medicine cabinets locked and the key available only to personnel identified by the CBRF. DHS 83.37(3)(d)(d) Refrigeration. Medications stored in a common refrigerator shall be properly labeled and stored in a locked box. DHS 83.37(3)(e)(e) Proximity to chemicals. The CBRF may not store prescription and over-the-counter medications or dietary supplements next to chemicals or other contaminants. DHS 83.37(3)(f)(f) Internal and external application. The CBRF shall physically separate medications for internal consumption from medications for external application. DHS 83.37(3)(g)(g) Controlled substances. The CBRF shall provide separately locked and securely fastened boxes or drawers or permanently fixed compartments within the locked medications area for storage of schedule II drugs subject to 21 USC 812 (c), and Wisconsin’s uniform controlled substances act, ch. 961, Stats. DHS 83.37(4)(4) Exemptions. Any CBRF that exclusively serves residents in the custody of a government correctional agency or who is alcohol or drug dependent is exempt from the requirements in sub. (2) (a) 2. These facilities may store medications in a central, secure area and employees may observe and record the self administration of medication as described in the resident’s individual service plan.