Strengthening Medication Compliance in Assisted Living

Medication management in assisted living communities is more than a daily task. It’s a cornerstone of resident safety, regulatory compliance, and operational excellence. With oversight from state agencies and the potential for serious consequences when errors occur, it’s critical that care teams understand and implement best practices for medication administration, documentation, and storage.

In Ohio, residential care facilities (RCFs) operate under specific rules outlined in Chapter 3701-16 of the Ohio Administrative Code. These regulations define who can administer medications, how they must be stored, and what documentation is required. Facilities must ensure that medications are only administered by qualified personnel, that residents are observed for adverse effects, and that all actions are properly recorded.

Common Medication Compliance Risks Include:

• Inaccurate documentation in MARs and EHRs

• Improper handling of PRN medications

• Failure to follow up on medication refusals

• Unavailable medications without proper notification

• Narcotic documentation errors

• Inadequate infection control during med pass

Each of these issues can lead to deficiencies during state surveys, with R-tags such as R339 (medications administered as prescribed) and R333 (personal care services provided appropriately) frequently cited.

Medication Storage Protocols Matter

Medications must be stored securely, whether in locked cabinets or refrigerated units. Internal and external medications should be clearly labeled, dated when opened, and organized to prevent mix-ups. Regular audits of storage areas help identify expired medications and ensure compliance with pharmacy and DEA regulations.

Preventing Drug Diversion

Drug diversion poses a serious threat to resident safety and staff integrity. Warning signs include discrepancies in documentation, excessive PRN usage, and missing co-signatures on controlled substance records. Facilities must have clear policies, secure storage, and a culture that encourages reporting suspicious activity without fear of retaliation.

Strategies for Safer Medication Management

• Use a robust eMAR system with audit capabilities

• Partner with a single pharmacy to streamline processes

• Automate compliance with barcode packaging

• Train staff regularly on regulations and procedures

• Standardize medication administration protocols

• Review resident prescriptions before move-in

• Communicate clearly with residents and families

Medication management is not just about compliance, it’s about care. When done right, it protects residents, supports staff, and strengthens the entire community.