Virginia Law

A. Provision shall be made for the procurement, storage, dispensing, and accounting of drugs and other pharmacy products in compliance with 18VAC110-20. This may be by arrangement with an off-site pharmacy, but must include provisions for 24-hour emergency service.

B. Each nursing facility shall develop and implement policies and procedures for the handling of drugs and biologicals, including procurement, storage, administration, self-administration, and disposal of drugs.

C. Each nursing facility shall have a written agreement with a qualified pharmacist to provide consultation on all aspects of the provision of pharmacy services in the nursing facility.

D. The consultant pharmacist shall make regularly scheduled visits, at least monthly, to the nursing facility for a sufficient number of hours to carry out the function of the agreement.

E. Excluding cannabidiol oil and THC-A oil, no drug or medication shall be administered to any resident without a valid verbal order or a written, dated and signed order from a physician, dentist, podiatrist, nurse practitioner, or physician assistant, licensed in Virginia.

F. Nursing facility employees who are authorized to possess, distribute, or administer medications to residents may store, dispense, or administer cannabidiol oil or THC-A oil to a resident who has:

1. Been issued a valid written certification for the use of cannabidiol oil or THC-A oil in accordance with § 54.1-3408.3 B of the Code of Virginia; and

2. Registered with the Board of Pharmacy.

G. Advanced medication aides registered by the Board of Nursing pursuant to Article 7 (§ 54.1-3041 et seq.) of Chapter 30 of Title 54.1 of the Code of Virginia may administer drugs that would be administered by a registered medication aide pursuant to § 54.1-3408 M of the Code of Virginia in an assisted living facility licensed by the Department of Social Services, in addition to drugs determined permissible by the Board of Nursing, in a nursing home licensed by the Virginia Department of Health. Advanced medication aides shall administer drugs pursuant to this section:

1. In accordance with the prescriber's instructions pertaining to dosage, frequency, and manner of administration;

2. In accordance with regulations promulgated by the Board of Pharmacy relating to security and recordkeeping;

3. In accordance with the licensed nursing home's policies and procedures; and

4. In accordance with such other regulations promulgated by the Board of Nursing governing the practice of medication aides.

H. Verbal orders for drugs or medications shall only be given to a licensed nurse, pharmacist, or physician.

I. Drugs and medications not limited as to time or number of doses when ordered shall be automatically stopped, according to the written policies of the nursing facility, and the attending physician shall be notified.

J. Each resident's medication regimen shall be reviewed by a pharmacist licensed by the Board of Pharmacy. Any irregularities identified by the pharmacist shall be reported to the physician and the director of nursing, and their response documented.

K. Medication orders shall be reviewed at least every 60 days by the attending physician, nurse practitioner, or physician's assistant.

L. Prescription and nonprescription drugs and medications may be brought into the nursing facility by a resident's family, friend, or other person provided:

1. The individual delivering the drugs and medications ensures timely delivery, in accordance with the nursing facility's written policies, so that the resident's prescribed treatment plan is not disrupted;

2. Each drug or medication is in an individual container; and

3. Delivery is not allowed directly to an individual resident.

In addition, prescription medications shall be obtained and labeled as required by law.