Part V. Veterinary Establishments
18VAC150-20-180. Requirements to be registered as a veterinary establishment.
A. Every veterinary establishment shall apply for registration on a form provided by the board and submit the application fee specified in 18VAC150-20-100. The board may issue a registration as a stationary or ambulatory establishment. Every veterinary establishment shall have a veterinarian-in-charge registered with the board in order to operate.
1. Veterinary medicine may only be practiced out of a registered establishment except in emergency situations or in limited specialized practices as provided in 18VAC150-20-171. The injection of a microchip for identification purposes shall only be performed in a veterinary establishment, except personnel of public or private animal shelters may inject animals while in their possession.
2. An application for registration must be made to the board 45 days in advance of opening or changing the location of the establishment or requesting a change in the establishment category listed on the registration.
3. Any addition or renovation of a stationary establishment or an ambulatory establishment that involves changes to the structure or composition of a surgery room shall require reinspection by the board and payment of the required fee prior to use.
B. A veterinary establishment will be registered by the board when:
1. It is inspected by the board and is found to meet the standards set forth by 18VAC150-20-190 and 18VAC150-20-200 or 18VAC150-20-201 where applicable. If, during a new or routine inspection, violations or deficiencies are found necessitating a reinspection, the prescribed reinspection fee will be levied. Failure to pay the fee shall be deemed unprofessional conduct and, until paid, the establishment shall be deemed to be unregistered.
2. A veterinarian currently licensed by and in good standing with the board is registered with the board in writing as veterinarian-in-charge and ensures that the establishment registration fee has been paid.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from VR645-01-1 § 4.1, eff. June 10, 1987; amended, Virginia Register Volume 6, Issue 26, eff. October 31, 1990; Volume 12, Issue 9, eff. February 21, 1996; Volume 15, Issue 5, eff. December 23, 1998; Volume 19, Issue 9, eff. March 1, 2003; Volume 26, Issue 4, eff. November 25, 2009; Volume 34, Issue 1, eff. October 25, 2017.
18VAC150-20-181. Requirements for veterinarian-in-charge.
A. The veterinarian-in-charge of a veterinary establishment is responsible for:
1. Regularly being on site as necessary to provide routine oversight to the veterinary establishment for patient safety and compliance with law and regulation.
2. Maintaining the facility within the standards set forth by this chapter.
3. Performing the biennial controlled substance inventory and ensuring compliance at the facility with any federal or state law relating to controlled substances as defined in § 54.1-3404 of the Code of Virginia. The performance of the biennial inventory may be delegated to another licensee, provided the veterinarian-in-charge signs the inventory and remains responsible for its content and accuracy.
4. Notifying the board in writing of the closure of the registered facility 10 days prior to closure.
5. Notifying the board immediately if no longer acting as the veterinarian-in-charge.
6. Ensuring the establishment maintains a current and valid registration issued by the board.
B. Upon any change in veterinarian-in-charge, these procedures shall be followed:
1. The veterinarian-in-charge registered with the board remains responsible for the establishment and the stock of controlled substances until a new veterinarian-in-charge is registered or for five days, whichever occurs sooner.
2. An application for a new registration, naming the new veterinarian-in-charge, shall be made five days prior to the change of the veterinarian-in-charge. If no prior notice was given by the previous veterinarian-in-charge, an application for a new registration naming a new veterinarian-in-charge shall be filed as soon as possible, but no more than 10 days, after the change.
3. The previous establishment registration is void on the date of the change of veterinarian-in-charge and shall be returned by the former veterinarian-in-charge to the board five days following the date of change.
4. Prior to the opening of the business, on the date of the change of veterinarian-in-charge, the new veterinarian-in-charge shall take a complete inventory of all Schedules II through V drugs on hand. He shall date and sign the inventory and maintain it on premises for three years. That inventory may be designated as the official biennial controlled substance inventory.
C. Prior to the sale or closure of a veterinary establishment, the veterinarian-in-charge shall:
1. Follow the requirements for transfer of patient records to another location in accordance with § 54.1-2405 of the Code of Virginia; and
2. If there is no transfer of records upon sale or closure of an establishment, the veterinarian-in-charge shall provide to the board information about the location of or access to patient records and the disposition of all scheduled drugs.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 19, Issue 9, eff. March 1, 2003; amended, Virginia Register Volume 26, Issue 4, eff. November 25, 2009; Volume 34, Issue 1, eff. October 25, 2017.
18VAC150-20-185. Renewal of veterinary establishment registrations.
A. Every veterinary establishment shall be required to renew the registration by January 1 of each year and pay to the board a registration fee as prescribed in 18VAC150-20-100.
B. Failure to renew the establishment registration by January 1 of each year shall cause the registration to expire and become invalid. Practicing veterinary medicine in an establishment with an expired registration may subject a licensee or registration holder to disciplinary action by the board. The registration may be renewed without reinspection within 30 days of expiration, provided the board receives a properly executed renewal application, renewal fee, and a late fee as prescribed in 18VAC150-20-100.
C. Reinstatement of an expired registration after 30 days shall be at the discretion of the board and contingent upon a properly executed reinstatement application and payment of the late fee, the reinspection fee, the renewal fee and the veterinary establishment registration reinstatement fee. A reinspection is required when an establishment is reinstated.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 15, Issue 5, eff. December 23, 1998; amended, Virginia Register Volume 19, Issue 9, eff. March 1, 2003; Volume 34, Issue 1, eff. October 25, 2017; Volume 34, Issue 25, eff. September 20, 2018.
18VAC150-20-190. Requirements for drug storage, dispensing, destruction, and records for all establishments.
A. All drugs shall be maintained, administered, dispensed, prescribed, and destroyed in compliance with state and federal laws, which include § 54.1-3303 of the Code of Virginia, the Drug Control Act (§ 54.1-3400 et seq. of the Code of Virginia), applicable parts of the federal Food, Drug, and Cosmetic Control Act (21 USC § 301 et seq.), the Prescription Drug Marketing Act (21 USC § 301 et seq.), and the Controlled Substances Act (21 USC § 801 et seq.), as well as applicable portions of Title 21 of the Code of Federal Regulations.
B. All repackaged tablets and capsules dispensed for companion animals shall be in approved safety closure containers, except safety caps shall not be required when any person who requests that the medication not have a safety cap or in such cases in which the medication is of such form or size that it cannot be reasonably dispensed in such containers (e.g., topical medications, ophthalmic, or otic). An owner request for nonsafety packaging shall be documented in the patient record.
C. All drugs dispensed for companion animals shall be labeled with the following:
1. Name and address of the facility;
2. First and last name of owner;
3. Animal identification and species;
4. Date dispensed;
5. Directions for use;
6. Name, strength (if more than one dosage form exists), and quantity of the drug; and
7. Name of the prescribing veterinarian.
D. All veterinary establishments shall maintain drugs in a secure manner with precaution taken to prevent theft or diversion. Only the veterinarian, veterinary technician, pharmacist, or pharmacy technician shall have access to Schedules II through V drugs, with the exception provided in subdivision 6 of this subsection.
1. In a stationary establishment, the general stock of Schedules II through V drugs shall be stored in a securely locked cabinet or safe that is not easily movable.
2. The establishment may also have a working stock of Schedules II through V drugs that shall be kept in (i) a securely locked container, cabinet, or safe when not in use or (ii) direct possession of a veterinarian or veterinary technician. A working stock shall consist of only those drugs that are necessary for use during a normal business day or 24 hours, whichever is less.
3. Whenever the establishment is closed, all general and working stock of Schedules II through V drugs and any dispensed prescriptions that were not delivered during normal business hours shall be securely stored as required for the general stock.
4. Prescriptions that have been dispensed and prepared for delivery shall be maintained under lock or in an area that is not readily accessible to the public and may be delivered to an owner by an unlicensed person, as designated by the veterinarian.
5. Whenever a theft or any unusual loss of Schedules II through V drugs is discovered, the veterinarian-in-charge, or in his absence, his designee, shall immediately report such theft or loss to the Board of Veterinary Medicine and the Board of Pharmacy and to the DEA. The report to the boards shall be in writing and sent electronically or by regular mail. The report to the DEA shall be in accordance with 21 CFR 1301.76(b). If the veterinarian-in-charge is unable to determine the exact kind and quantity of the drug loss, he shall immediately take a complete inventory of all Schedules II through V drugs.
6. Access to drugs by unlicensed persons shall be allowed only under the following conditions:
a. An animal is being kept at the establishment outside of the normal hours of operation, and a licensed practitioner is not present in the facility;
b. The drugs are limited to those dispensed to a specific patient; and
c. The drugs are maintained separately from the establishment's general drug stock and kept in such a manner so they are not readily available to the public.
E. Schedules II through V drugs shall be destroyed by (i) transferring the drugs to another entity authorized to possess or provide for proper disposal of such drugs or (ii) destroying the drugs in compliance with applicable local, state, and federal laws and regulations. If Schedules II through V drugs are to be destroyed, a DEA drug destruction form shall be fully completed and used as the record of all drugs to be destroyed. A copy of the destruction form shall be retained at the veterinarian practice site with other inventory records.
F. The drug storage area shall have appropriate provision for temperature control for all drugs and biologics. If drugs requiring refrigeration are maintained at the facility, the drugs shall be kept in a refrigerator with the interior thermometer maintained between 36°F and 46°F. If a refrigerated drug is in Schedules II through V, the drug shall be kept in a locked container secured to the refrigerator, or the refrigerator shall be locked. Drugs stored at room temperature shall be maintained between 59°F and 86°F.
G. The stock of drugs shall be reviewed frequently, and expired drugs shall be removed from the working stock of drugs at the expiration date and shall not be administered or dispensed.
H. A distribution record shall be maintained in addition to the patient's record, in chronological order, for the administration and dispensing of all Schedules II through V drugs.
This record is to be maintained for a period of three years from the date of transaction. This distribution record shall include the following:
1. Date of transaction;
2. Drug name, strength, and the amount dispensed, administered, and wasted;
3. Owner and animal identification; and
4. Identification of the veterinarian authorizing the administration or dispensing of the drug.
I. Original invoices for all Schedules II through V drugs received shall be maintained in chronological order on the premises where the stock of drugs is held, and the actual date of receipt shall be noted. All drug records shall be maintained for a period of three years from the date of transaction.
J. A complete and accurate inventory of all Schedules II through V drugs shall be taken, dated, and signed on any date that is within two years of the previous biennial inventory. Drug strength must be specified. This inventory shall indicate if it was made at the opening or closing of business and shall be maintained on the premises where the drugs are held for three years from the date of taking the inventory.
K. Inventories and records, including original invoices, of Schedule II drugs shall be maintained separately from all other records, and the establishment shall maintain a continuous inventory of all Schedule II drugs received, administered, or dispensed, with reconciliation at least monthly. Reconciliation requires an explanation noted on the inventory for any difference between the actual physical count and the theoretical count indicated by the distribution record. A continuous inventory shall accurately indicate the physical count of each Schedule II drug in the general and working stocks at the time of performing the inventory.
L. Veterinary establishments shall (i) maintain records of the dispensing of feline buprenorphine and canine butorphanol, (ii) reconcile such records monthly, and (iii) make such records available for inspection upon request.
M. Veterinary establishments in which bulk reconstitution of injectable, bulk compounding, or the prepackaging of drugs is performed shall maintain adequate control records for a period of one year or until the expiration, whichever is greater. The records shall show the name of the drugs used; strength, if any; date repackaged; quantity prepared; initials of the veterinarian verifying the process; the assigned lot or control number; the manufacturer's or distributor's name and lot or control number; and an expiration date.
N. If a limited stationary or ambulatory practice uses the facilities of another veterinary establishment, the drug distribution log shall clearly reveal whose Schedules II through V drugs were used. If the establishment's drug stock is used, the distribution record shall show that the procedure was performed by a visiting veterinarian who has the patient record. If the visiting veterinarian uses his own stock of drugs, he shall make entries in his own distribution record and in the patient record and shall leave a copy of the patient record at the other establishment.
Statutory Authority
§§ 54.1-2400 and 54.1-3804 of the Code of Virginia.
Historical Notes
Derived from VR645-01-1 § 4.2, eff. June 10, 1987; amended, Virginia Register Volume 6, Issue 26, eff. October 31, 1990; Volume 12, Issue 9, eff. February 21, 1996; Volume 15, Issue 5, eff. December 23, 1998; Errata, 15:9 VA.R. 1276 January 18, 1999; amended, Virginia Register Volume 19, Issue 9, eff. March 1, 2003; Volume 26, Issue 4, eff. November 25, 2009; Volume 28, Issue 5, eff. December 22, 2011; Volume 34, Issue 1, eff. October 25, 2017; Volume 35, Issue 26, eff. September 18, 2019.
18VAC150-20-195. Recordkeeping.
A. A legible, daily record of each patient treated shall be maintained by the veterinarian at the registered veterinary establishment and shall include at a minimum:
1. Name of the patient and the owner;
2. Identification of the treating veterinarian and of the person making the entry (Initials may be used if a master list that identifies the initials is maintained.);
3. Presenting complaint or reason for contact;
4. Date of contact;
5. Physical examination findings;
6. Tests and diagnostics performed and results;
7. Procedures performed, treatment given, and results;
8. Drugs administered, dispensed, or prescribed, including quantity, strength and dosage, and route of administration. For vaccines, identification of the lot and manufacturer shall be maintained;
9. Radiographs or digital images clearly labeled with identification of the establishment, the patient name, date taken, and anatomic specificity. If an original radiograph or digital image is transferred to another establishment or released to the owner, a record of this transfer or release shall be maintained on or with the patient's records; and
10. Any specific instructions for discharge or referrals to other practitioners.
B. An individual record shall be maintained on each patient, except that records for economic animals or litters of companion animals under the age of four months may be maintained on a per owner basis. Patient records, including radiographs or digital images, shall be kept for a period of three years following the last office visit or discharge of such animal from a veterinary establishment.
C. An initial rabies certification for an animal receiving a primary rabies vaccination shall clearly display the following information: "An animal is not considered immunized for at least 28 days after the initial or primary vaccination is administered."
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 15, Issue 5, eff. December 23, 1998; amended, Virginia Register Volume 19, Issue 9, eff. March 1, 2003; Volume 21, Issue 23, eff. October 8, 2005; Volume 26, Issue 4, eff. November 25, 2009; Volume 34, Issue 1, eff. October 25, 2017.
18VAC150-20-200. Standards for stationary veterinary establishments.
A. Stationary establishments. A stationary establishment shall provide surgery and encompass all aspects of health care for small or large animals, or both. All stationary establishments shall meet the requirements set forth in this subsection:
1. Buildings and grounds must be maintained to provide sanitary facilities for the care and medical well-being of patients.
a. Temperature, ventilation, and lighting must be consistent with the medical well-being of the patients.
b. There shall be on-premises:
(1) Hot and cold running water of drinking quality, as defined by the Virginia Department of Health;
(2) An acceptable method of disposal of deceased animals, in accordance with any local ordinance or state and federal regulations; and
(3) Refrigeration exclusively for carcasses of companion animals that require storage for 24 hours or more.
c. Sanitary toilet and lavatory shall be available for personnel and owners.
2. Areas within building. The areas within the facility shall include the following:
a. A reception area separate from other designated rooms;
b. Examination room or rooms containing a table or tables with nonporous surfaces;
c. A room that is reserved only for surgery and used for no other purpose. In order that surgery can be performed in a manner compatible with current veterinary medical practice with regard to anesthesia, asepsis, life support, and monitoring procedures, the surgery room shall:
(1) Have walls constructed of nonporous material and extending from the floor to the ceiling;
(2) Be of a size adequate to accommodate a surgical table, anesthesia support equipment, surgical supplies, and all personnel necessary for safe performance of the surgery;
(3) Be kept so that storage in the surgery room shall be limited to items and equipment normally related to surgery and surgical procedures;
(4) Have a surgical table made of nonporous material;
(5) Have surgical supplies, instruments, and equipment commensurate with the kind of services provided;
(6) Have surgical and automatic emergency lighting to facilitate performance of procedures; and
(7) For establishments that perform surgery on small animals, have a door to close off the surgery room from other areas of the practice.
3. The veterinary establishment shall have, at a minimum, proof of use of either in-house laboratory service or outside laboratory services for performing lab tests, consistent with appropriate professional care for the species being treated.
4. For housing animals, the establishment shall provide:
a. An animal identification system at all times when housing an animal;
b. Accommodations of appropriate size and construction to prevent residual contamination or injury;
c. Accommodations allowing for the effective separation of contagious and noncontagious patients; and
d. Exercise areas that provide and allow effective separation of animals or walking the animals at medically appropriate intervals.
5. A veterinary establishment shall either have radiology service in-house or documentation of outside services for obtaining diagnostic-quality radiographs. If radiology is in-house, the establishment shall:
a. Document that radiographic equipment complies with Part VI (12VAC5-481-1581 et seq.), Use of Diagnostic X-Rays in the Healing Arts, of the Virginia Radiation Protection Regulations of the Virginia Department of Health, which requirements are adopted by this board and incorporated herewith by reference in this chapter.
b. Maintain and utilize lead aprons and gloves and individual radiation exposure badges for each employee exposed to radiographs.
6. Minimum equipment in the establishment shall include:
a. An appropriate method of sterilizing instruments;
b. Internal and external sterilization monitors;
c. Stethoscope;
d. Equipment for delivery of assisted ventilation appropriate to the species being treated, including endotracheal tubes;
e. Adequate means of determining patient's weight; and
f. Storage for records.
B. Additional requirements for stationary establishments.
1. A stationary establishment that is open to the public 24 hours a day shall have licensed personnel on premises at all times and shall be equipped to handle emergency critical care and hospitalization. The establishment shall have radiology/imaging and laboratory services available on site.
2. A stationary establishment that is not open to the public 24 hours a day shall have licensed personnel available during its advertised hours of operation and shall disclose to the public that the establishment does not have continuous staffing in compliance with § 54.1-3806.1 of the Code of Virginia.
3. All stationary establishments shall provide for continuity of care when a patient is transferred to another establishment.
C. Limited stationary establishments. When the scope of practice is less than full service, a specifically limited establishment registration shall be required. Upon submission of a completed application, satisfactory inspection, and payment of the veterinary establishment registration fee, a limited establishment registration may be issued. Such establishments shall have posted in a conspicuous manner the specific limitations on the scope of practice on a form provided by the board.
D. A separate establishment registration is required for separate practices that share the same location.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from VR645-01-1 § 4.3, eff. June 10, 1987; amended, Virginia Register Volume 6, Issue 26, eff. October 31, 1990; Volume 12, Issue 9, eff. February 21, 1996; Volume 15, Issue 5, eff. December 23, 1998; Errata, 15:9 VA.R. 1276 January 18, 1999; amended, Virginia Register Volume 19, Issue 9, eff. March 1, 2003; Volume 26, Issue 4, eff. November 25, 2009; Volume 29, Issue 14, eff. April 10, 2013; Volume 34, Issue 1, eff. October 25, 2017.
18VAC150-20-201. Standards for ambulatory veterinary establishments.
A. Agricultural or equine ambulatory practice. An agricultural or equine ambulatory establishment is a mobile practice in which health care is performed at the location of the animal. Surgery on large animals may be performed as part of an agricultural or equine ambulatory practice provided the establishment has surgical supplies, instruments, and equipment commensurate with the kind of surgical procedures performed. All agricultural or equine ambulatory establishments shall meet the requirements of a stationary establishment for laboratory, radiology, and minimum equipment, with the exception of equipment for assisted ventilation.
B. House call or proceduralist establishment. A house call or proceduralist establishment is an ambulatory practice in which health care of small animals is performed at the residence of the owner of the small animal or another establishment registered by the board. A veterinarian who has established a veterinarian-owner-patient relationship with an animal at the owner's residence or at another registered veterinary establishment may also provide care for that animal at the location of the patient.
1. Surgery may be performed only in a surgical suite at a registered establishment that has passed inspection. However, surgery requiring only local anesthetics may be performed at a location other than in a surgical suite.
2. House call or proceduralist establishments shall meet the requirements of a stationary establishment for laboratory, radiology, and minimum equipment, with the exception of equipment for assisted ventilation.
C. Mobile service establishment. A mobile service establishment is a veterinary clinic or hospital that can be moved from one location to another and from which veterinary services are provided. A mobile service establishment shall meet all the requirements of a stationary establishment appropriate for the services provided.
D. A separate establishment registration is required for separate practices that share the same location.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 1, eff. October 25, 2017.
18VAC150-20-205. (Repealed.)
Historical Notes
Derived from Virginia Register Volume 15, Issue 5, eff. December 23, 1998; repealed, Virginia Register Volume 19, Issue 9 eff. March 1, 2003.
18VAC150-20-210. Revocation or suspension of a veterinary establishment registration.
The board may revoke or suspend or take other disciplinary action deemed appropriate against the registration of a veterinary establishment if it finds the establishment to be in violation of any provision of laws or regulations governing veterinary medicine or if:
1. The board or its agents are denied access to the establishment to conduct an inspection or investigation;
2. The holder of a registration does not pay any and all prescribed fees or monetary penalties;
3. The establishment is performing procedures beyond the scope of a limited stationary establishment registration; or
4. The establishment has no veterinarian-in-charge registered with the board.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from VR645-01-1 § 4.4, eff. June 10, 1987; amended, Virginia Register Volume 6, Issue 26, eff. October 31, 1990; Volume 12, Issue 9, eff. February 21, 1996; Volume 15, Issue 5, eff. December 23, 1998; Volume 19, Issue 9, eff. March 1, 2003; Volume 26, Issue 4, eff. November 25, 2009; Volume 34, Issue 1, eff. October 25, 2017.