Part III. Registration of Medication Aides
18VAC90-60-90. Requirements for initial registration.
A. To be registered as a medication aide, an applicant shall:
1. Provide documentation of successful completion of:
a. A staff training program in direct client care approved by the Department of Social Services;
b. A nursing education program;
c. An approved nurse aide education program; or
d. A clinical nursing course that includes at least 40 hours of clinical experience involving direct client care within the past 12 months;
2. Provide documentation of successful completion of one of the following:
a. A medication aide training program approved by the board in accordance with this chapter; or
b. A nursing education program preparing for registered nurse licensure or practical nurse licensure;
3. Submit the required application and fee as prescribed by the board;
4. Disclose whether there are grounds for denial of registration as specified in § 54.1-3007 of the Code of Virginia; and
5. Provide documentation of successful completion of competency evaluations consisting of:
a. A clinical evaluation of minimal competency in the skills of administering medications as specified in 18VAC90-60-60 B 2; and
b. A written examination as specified by the board with a passing score determined by the board.
B. An applicant who fails to take the board-approved examination within two years of completion of the training or who has failed the examination in three attempts shall reenroll and successfully complete another approved medication aide training program before reapplying for registration.
Statutory Authority
§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 23, Issue 19, eff. July 1, 2007; amended, Virginia Register Volume 25, Issue 16, eff. May 13, 2009; Volume 29, Issue 22, eff. August 15, 2013; Volume 35, Issue 20, eff. July 15, 2019.
18VAC90-60-91. Requirements for provisional practice.
A. An applicant for registration who wants to practice as a medication aide on a provisional basis shall:
1. Submit the required application for registration and fee as prescribed by the board; and
2. Provide evidence to the board of successful completion of the medication aide training course or a nursing education program.
B. An applicant shall practice for no more than 120 days from the date of a letter from the board acknowledging receipt of the documentation required in subsection A of this section and granting provisional authorization.
C. An applicant acting as a medication aide under provisional authorization shall be identified as a "provisional medication aide" on a nametag worn in the facility.
D. An applicant with provisional authorization shall immediately cease acting as a medication aide at the conclusion of the 120-day period or upon notification of failure after three attempts to pass the written examination required for registration, whichever comes first.
Statutory Authority
§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 25, Issue 16, eff. May 13, 2009; amended, Virginia Register Volume 35, Issue 20, eff. July 15, 2019.
18VAC90-60-92. Requirements for registration by endorsement.
An applicant applying for registration by endorsement who has met the requirements for registration or certification as a medication aide in another state or the District of Columbia may be deemed eligible to sit for the state examination if there are no grounds for denial of registration as specified in § 54.1-3007 of the Code of Virginia and upon submission of:
1. A completed application and fee; and
2. Verification of registration or certification as a medication aide in another state or the District of Columbia that is current or eligible for reinstatement.
Statutory Authority
§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 25, Issue 16, eff. May 13, 2009; amended, Virginia Register Volume 29, Issue 22, eff. August 15, 2013; Volume 35, Issue 20, eff. July 15, 2019.
18VAC90-60-100. Renewal or reinstatement of registration.
A. Renewal of registration.
1. Registered medication aides shall renew by the last day of their birth month each year.
2. The medication aide shall complete the renewal notice and submit it with the required fee and an attestation that he has completed continuing education as required by subsection B of this section.
3. Failure to receive the notice for renewal shall not relieve the medication aide of the responsibility for renewing his registration by the expiration date.
4. The registration shall automatically lapse if the medication aide fails to renew by the expiration date.
5. Any person administering medications in an assisted living facility during the time a registration has lapsed shall be considered an illegal practitioner and shall be subject to prosecution under the provisions of § 54.1-3008 of the Code of Virginia.
B. Continuing education required for renewal.
1. In addition to hours of continuing education in direct client care required for employment in an assisted living facility, a medication aide shall have the following:
a. Four hours each year of population-specific training in medication administration in the assisted living facility in which the aide is employed; or
b. A refresher course in medication administration offered by an approved program.
2. A medication aide shall maintain documentation of continuing education for a period of four years following the renewal period for which the records apply.
3. The board shall periodically conduct a random audit of its registrants to determine compliance. A medication aide selected for audit shall provide documentation as evidence of compliance within 30 days of receiving notification of the audit.
4. The board may grant an extension for compliance with continuing education requirements for up to one year, for good cause shown, upon a written request from the registrant prior to the renewal deadline.
C. Reinstatement of registration.
1. An individual whose registration has lapsed for less than one renewal cycle may renew by payment of the renewal fee and late fee and attestation that the individual has completed all required continuing education for the period since his last renewal.
2. An individual whose registration has lapsed for more than one year shall:
a. Apply for reinstatement of registration by submission of a completed application and fee;
b. Provide evidence of completion of all required continuing education for the period since his last renewal, not to exceed eight hours of training in medication administration;
c. Retake the written and practical competency evaluation as required by the board; and
d. Attest that there are no grounds for denial of registration as specified in § 54.1-3007 of the Code of Virginia.
D. A medication aide whose registration has been suspended or revoked by the board may apply for reinstatement by filing a reinstatement application, fulfilling requirements of subsection C of this section, and paying the fee for reinstatement after suspension or revocation. A medication aide whose registration has been revoked may not apply for reinstatement sooner than three years from entry of the order of revocation.
Statutory Authority
§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 23, Issue 19, eff. July 1, 2007; amended, Virginia Register Volume 24, Issue 3, eff. November 29, 2007; Volume 29, Issue 22, eff. August 15, 2013; Volume 35, Issue 20, eff. July 15, 2019.
18VAC90-60-110. Standards of practice.
A. A medication aide shall:
1. Document and report all medication errors and adverse reactions immediately to the licensed health care professional in the facility or to the client's prescriber;
2. Give all medications in accordance with the prescriber's orders and instructions for dosage and time of administration and document such administration in the client's record; and
3. Document and report any information giving reason to suspect the abuse, neglect, or exploitation of clients immediately to the licensed health care professional in the facility or to the facility administrator.
B. A medication aide shall not:
1. Transmit verbal orders to a pharmacy;
2. Make an assessment of a client or deviate from the medication regime ordered by the prescriber;
3. Mix, dilute, or reconstitute two or more drug products, with the exception of insulin or glucagon;
4. Administer by intramuscular or intravenous routes or medications via a nasogastric or percutaneous endoscopic gastric tube; or
5. Administer by subcutaneous route, except for insulin medications, glucagon, or auto-injectable epinephrine.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 23, Issue 19, eff. July 1, 2007, amended, Virginia Register Volume 24, Issue 23, eff. September 4, 2008; Volume 29, Issue 22, eff. August 15, 2013; Volume 33, Issue 11, eff. March 9, 2017.
18VAC90-60-120. Disciplinary provisions for medication aides.
The board has the authority to deny, revoke, or suspend a registration issued, or to otherwise discipline a registrant upon proof that the registrant has violated any of the provisions of § 54.1-3007 of the Code of Virginia. For the purpose of establishing allegations to be included in the notice of hearing, the board has adopted the following definitions:
1. Fraud or deceit in order to procure or maintain a registration shall mean, but shall not be limited to:
a. Filing false credentials;
b. Falsely representing facts on an application for initial registration, reinstatement or renewal of a registration; or
c. Giving or receiving assistance in taking the competency evaluation.
2. Unprofessional conduct shall mean, but shall not be limited to:
a. Performing acts beyond those authorized by the Code of Virginia and this chapter for practice as a medication aide;
b. Assuming duties and responsibilities within the practice of a medication aide without adequate training or when competency has not been maintained;
c. Obtaining supplies, equipment or drugs for personal or other unauthorized use;
d. Falsifying or otherwise altering client or drug records relating to administration of medication;
e. Falsifying or otherwise altering employer records, including falsely representing facts on a job application or other employment-related documents;
f. Abusing, neglecting or abandoning clients;
g. Having been denied a license, certificate, or registration or having had a license, certificate, or registration issued by the board revoked or suspended;
h. Giving to or accepting from a client property or money for any reason other than fee for service or a nominal token of appreciation;
i. Obtaining money or property of a client by fraud, misrepresentation or duress;
j. Entering into a relationship with a client that constitutes a professional boundary violation in which the medication aide uses his professional position to take advantage of a client's vulnerability, to include actions that result in personal gain at the expense of the client, an inappropriate personal involvement or sexual conduct with a client;
k. Violating state laws relating to the privacy of client information, including § 32.1-127.1:03 of the Code of Virginia;
l. Failing to follow provisions of the Medication Management Plan for the assisted living facility in which the aide is employed; or
m. Violating any provision of this chapter, including the standards of practice as set forth in 18VAC90-60-110.
3. For the purposes of interpreting provisions of subdivision 5 of § 54.1-3007 of the Code of Virginia, a pattern of medication errors may constitute practice that presents a danger to the health and welfare of clients or to the public.
Statutory Authority
§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 23, Issue 19, eff. July 1, 2007; Errata, 23:20 VA.R. 3378 June 11, 2007; amended, Volume 27, Issue 3, eff. November 10, 2010; Volume 35, Issue 20, eff. July 15, 2019.