Part IV. Advanced Registered Medication Aides
18VAC90-60-130. Requirements for initial registration as an advanced registered medication aide.
In order to be registered as an advanced registered medication aide, an applicant shall:
1. Hold both a current Virginia certification as a certified nurse aide and as a registered medication aide or be eligible for endorsement as a registered medication aide;
2. Have successfully completed a minimum of 60 hours of advanced training in a nursing facility that includes population and medication specific training; and
3. Submit the required application and fee.
Statutory Authority
§§ 54.1-2400, 54.1-3005, and 54.1-3041 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 42, Issue 13, eff. March 11, 2026.
18VAC90-60-140. Renewal and reinstatement as an advanced registered medication aide.
A. Current certification as a nurse aide in Virginia must be maintained to hold certification as an advanced registered medication aide. If an individual is not eligible to renew as a certified nurse aide, registration as an advanced registered medication aide may not be renewed.
B. Advanced registered medication aides shall renew annually. To renew an advanced registration, an individual must:
1. Submit the renewal application and required fee; and
2. Attest that the individual has completed continuing education as required in 18VAC90-60-100 B and four hours of nursing facility population and medication specific training.
C. Failure to receive a notice for renewal shall not relieve the advanced registered medication aide of the responsibility for renewing the registration by the expiration date.
D. The registration shall automatically lapse if the advanced registered medication aide fails to renew by the expiration date.
E. Any person administering medications in an assisted living facility or licensed nursing home during the time a registration has lapsed shall be considered an unlicensed practitioner and shall be subject to prosecution under the provisions of § 54.1-3008 of the Code of Virginia.
F. If an advanced registered medication aide has not renewed for 90 days following the expiration date, the advanced registration shall only be reinstated if the applicant:
1. Holds current certification as a nurse aide in Virginia;
2. Submits a completed reinstatement application on a form provided by the board;
3. Pays the reinstatement fee; and
4. Provides evidence that the applicant has completed all required hours of continuing education and training.
Statutory Authority
§§ 54.1-2400, 54.1-3005, and 54.1-3041 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 42, Issue 13, eff. March 11, 2026.
18VAC90-60-150. Standards of practice for advanced registered medication aides working in a nursing facility.
A. An advanced registered 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. Immediately document and report any information giving reason to suspect the abuse, neglect, or exploitation of clients to the licensed health care professional in the facility or to the facility administrator.
B. An advanced registered 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 intravenous medications or medications via a nasogastric or percutaneous endoscopic gastric tube or intramuscular medication, except for vaccinations and auto-injectable epinephrine; or
5. Administer by subcutaneous route, except for insulin medications, glucagon, glucagon-like peptide-1, Vitamin B12, or anticoagulants.
C. An advanced registered medication aide working in an assisted living facility shall abide by the limitations included in 18VAC90-60-110.
Statutory Authority
§§ 54.1-2400, 54.1-3005, and 54.1-3041 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 42, Issue 13, eff. March 11, 2026.
18VAC90-60-160. Disciplinary provisions for advanced registered 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.
1. Fraud or deceit in order to procure or maintain a registration includes:
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 includes;
a. Performing acts beyond those authorized by the Code of Virginia and this chapter for practice as an advanced registered medication aide;
b. Assuming duties and responsibilities within the practice of an advanced registered 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 advanced registered medication aide uses a 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 facility in which the advanced registered medication aide is employed; or
m. Violating any provision of this chapter, including the standards of practice as set forth in 18VAC90-60-150.
3. A pattern of medication errors may constitute practice that presents a danger to the health and welfare of clients or to the public as referenced in subdivision 5 of § 54.1-3007 of the Code of Virginia.
Statutory Authority
§§ 54.1-2400, 54.1-3005, and 54.1-3041 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 42, Issue 13, eff. March 11, 2026.