(a)

1. (1) Schedule II, III, IV, and V drugs dispensed by prescription for a patient and no longer needed by the patient must be delivered in person or by registered mail to the Drug Control Division of the Department of Health, 4815 West Markham Street, Little Rock, Arkansas 72201 along with Department of Health Form (PHA-DC-1) Report of Drugs Surrendered for Disposition According to Law.

2. (2)

   1. (A) When unused portions of controlled drugs go with a patient who leaves the facility, the controlled drug record shall be signed by the:

(i) Person who assumes responsibility for the patient; and

1. (ii) Person in charge of the medication in the nursing home.

   1. (B) This shall be done only on the written order of the physician and at the time the patient:

      1. (i) Is discharged;
      2. (ii) Is transferred; or
      3. (iii) Visits home.

(b)

1. (1)

   1. (A) Except as provided in Arkansas Code § 17-92-1101 et seq. and subsection (f) of this section, all medications other than Schedule II, III, IV, and V not taken out of the home by the patient with the physician's consent when he or she is discharged from the home shall be destroyed.
   2. (B) See subsection (e) of this section on handling medication when a resident enters a hospital or is transferred.
2. (2) All discontinued medications, except controlled drugs, shall be destroyed on the premises of the facility.
3. (3) Destruction shall be made by the consultant pharmacist and a nurse with a record made as to the date, quantity, prescription number, patient's name, and strength of medications destroyed.

4. (4) The destruction should be by means of:

   1. (A) Incineration;
   2. (B) Garbage disposal; or
   3. (C) Flushing down the commode.

5. (5) This record shall be:

   1. (A) Kept in a bound ledger with consecutively numbered pages; and

   2. (B) Retained by the facility as a permanent record and be readily retrievable.

      1. (c)
6. (1) Only oral solid medications may be cycle-filled.

7. (2) Provided, however, that if an oral solid medication meets one (1) of the categories below, then that oral solid medication may not be cycle-filled:

   1. (A) PRN or “as needed” medications;
   2. (B) Controlled drugs (C-II – C-V);
   3. (C) Refrigerated medications;
   4. (D) Antibiotics; and

   5. (E) Anti-infectives.

      1. (d)

8. (1)

   1. (A) A facility shall notify the pharmacy in writing of any change of condition that affects the medication status of a resident.
   2. (B) For purposes of this section, “change of condition” includes death, discharge, or transfer of a resident, as well as medical changes of condition that necessitate a change to the medication prescribed or the dosage given.

9. (2)

   1. (A) The notification shall be made within twenty-four (24) hours of the change of condition.
   2. (B) If the notification would occur after 4:30 p.m. Monday through Friday, or would occur on a weekend or holiday, the facility shall notify the pharmacy by no later than 11:00 a.m. the next business day.
10. (3) Documentation for drugs ordered, changed, or discontinued shall be retained by the facility for a period of no less than fifteen (15) months.

(e)

1. (1) When a resident is transferred or enters a hospital, a facility shall hold all medication until the return of the resident, unless otherwise directed by the authorized prescriber.
2. (2) All continued or reordered medications will be placed in active medication cycles upon the return of the resident.

3. (3) Except as provided in Arkansas Code § 17-92-1101 et seq. and subsection (f) of this section, if the resident does not return to the facility, any medications held by the facility shall be:

   1. (A) Placed with other medications or drugs for destruction; or
   2. (B) Returned as permitted by Arkansas State Board of Pharmacy rules.

(f)

1. (1) Pursuant to Arkansas Code § 17-92-1101 et seq., facilities may elect to donate designated medications to charitable clinics.

2. (2) If a facility elects to donate medications, facilities shall:

   1. (A) Obtain the written consent of the resident or the person who assumes responsibility for the resident through the execution of a donor form created by the Arkansas State Board of Pharmacy that states that the donor:

      1. (i) Is authorized to donate the drugs; and
      2. (ii) Intends to voluntarily donate them to a charitable clinic pharmacy;
   2. (B) Retain the donor form along with other acquisition records in accordance with 20 CAR § 400-1904(b);

   3. (C) Obliterate from the packaging before the nursing facility sends the drug to the charitable clinic:

      1. (i) The donor patient’s name;
      2. (ii) The prescription number; and
      3. (iii) Any other marks that identify the resident;
   4. (D) Ensure that the drug name, strength, and expiration date remain on the drug package label;
   5. (E) Enter into a contract, approved by the Arkansas State Board of Pharmacy, with all charitable clinics to which the facility will donate drugs;
   6. (F) Donate drugs only in their original sealed and tamper-evident packaging or, if acceptable to the charitable clinic, drugs packaged in single-unit doses or blister packs with the outside packaging opened if the single-unit dose packaging remains intact;
   7. (G) Ensure that all drugs physically transferred from the nursing facility to a charitable clinic pharmacy is performed by a person authorized by the Arkansas State Board of Pharmacy to pick up the drugs for the charitable clinic;
   8. (H) Provide all drug recall notices and information received by, or known to, the facility to all charitable clinics with which the facility has a contract to donate drugs;
   9. (I) Donate only those medications permitted under Arkansas Code § 17-92-1101 et seq.; and
   10. (J) Comply with all applicable rules concerning donation of unused drugs to charitable clinics promulgated by the Arkansas State Board of Pharmacy.