(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: Division of Pharmacy Services and Drug Control, Arkansas Department of Health, 4815 West Markham Street, Little Rock, Arkansas 72204 along with Department of Health Form (PHA-DC-1) Report of Drugs Surrendered for Disposition According to Law.
2. (2) When unused portions of controlled drugs go with a patient who leaves the facility, the controlled drug record shall be signed by the person who assumes responsibility for the patient and the person in charge of the medication in the facility.

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

   1. (A) Is discharged;
   2. (B) Is transferred; or
   3. (C) Visits home.

(b)

1. (1)

   1. (A) All medications other than Schedule II, III, IV, and V not taken out of the facility by the patient with the physician's consent when he or she is discharged from the facility shall be destroyed.
   2. (B) See subdivision (b)(4) of this section, on handling medication when a resident enters a hospital or is transferred.
   3. (C) All discontinued medications, except controlled drugs, shall be destroyed on the premises of the facility.
   4. (D) 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.
   5. (E) The destruction should be by means of:

(i) Incineration;

1. (ii) Garbage disposal; or

   1. (iii) Flushing down the commode.
   2. (F) This record shall be kept in a bound ledger with consecutively numbered pages.
   3. (G) This record shall be retained by the facility as a permanent record and be readily retrievable.

2. (2)

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

   2. (B) 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. (i) PRN or “as needed” medications;
      2. (ii) Controlled drugs (Schedule II – V);
      3. (iii) Refrigerated medications;
      4. (iv) Antibiotics; and
      5. (v) Anti-infectives.

3. (3)

   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 subdivision (b)(3), 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.
   3. (C) The notification shall be made within twenty-four (24) hours of the change of condition.
   4. (D) 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.
   5. (E) Documentation for drugs ordered, changed, or discontinued shall be retained by the facility for a period of no less than fifteen (15) months.

4. (4)

   1. (A) 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. (B) All continued or reordered medications will be placed in active medication cycles upon the return of the resident.
   3. (C) If the resident does not return to the facility, any medications held by the facility shall be placed with other medications or drugs for destruction or return as permitted by Arkansas State Board of Pharmacy rules.