1. (a) Administration of medication to a resident of a facility may be performed only by:

   1. (1) a person who holds a license under state law that authorizes the person to administer medication;

   2. (2) in a facility, as defined in §95.101 of this title (relating to Introduction):

      1. (A) a person who holds a permit issued under Texas Health and Safety Code §242.610 and acts under the authority of a person described in paragraph (1) of this subsection; or
      2. (B) a person who is exempt from licensure or permit requirements in accordance with Texas Health and Safety Code §242.607;
   3. (3) a person to whom a registered nurse has delegated the administration of medication under 22 TAC Chapter 224 or 225 (relating to Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments and RN Delegation to Unlicensed Personnel and Tasks Not Requiring Delegation in Independent Living Environments for Clients with Stable and Predictable Conditions); or
   4. (4) in a facility with a licensed or certified capacity of less than 14 residents, an unlicensed person who administers medication in accordance with Texas Human Resource Code, Chapter 161, Subchapter D-1.

2. (b) A person may perform administration of medication in accordance with subsection (a)(4) of this section without the requirement that a registered nurse delegate or oversee each administration if:

   1. (1) the medication is:

      1. (A) an oral medication;
      2. (B) a topical medication; or
      3. (C) a metered dose inhaler;
   2. (2) the medication is administered to the resident for a stable or predictable condition;
   3. (3) the resident has been personally assessed by a registered nurse initially and in response to significant changes in the resident's health status, and the registered nurse has determined that the resident's health status permits the administration of medication by an unlicensed person; and

   4. (4) the unlicensed person has been:

      1. (A) trained by a registered nurse or licensed vocational nurse under the direction of a registered nurse regarding proper administration of medication; or
      2. (B) determined to be competent by a registered nurse or licensed vocational nurse under the direction of a registered nurse regarding proper administration of medication, including through a demonstration of proper technique by the unlicensed person.
3. (c) A registered nurse or a licensed vocational nurse under the supervision of a registered nurse must review the administration of medication to a resident by a person described in subsection (a)(4) of this section at least annually and after any significant change in the resident's condition.

Source Note:The provisions of this §551.43 adopted to be effective September 1, 2012, 37 TexReg 3871; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1883.