Assisting with PRN Medication

This week a Tuesday Tip subscriber asked us for clarification on assisting residents with PRN medications.  This is a common area of confusion for providers and caregivers.  Fortunately this is addressed in RCFE Regulation 87465, which clarifies that the amount of assistance that can be provided and when the physician must be called is based on the resident’s ability to communicate his/her symptoms and/or need for the PRN medication.

Scenario 1: Able to Determine and Communicate Need
If the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, properly trained staff may assist with the medication.

Scenario 2: Able to Communicate Symptoms
If the resident is unable to determine the need for a nonprescription PRN medication but can communicate his/her symptoms clearly, properly trained staff may assist with the medication.

Scenario 3: Unable to Determine Need and Unable to Communicate Symptoms
If the resident is unable to determine his/her need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms, properly trained staff can assist with the medication but must contact the physician prior to each dose.  Obviously this creates a practical challenge that may be very difficult to actually implement.  Work with the resident and physician to see if it is possible to communicate the symptoms.

If the resident fits into “scenario 1” or “scenario 2” the physician does not have to be contacted prior to each dose.

Review Regulation 87465 for other requirements related to PRN medications, including physician documentation that must be maintained.

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