Morphine Administration in an RCFE

This week’s Tuesday Tip is in response to one of the most common questions we are asked:

What are the regulations/best practice in an RCFE for the administration of morphine to residents who are able to assist and to those who are not able to assist (ex. bedridden hospice resident)?


Here are the options in this situation:

If the resident can participate in self-administration with assistance:

A trained caregiver/med aide may assist the resident with self administration.

If the resident CANNOT participate in self-administration with assistance:

The medication must be administered by a licensed medical professional, or if the resident is on hospice by a family member or friend who is trained by the hospice agency.

These requirements actually apply to most medications, not just morphine.

Care & Compliance Training

10 Responses to “Morphine Administration in an RCFE”

  1. What happens if the resident doesn’t have family and friends and she is unable to give morphine to herself. Who can give the morphine if it is needed every 4-6 hours?

  2. Hello Lynn… In that situation it would need to be administered by a licensed medical professional. Such as an RN or LVN/LPN.

  3. How can this work if the RN only comes twice a week? Can an exception be requested for regulation 87633 to allow caregivers to administer morphine? Can families contact licensing that they cannot be available every 4-6 hours to give morphine? They cannot even hire someone to give it… if I am reading it correctly.

  4. Hello Lynn… You would need to either:

    1. Hire an outside RN/LVN to come in.
    2. Ask the hospice agency if they can do it.
    3. Not retain the resident.

  5. Hi there I have a question for you who is allowed to minister morphine and would hospice tell someone that is not a licensed to go ahead and overdose their partner with 5ml of extra morphine as he is dying anyway.

  6. Gary… It depends on what state you are in, but in California medications can only be “administered” by the resident of a licensed medical professional. If the resident is on hospice, it is acceptable for a trained friend or family member to administer the medications.

  7. Can a private caregiver in the state of Arizona who is hired/paid by a family administer medication or morphine to a patient?

  8. I live in Nevada and was hired by a cargiver agency to just sit with my client , cook a few meals etc a few hours a day. After 3 years with him, he is now on Hospice and the agency says I MUST administer morphine and fentanyl every two hours and sometimes Hospice forgets to re fill the syringes (oral ones) and the unlicensed caregivers have to do it. I refused and quit. I am not licensed to do this. He has no family. Is this legal to administer this srong drug to someone and I don’t know what I am doing? All of the caregivers tell me they do it all the time on other caregiving positions when they do Hospice work,,

  9. Can a caregiver prepare dose of oral morphine for hospice patient?

  10. I wanted to find additional medication training for my staff that are going into their second year of employment and I understand I have to provide them with 4 hours of continuing education training in medications.
    I am using some of yours however that’s only 2 hrs what other ones would you recommend?

    Thanks, Lisa

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