SECTION 310:661-5-8. Drugs and Biologicals, Medical Supplies, Durable Medical Equipment

(a)   General. Medical supplies and appliances; durable medical equipment; and drugs and biologicals related to the palliation and management of the terminal illness and related conditions, as identified in the hospice plan of care, shall be provided by the hospice while the patient is under hospice care.

(b)   Managing drugs and biologicals.

(1)   The hospice shall ensure that the interdisciplinary group confers with an individual with education and training in drug management as defined in hospice policies and procedures and State law, who is an employee of or under contract with the hospice to ensure that drugs and biologicals meet each patient's needs.

(2)   A hospice that provides inpatient care directly in its own facility shall provide pharmacy services under the direction of a qualified licensed pharmacist who is an employee of or under contract with the hospice. The provided pharmacist services shall include evaluation of a patient's response to medication therapy, identification of potential adverse drug reactions, and recommended appropriate corrective action.

(c)   Ordering of drugs.

(1)   Only a icensed independent practitioner with prescriptive authority, in accordance with the plan of care and State law, may order drugs for the patient.

(2)   If the drug order is verbal or given by or through electronic transmission:

(A)   It shall be given only to a licensed health care practitioners within their scope of practice under state law and authorized by hospice policy to receive verbal orders; and

(B)   The individual receiving the order shall record and sign it immediately and have the prescribing person sign it in accordance with State and Federal regulations.

(d)   Dispensing of drugs and biologicals. The hospice shall obtain drugs and biologicals from community or institutional pharmacists or stock drugs and biologicals itself.

(e)   Administration of drugs and biologicals. The interdisciplinary group, as part of the review of the plan of care, shall determine the ability of the patient and/or family to safely self-administer drugs and biologicals to the patient in his or her home.

(f)   Labeling, disposing, and storing of drugs and biologicals.

(1)   Labeling. Drugs and biologicals shall be labeled in accordance with currently accepted professional practice and shall include appropriate usage and cautionary instructions, as well as an expiration date (if applicable).

(2)   Disposing. The hospice shall have written policies and procedures for the management and disposal of controlled drugs in the patient's home. At the time when controlled drugs are first ordered the hospice shall:

(A)   Provide a copy of the hospice written policies and procedures on the management and disposal of controlled drugs to the patient or patient representative and family;

(B)   Discuss the hospice policies and procedures for managing the safe use and disposal of controlled drugs with the patient or representative and the family in a language and manner that they understand to ensure that these parties are educated regarding the safe use and disposal of controlled drugs; and

(C)   Document in the patient's clinical record that the written policies and procedures for managing controlled drugs was provided and discussed.

(g)   Use and maintenance of equipment and supplies.

(1)   The hospice shall ensure that manufacturer recommendations for performing routine and preventive maintenance on durable medical equipment are followed. The equipment shall be safe and work as intended for use in the patient's environment. Where a manufacturer recommendation for a piece of equipment does not exist, the hospice shall ensure that repair and routine maintenance policies are developed. The hospice may use persons under contract to ensure the maintenance and repair of durable medical equipment.

(2)   The hospice shall ensure that the patient, where appropriate, as well as the family and/or other caregiver(s), receive instruction in the safe use of durable medical equipment and supplies. The hospice may use persons under contract to ensure patient and family instruction. The patient, family, and/or caregiver shall be able to demonstrate the appropriate use of durable medical equipment to the satisfaction of the hospice staff.

[Source: Added at 26 Ok Reg 2042, eff 6-25-09]