A. Any person regulated by this chapter shall, while on duty, wear identification that is clearly visible to the client and that indicates the appropriate title issued to such person by the board under which the person is practicing in that setting. Name identification on a badge shall follow the policy of the assisted living facility in which the medication aide is employed.

B. A medication aide or advanced registered medication aide who has changed his name shall submit as legal proof to the board a copy of the marriage certificate, a certificate of naturalization, or a court order evidencing the change. A duplicate certificate shall be issued by the board upon receipt of such evidence.

C. A medication aide or advanced registered medication aide shall maintain an address of record with the board. Any change in the address of record or in the public address, if different from the address of record, shall be submitted electronically or in writing to the board within 30 days of such change. All notices required by law and by this chapter to be sent by the board to any registrant shall be validly given when sent to the latest address of record on file with the board.

A. The following fees shall apply:

B. Fees shall not be refunded once submitted.

C. The fee for the state examination shall be paid directly to the examination service contracted by the board for its administration.

A. A medication aide shall:

1. Document and report all medication errors and adverse reactions immediately to the licensed health care professional in the facility or to the client's prescriber;

2. Give all medications in accordance with the prescriber's orders and instructions for dosage and time of administration and document such administration in the client's record; and

3. Document and report any information giving reason to suspect the abuse, neglect, or exploitation of clients immediately to the licensed health care professional in the facility or to the facility administrator.

B. A medication aide shall not:

1. Transmit verbal orders to a pharmacy;

2. Make an assessment of a client or deviate from the medication regime ordered by the prescriber;

3. Mix, dilute, or reconstitute two or more drug products, with the exception of insulin or glucagon;

4. Administer by intramuscular or intravenous routes or medications via a nasogastric or percutaneous endoscopic gastric tube; or

5. Administer by subcutaneous route, except for insulin medications, glucagon, or auto-injectable epinephrine.

C. An advanced registered medication aide working in an assisted living facility shall abide by the limitations included in this section.

In order to be registered as an advanced registered medication aide, an applicant shall:

1. Hold both a current Virginia certification as a certified nurse aide and as a registered medication aide or be eligible for endorsement as a registered medication aide;

2. Have successfully completed a minimum of 60 hours of advanced training in a nursing facility that includes population and medication specific training; and

3. Submit the required application and fee.

A. Current certification as a nurse aide in Virginia must be maintained to hold certification as an advanced registered medication aide. If an individual is not eligible to renew as a certified nurse aide, registration as an advanced registered medication aide may not be renewed.

B. Advanced registered medication aides shall renew annually. To renew an advanced registration, an individual must:

a. Submit the renewal application and required fee; and

b. An attestation that the individual has completed continuing education as required in 18VAC90-60-100(B) and four hours nursing facility population and medication specific training.

C. Failure to receive a notice for renewal shall not relieve the advanced registered medication aide of the responsibility for renewing the registration by the expiration date.

D. The registration shall automatically lapse if the advanced registered medication aide fails to renew by the expiration date.

E. Any person administering medications in an assisted living facility or licensed nursing home during the time a registration has lapsed shall be considered an unlicensed practitioner and shall be subject to prosecution under the provisions of § 54.1-3008 of the Code of Virginia.

F. If an advanced registered medication aide has not renewed for 90 days following the expiration date, the advanced registration shall only be reinstated if the applicant:

a. Holds current certification as a nurse aide in Virginia;

b. Submits a completed reinstatement application on a form provided by the board;

c. Pays the reinstatement fee; and

d. Provides evidence that the applicant has completed all required hours of continuing education and training.

A. An advanced registered medication aide shall:

1. Document and report all medication errors and adverse reactions immediately to the licensed health care professional in the facility or to the client's prescriber;

2. Give all medications in accordance with the prescriber’s orders and instructions for dosage and time of administration and document such administration in the client’s record; and

3. Document and report any information giving reason to suspect the abuse, neglect, or exploitation of clients immediately to the licensed health care professional in the facility or to the facility administrator.

B. An advanced registered medication aide shall not:

1. Transmit verbal orders to a pharmacy;

2. Make an assessment of a client or deviate from the medication regime ordered by the prescriber;

3. Mix, dilute, or reconstitute two or more drug products, with the exception of insulin or glucagon;

4. Administer intravenous medications or medications via a nasogastric or percutaneous endoscopic gastric tube or intramuscular medication except for vaccinations and auto-injectable epinephrine; or

5. Administer by subcutaneous route, except for insulin medications, glucagon, glucagon-like peptide-1, Vitamin B12, or anticoagulants.

C. An advanced registered medication aide working in an assisted living facility shall abide by the limitations included in section 110.

The board has the authority to deny, revoke, or suspend a registration issued, or to otherwise discipline a registrant upon proof that the registrant has violated any of the provisions of § 54.1-3007 of the Code of Virginia.

1. Fraud or deceit in order to procure or maintain a registration includes:

a. Filing false credentials;

b. Falsely representing facts on an application for initial registration, reinstatement or renewal of a registration; or

c. Giving or receiving assistance in taking the competency evaluation.

2. Unprofessional conduct includes;

a. Performing acts beyond those authorized by the Code of Virginia and this chapter for practice as an advanced registered medication aide;

b. Assuming duties and responsibilities within the practice of an advanced registered medication aide without adequate training or when competency has not been maintained;

c. Obtaining supplies, equipment or drugs for personal or other unauthorized use;

d. Falsifying or otherwise altering client or drug records relating to administration of medication;

e. Falsifying or otherwise altering employer records, including falsely representing facts on a job application or other employment-related documents;

f. Abusing, neglecting or abandoning clients;

g. Having been denied a license, certificate, or registration or having had a license, certificate, or registration issued by the board revoked or suspended;

h. Giving to or accepting from a client property or money for any reason other than fee for service or a nominal token of appreciation;

i. Obtaining money or property of a client by fraud, misrepresentation or duress;

j. Entering into a relationship with a client that constitutes a professional boundary violation in which the advanced registered medication aide uses a professional position to take advantage of a client’s vulnerability, to include actions that result in personal gain at the expense of the client, an inappropriate personal involvement or sexual conduct with a client;

k. Violating state laws relating to the privacy of client information, including § 32.1-127.1:03 of the Code of Virginia;

l. Failing to follow provisions of the Medication Management Plan for the facility in which the advanced registered medication aide is employed; or

m. Violating any provision of this chapter, including the standards of practice as set forth in 18VAC90-60-150.

3. A pattern of medication errors may constitute practice that presents a danger to the health and welfare of clients or to the public as referenced in subdivision 5 of § 54.1-3007 of the Code of Virginia.