Section 141.207 - Pharmaceutical Services and Medications(A) All hospices shall maintain current written policies and procedures regarding the administration and recording of drugs and biologicals.(B) Hospices shall comply with all federal and state laws and regulations (including 105 CMR 700.000: Implementation of M.G.L. c. 94C) relating to the procurement, storage, dispensing, administration, recording and disposal of drugs.(C) No drug or medication that has been removed from the market by the Food and Drug Administration shall be stocked or administered by a hospice.(D) The hospice shall make arrangements for 24-hour availability of medications. If the hospice program admits pediatric patients, it shall provide age and size appropriate drug administration and dosing.(E) There shall be a current written order by a physician, nurse practitioner or physician assistant in the patient's clinical record for all medications or drugs administered by hospice staff to the patient. All drugs and medications the patient receives shall be recorded on a profile sheet which shall be kept as part of the patient's clinical record.(1) Verbal or telephone orders shall be given only to a licensed nurse and shall be immediately recorded in writing in the patient's clinical record and signed by the same nurse. All verbal or telephone orders shall be countersigned by a physician, physician assistant or nurse practitioner within 21 days.(2) If medications for a patient are ordered by a physician assistant or nurse practitioner, there shall be a general review of medications by the physician assistant or nurse practitioner and the supervising physician as specified in 105 CMR 700.000: Implementation of M.G.L. c. 94C.(3) Orders for medication and treatments shall be in effect for the specific number of days indicated by the physician, physician assistant or nurse practitioner.(4) Hospice staff administering drugs shall be appropriately licensed to carry out this function.(F) The Primary Care Givers and each drug and biological they are instructed to administer must be specified in the patient's plan of care.(G) All medications administered by the hospice staff shall be accurately recorded in the patient's clinical record with the signature of the person administering the medication.(H) Hospice staff, patients/families and Primary Care Givers shall be made aware of the signs and symptoms, of the side effects of drug therapy.(I) Hospice staff shall have access to references for drug interaction and drug dosing.Amended by Mass Register Issue 1358, eff. 2/9/2018.