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Job aids

Centrally stored medications: the steps to remember

The short step lists from each lesson of Centrally stored medications: storage, counts, refills and records, on one page. Print it for the station or the break room. Each list points back to its lesson, where the sources are linked.

Open the coursePrint a poster with a QR code

Decision guide

A prescription medication is no longer used here. Where does it go?

Can you read from the label whose medication it is and what it is?

  • Yes

    Are her services here ending, and is she taking it with her?

    • Yes

      It goes with her in its own container. Follow your home's procedure for handing it over, and tell your supervisor.

    • No

      Is the home returning it to the pharmacy that issued it?

      • Yes

        Keep it locked until it goes back to the issuing pharmacy, under your home's procedure.

      • No

        Has her physician ordered it kept in the home, and is that written in her record?

        • Yes

          It stays centrally stored: locked, in its own container, on her record.

        • No

          Is a hospice disposing of it under the hospice's own established procedures?

          • Yes

            The hospice's established procedures apply. Tell your supervisor, and keep it locked until the hospice acts.

          • No

            Keep it locked and tell the administrator. The administrator and one other adult who is not a resident destroy it in the home, and both sign a record kept at least three years.

  • No

    Keep it locked and set apart. Do not guess or relabel it. Tell your supervisor; only the dispensing pharmacist may alter a label.

A job aid, not a rule book. It does not replace the physician's orders, the hospice's procedures or your facility's procedures. Whether a medication is still needed is the physician's decision. Call 911 for an imminent threat to health.

Step through it one question at a time: alwbeta.com/training/courses/centrally-stored-medications#decision-guide

Lesson 1

When a medication must be centrally stored

Most residents keep and take their own medications. Some medications must be kept by the home instead. This lesson gives you the three reasons the rule names, and who decides each one, so you know when a medication belongs in the home's locked storage.

  1. Needs a refrigerator and she has none of her own: centrally stored
  2. Physician finds it hazardous in her hands: centrally stored
  3. Physician, administrator or Department finds it a hazard to others: centrally stored
  4. Not sure? Tell your supervisor; do not decide alone
  5. Her record lists her current centrally stored medications

Lesson: alwbeta.com/training/courses/centrally-stored-medications#lesson-csm-when

Lesson 2

Locked, labeled and in the original container

Once a medication is centrally stored, the rules say how it is kept. They cover who can reach it, what the label shows, who may change the label and what container it stays in. This lesson helps you decide whether a cabinet, a key or a bottle meets those rules.

  1. Locked; only the employees who supervise the medications can reach them
  2. Refrigerated medications are locked too
  3. Label: resident, physician, drug, strength, quantity, date filled, Rx number, pharmacy, expiration, refills
  4. Only the dispensing pharmacist changes a label
  5. Original container; never pour from one container to another

Lesson: alwbeta.com/training/courses/centrally-stored-medications#lesson-csm-storage

Lesson 3

The centrally stored medication record and LIC 622

Every centrally stored prescription has a record behind it. A licensing analyst may read it, and the next shift relies on it. This lesson shows what the record must hold, what CDSS form LIC 622 adds, and how long the record is kept, so you can tell whether a record is complete.

  1. Each resident: a record of centrally stored prescriptions, kept at least one year
  2. Resident, physician, drug, strength, quantity, date filled, Rx number, pharmacy
  3. Any control and custody instructions
  4. LIC 622 Part I: also expiration date, date started and refills
  5. Dosage record when the physician or the Department asks

Lesson: alwbeta.com/training/courses/centrally-stored-medications#lesson-csm-record

Lesson 4

Deliveries, counts, refills and running out

Pharmacy deliveries arrive, pills get used and refills run low. When the numbers do not add up, it is tempting to fix it fast. This lesson shows what the rules say and what they leave to your home's procedures, so you report a problem instead of hiding it.

  1. Count the way your home's procedure says
  2. Delivery: check the name, drug, strength and quantity against the record before storing
  3. Count does not match: write what you counted, tell your supervisor
  4. Never pour, borrow or change a label to fix a count
  5. Few refills left: tell your supervisor early
  6. Ran out: no borrowing; your supervisor reaches the physician

Lesson: alwbeta.com/training/courses/centrally-stored-medications#lesson-csm-counts

Lesson 5

Medications that leave the home, and destruction

A resident moves out. A physician stops a medication. A hospice resident dies. Each time, prescription medications are left in the cabinet. The rule gives them a short list of paths. This lesson prepares you to choose the right one, and to destroy a medication only the way the rule allows.

  1. Services end: medications may go with her, in their own containers
  2. Or: back to the pharmacy, kept by physician order in her record, or hospice procedures
  3. Otherwise: administrator plus one adult who is not a resident destroy it in the home
  4. Both sign: resident, Rx number, pharmacy, drug, strength, quantity, date
  5. Storage record at least one year; destruction record at least three years

Lesson: alwbeta.com/training/courses/centrally-stored-medications#lesson-csm-leaving

Beta’s ALW team, course version 2026.10.4, text checked against its sources on October 22, 2026. Educational only. Not continuing-education, licensure or regulatory credit. Follow your employer’s current procedure and the person’s current plan. Call 911 for a medical emergency.

Call the ALW teamFit check