As part of the LTCF admission process, and prior to administering any take-home methadone, the LTCF shall review all prescription orders, including the take-home methadone documentation obtained from the OTP, to ensure that medications prescribed at the LTCF are not contraindicated due to interactions with the currently prescribed medications for medical conditions.
The LTCF shall establish a procedure for obtaining take-home methadone doses from the resident’s OTP. The procedure shall include instructions for secure transport of the drugs, transfer documentation, and completion of a chain of custody form. The LTCF shall ensure that all take-home methadone doses received from the OTP are properly packaged and labeled. Once the methadone is in the custody of the LTCF, the facility shall store the drugs in a double-locked secure area in the LTCF nursing unit, administer the drugs consistent with Department of Public Health (Department) regulations at 105 CMR 700.000 and 105 CMR 150.008(D) and applicable federal regulations, and document each administration in the resident’s record.
When residents using methadone for medication assisted treatment are discharged from the LTCF, the residents may take all remaining methadone doses with them, if they have a written order from the OTP physician to do so. If the resident dies or if the take-home medication is only available to the patient until the patient is ambulatory or the medication is discontinued, the LTCF shall destroy the medication in compliance with Drug Enforcement Administration (DEA) and the Department’s Office of Prescription Monitoring and Drug Control rules, as with all medications.