§ 131E-128.1. Nursing home medication management advisory committee.
§ 131E‑128.1. Nursing home medicationmanagement advisory committee.
(a) Definitions. As used in this section, unless the contextrequires otherwise, the term:
(1) "Advisory committee" means a medication managementcommittee established under this section to advise the quality assurancecommittee.
(2) "Medication‑related error" means anypreventable medication‑related event that adversely affects a patient ina nursing home and that is related to professional practice, or health careproducts, procedures, and systems, including prescribing, prescription ordercommunications, product labeling, packaging and nomenclature, compounding,dispensing, distribution, administration, education, monitoring, and use.
(3) "Nursing home" means a nursing home licensed underthis Chapter and includes an adult care home operated as part of a nursinghome.
(4) "Potential medication‑related error" means amedication‑related error that has not yet adversely affected a patient ina nursing home, but that has the potential to if not anticipated or preventedor if left unnoticed.
(5) "Quality assurance committee" means a committeeestablished in a nursing home in accordance with federal and State regulationsto identify circumstances requiring quality assessment and assurance activitiesand to develop and implement appropriate plans of action to correctdeficiencies in quality of care.
(b) Purpose. It is the purpose of the General Assembly toenhance compliance with this Part through the establishment of medicationmanagement advisory committees in nursing homes. The purpose of thesecommittees is to assist nursing homes to identify medication‑relatederrors, evaluate the causes of those errors, and take appropriate actions toensure the safe prescribing, dispensing, and administration of medications tonursing home patients.
(c) Advisory Committee Established; Membership. Every nursinghome shall establish a medication management advisory committee to advise thequality assurance committee on quality of care issues related to pharmaceuticaland medication management and use in the nursing home. The nursing home shallmaintain the advisory committee as part of its administrative duties. Theadvisory committee shall be interdisciplinary and consist of the nursing homeadministrator and at least the following members appointed by the nursing homeadministrator:
(1) The director of nursing.
(2) The consultant pharmacist.
(3) A physician designated by the nursing home administrator.
(4) At least three other members of the nursing home staff.
(d) Meetings. The advisory committee shall meet as needed butnot less frequently than quarterly. The Director of Nursing or StaffDevelopment Coordinator shall chair the advisory committee. The nursing homeadministrator shall ensure that a record is maintained of each meeting.
(e) Confidentiality. The meetings or proceedings of theadvisory committee, the records and materials it produces, and the materials itconsiders, including analyses and reports pertaining to medication‑relatederror reporting under G.S. 131E‑128.2 and G.S. 131E‑128.5 andpharmacy reports on drug defects and adverse reactions under G.S. 131E‑128.4,shall be confidential and not be considered public records within the meaningof G.S. 132‑1. The meetings or proceedings and records and materials alsoshall not be subject to discovery or introduction into evidence in any civilaction against a nursing home or a provider of professional health servicesresulting from matters that are the subject of evaluation and review by the committee.No person who was in attendance at a meeting of the committee shall testify inany civil action as to any evidence or other matters produced or presentedduring the meetings or proceedings of the committee or as to any findings,recommendations, evaluations, opinions, or other actions of the committee orits members. Notwithstanding the foregoing:
(1) Information, documents, or records otherwise available,including any deficiencies found in the course of an inspection conducted underG.S. 131E‑105, shall not be immune from discovery or use in a civilaction merely because they were presented during meetings or proceedings of theadvisory committee. A member of the advisory committee or a person whotestifies before the committee may testify in a civil action but cannot beasked about that person's testimony before the committee or any opinion formedas a result of the committee meetings or proceedings.
(2) Information that is confidential and not subject todiscovery or use in civil actions under this subsection may be released to aprofessional standards review organization that performs any accreditation orcertification function. Information released to the professional standardsreview organization shall be limited to information reasonably necessary andrelevant to the standards review organization's determination to grant orcontinue accreditation or certification. Information released to the standardsreview organization retains its confidentiality and is not subject to discoveryor use in any civil action as provided under this subsection. The standardsreview organization shall keep the information confidential subject to thissubsection.
(3) Information that is confidential and not subject todiscovery or use in civil actions under this subsection may be released to theDepartment of Health and Human Services pursuant to its investigative authorityunder G.S. 131E‑105. Information released to the Department shall belimited to information reasonably necessary and relevant to the Department'sinvestigation of compliance with Part 1 of Article 6 of this Chapter.Information released to the Department retains its confidentiality and is notsubject to discovery or use in any civil action as provided in this subsection.The Department shall keep the information confidential subject to thissubsection.
(4) Information that is confidential and is not subject todiscovery or use in civil actions under this subsection may be released to anoccupational licensing board having jurisdiction over the license of anindividual involved in an incident that is under review or investigation by theadvisory committee. Information released to the occupational licensing boardshall be limited to information reasonably necessary and relevant to aninvestigation being conducted by the licensing board pertaining to theindividual's involvement in the incident under review by the advisorycommittee. Information released to an occupational licensing board retains itsconfidentiality and is not subject to discovery or use in any civil action asprovided in this subsection. The occupational licensing board shall keep theinformation confidential subject to this subsection.
(f) Duties. The advisory committee shall do the following:
(1) Assess the nursing home's pharmaceutical management system,including its prescribing, distribution, administration policies, procedures,and practices and identify areas at high risk for medication‑relatederrors.
(2) Review the nursing home's pharmaceutical management goalsand respond accordingly to ensure that these goals are being met.
(3) Review, investigate, and respond to nursing home incidentreports, deficiencies cited by licensing or credentialing agencies, andresident grievances that involve actual or potential medication‑related errors.
(4) Identify goals and recommendations to implement bestpractices and procedures, including risk reduction technology, to improvepatient safety by reducing the risk of medication‑related errors.
(5) Develop recommendations to establish a mandatory,nonpunitive, confidential reporting system within the nursing home of actualand potential medication‑related errors.
(6) Develop specifications for drug dispensing andadministration documentation procedures to ensure compliance with federal andState law, including the North Carolina Nursing Practice Act.
(7) Develop specifications for self‑administration ofdrugs by qualified patients in accordance with law, including recommendationsfor assessment procedures that identify patients who may be qualified to self‑administertheir medications.
(g) Penalty. The Department may take adverse action againstthe license of a nursing home upon a finding that the nursing home has failedto comply with this section, G.S. 131E‑128.2, 131E‑128.3, 131E‑128.4,or 131E‑128.5. (2003‑393, s. 1.)