As you may be aware, the insulin pens administered to your residents have stability limits. The following chart includes the stability of in-use pens at room temperature. We recommend that when a pen is first used, to label it with the date and adhere to the following manufacturer’s recommendations:

Levemir FlexPen                              42 days

NovoLog FlexPen                            28 days

NovoLog Mix 70/30 FlexPen         14 days

Humalog KwikPen                          28 days

Humalog Mix 75/25 KwikPen        10 days

Humalog Mix 50/50 KwikPen        10 days

Humulin N prefilled pen                 14 days

Humulin 70/30 prefilled pen          10 days

Apidra Solostar                                 28 days

Lantus Solostar                                28 days

Note: For any unopened insulin pen which has been refrigerated, the expiration date listed on the pen may still be observed.

CCDET developed a program to certify instructors and maintain a database of instructors and caregivers. During the first year of the program from April 1, 2010 to March 31, 2011, there were 1,351 instructors approved by CCDET to teach First Aid and Choking, Fire Safety, Medication Administration, and Standard Precautions. During this time period, approved instructors taught 10,311 classes to 30,867 participants! The Bureau of Assisted Living congratulates CCDET and the assisted living industry on this remarkable accomplishment.

Prior to the new requirements, data shows that initial CBRF staff training consistently ranked in the Bureau of Assisted Living’s Top 10 Citations. Since the implementation of the new training requirements, data shows that initial CBRF staff training is no longer ranked in the Top 10 Citations. This trend in improved compliance is a testament to the initiative and hard work of the Department, CCDET, and the assisted living industry.

Amy Consolazione, PharmD, RPh

Prescriptions Plus

10233 W. Greenfield Ave.

West Allis, WI 53214

(414) 727-5755

If an enrollee does not enroll in a Part D Plan during the Annual Enrollment Period they will be without a Medicare prescription drug plan for the following year. Important changes are highlighted below on what enrollees need to know about enrolling in a Part D Plan for 2012:

• The enrollment period for 2012 Part D Plans will begin on October 15, 2011 and end on December 7, 2011. This is a change from years past when you were able to enroll between November 15th and December 31st.
• The last application submitted during the Annual Enrollment Period will become effective on January 1, 2012. In other words if you submit an application but change your mind, as long as you are still in the enrollment period, you can submit another application.
• The plan you choose during the enrollment period cannot be changed after the enrollment period ends. The Open Enrollment Period that allowed changes between January 1st and March 31st was eliminated in 2011 and will not be available in 2012.

Compare 2012 Part D Plans Early - Plan information should be made available earlier this year to accommodate the moved up time frame for the Annual Enrollment Period.

For further information please click here for the Centers for Medicare & Medicaid Services (CMS) Announcement of Calendar Year (CY) 2012.

Notice that the regulations state “at least quarterly”; this means that if resident behaviors, side effects or dosage increases or reductions occur in between regularly scheduled reviews, that additional reviews may be indicated and expected.

These reviews must be done by a practitioner, registered nurse or pharmacist.  A practitioner is defined as a person licensed in Wisconsin to prescribe and administer drugs or licensed in another state and recognized by this state as a person authorized to prescribe and administer drugs. Note that this list does NOT include a licensed practical nurse (LPN).

Three things that should be included in these reviews are:

1. Is the resident achieving very specific behavioral goals?
2. Is the resident experiencing any side effects of the medications?
3. Is a gradual dosage reduction attempt appropriate?

When a psychotropic medication is ordered for a resident:

1. See that the service plan (care plan) includes specific rationale for its use and a detailed description of the behaviors which indicate the need for administration of the PRN medication
2. monitor for any inappropriate use of the PRN medications
3. monitor for proper documentation of the effectiveness of the medication given, the presence of any side effects, and watching for any inappropriate use of the medications.

If needed, Prescriptions Plus can provide you with forms to assist in your compliance with DHS 83 regulations:

• Psychotropic Medication Regimen Review Worksheet (form PH-13)
• Chronological Record of Psychotropic Medication Regimen Reviews (form PH-12)
• Antipsychotic Medication Quarterly Evaluation/AIMS (Med-Pass form MP5562)

Please let us know how we can help.