(1) An enhanced services facility providing medication service, either directly or indirectly, must:

(a) Meet the requirements of chapter 69.41 RCW regarding legend and prescription medications, and other applicable statutes and administrative rules;

(b) Develop and implement systems that support and promote safe medication service for each resident; and

(c) Ensure that each resident is monitored for desired responses and undesirable side effects of prescribed medications.

(2) The enhanced services facility must ensure residents receive their medications as prescribed, subject to the resident's right to refuse as described in this chapter.

(3) If resident requests assistance, the enhanced services facility assumes responsibility for obtaining a resident's prescribed medications and must obtain them in a correct and timely manner.

(4) The enhanced services facility must generally provide medications in the form they are prescribed when administering medications or providing medication assistance to a resident. The enhanced services facility may provide medications in an altered form consistent with the following:

(a) Alteration includes, but is not limited to, crushing tablets, cutting tablets in half, opening capsules, mixing powdered medications with foods or liquids, or mixing tablets or capsules with foods or liquids;

(b) Residents must be aware that the medication is being altered or added to their food;

(c) A pharmacist or other practitioner practicing within their scope of practice must determine that it is safe to alter a medication; and

(d) If the medication is altered, documentation of the appropriateness of the alteration must be on the prescription container, and in the resident's record.

(5) Alteration of medications for self-administration with assistance is provided in accordance with chapter 246-888 WAC.