Returning Medications to the Pharmacy

EVIDENCE TYPE

Return receipt or log entry for each returned medication · Controlled substance return documented separately · Disposition of returned medications recorded (destroyed or returned to stock per applicable law)

Audience

Pharmacists, pharmacy technicians, delivery staff

Returned medications in LTC@H arise for several reasons: a stop order was processed after a fill was already delivered, a patient was hospitalized and medications were not used, a dose change left excess stock, or a patient died. Each scenario requires a documented return process. Returned medications cannot simply be restocked — most states prohibit restocking returned medications, and controlled substances have specific DEA return requirements. A clear return policy protects the pharmacy from liability and ensures medication disposal is handled safely.

RETURNING MEDICATIONS TO PHARMACY

Policy

Non-narcotic medications must be returned within (check state requirements) hours per State Board of Pharmacy Reg. Bank (check state requirements) for credit to be given. Narcotic medications must be refused upon delivery, otherwise they may not be returned.

Medications may be returned for credit if the following conditions exist:

1. Full and unopened cards or unit dose boxes may be returned.
2. Liquids may be returned if seal has not been broken.
3. Injectables, that do not require refrigeration, may be returned if the seal has not been broken.
4. I.V. Prescriptions may not be returned.
5. Compounded prescriptions may not be returned.
6. Partial prescriptions may not be returned for credit.

All narcotic medications must be returned to the State Health Department for destruction.

Procedures

1. A “Return Medication Form” must be filled out and faxed to the pharmacy to request a medication pick-up. These forms are provided to each facility by the pharmacy.

A. The facility name and date must be written at the top of the form.
B. All columns of the form must be filled out.
▪ RX Date
▪ Patient Name
▪ RX#
▪ Drug and Strength
▪ QTY
▪ Nurse
▪ Reason for Return
C. The reason for returning the medication must be indicated in the “Reason for Return” column in order
for the medication to be considered for credit. Acceptable reasons include:
▪ Patient in Hospital/Discharged
▪ Medication was discontinued
▪ Medication dosage was changed
▪ Patient is now in a Medicare/Skilled bed
▪ Patient now uses another pharmacy for medications
▪ Other (must specify)

2. The nurse's initials must be included as an indication that the medication is full and unopened.

3. Upon pick-up, the pharmacy driver must sign and date the bottom of the “Return Medication Form.”

4. Medications not meeting these criteria will be destroyed.

• Return log with entry for every returned medication
• Separate documentation for controlled substance returns
• Disposition record showing whether returned medications were restocked or destroyed

• Restocking returned medications without verifying your state allows it — most states prohibit restocking returned medications
• No return log — a returned medication with no record creates an inventory discrepancy
• Controlled substance returns not segregated immediately — commingling returned controlled substances with other returns creates chain-of-custody issues