Medication aides in nursing homes: A push to save money or improve patient care?

A bill in the Tennessee Legislature would create a new ‘medication aide’ position in nursing homes. The bill would allow medication aides to administer medication under the supervision of licensed nurses as opposed to a registered nurse—a more advanced position. Applicants for the new position would need a high school diploma, one year experience as a nurses aide in a nursing home, and passage of a standardized exam.

An improvement to patient care or simply cutting corners?

Proponents of the bill claim the creation of a new group of medication aides will free up more experienced nurses to work directly with patients as opposed to dispensing routine medications. According to bill sponsor, Debra Young Maggart (R-Hendersonville, Tennessee), the bill could eventually reduce medication errors caused by over-extended nurses. The secondary benefit to some would be an inherent cost savings by hiring lesser credentialed employees.

The bill’s opponents worry that the credentialing requirements are insufficient for a job where a slight error could cost a life. Not surprisingly, some of the bills most vocal opponents are nurses groups who are quick to point out that there are thousands of drugs available in the United States and medication aides with limited training are simply unable to have a mastery of all of them.

Medication errors continue to climb each year. By some accounts, 1.5 million people are injured on an annual basis due to medication errors. In a study completed by The Institute of Medicine, 800,000 of the injuries occurred in the long-term care setting.

The Tennessee bill is currently in subcommittee. If passed, Tennessee would join the majority of other states that allow medication aides to dispense medication in nursing homes and long-term care facilities. Read more about this proposed nursing home legislation here.

I tend to think nurses aides can be a good idea in settings where common medications are dispensed on a regular basis. The argument that a medication aide should have a mastery of every medication available is ridiculous! Is it really fair (or necessary) to expect them to be intimately familiar with medications that would rarely be dispensed in a long-term care setting?


Preventing Medication Errors, Annals of Long-Term Care by Richard G. Stefanacci, DO, MGH, MBA, AGSF, CMD

Jonathan Rosenfeld is a lawyer who represents people injured in nursing homes and long-term care facilities. Visit his personal blog at

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