Background:

In December of 2020 the Idaho Division of Veterans Services (IDVS) leased a Pxyis Machine also known as an Automated Dispensing Systems or ADS that secures and dispenses medications for the residents of the Pocatello Veterans Home. The lease expired and the machine has been returned to the leasing organization - Carefusion. The Pocatello Home has located a new machine to purchase that meets the needs of the facility and has passed the State of Idaho's ITS Enterprise Architecture's checks in order to have the software that comes the machine on placed on the State of Idaho's network.

Business Need:

A medication secure storage cabinet is essential in a long-term care facility to ensure the safety of residents, regulatory compliance, and proper medication management. The following points provide clear justification.

Resident Safety

Residents in long-term care facilities often have complex medical conditions and may take multiple medications. A secure storage cabinet:

• Prevents unauthorized access to medications by residents, visitors, or untrained staff.

• Reduces the risk of medication errors, misuse, or accidental ingestion.

• Protects vulnerable residents, including those with cognitive impairments such as Alzheimer's disease or Dementia, who may unintentionally access medications.

Controlled Substance Security

Many long-term care residents are prescribed medications that require strict control, including opioids or other controlled substances. A locked medication cabinet:

• Limits access to authorized licensed staff only.

• Helps prevent diversion, theft, or tampering.

• Supports accurate controlled substance counts and tracking.

Regulatory Compliance

Federal and state regulations require medications in healthcare settings to be stored securely. A medication secure storage cabinet helps facilities comply with standards from organizations such as:

• Centers for Medicare & Medicaid Services (CMS)

• Drug Enforcement Administration (DEA)

• The Joint Commission

Compliance helps the facility maintain licensure, accreditation, and eligibility for reimbursement programs.

Infection Control and Medication Integrity

Proper cabinets are designed to:

• Protect medications from contamination, environmental damage, and improper handling.

• Allow organized storage, reducing the chance of administering the wrong medication.

Accountability and Audit Readiness

Secure medication cabinets often support:

• Inventory management

• Controlled access logs

• Easier auditing and inspections

This improves traceability and accountability for medication handling.

Risk Management and Liability Reduction

Secure medication storage reduces the risk of:

• Medication diversion

• Medication administration errors

• Regulatory citations or legal liability

By ensuring medications are stored in a locked, controlled environment, the facility demonstrates due diligence in protecting residents and maintaining safe medication practices.

Description:

The machine and software found meets an important business need of securing the facilities medications (IDAPA 38.05.01.042.05(a)) and unique property requirements by ITS (IDAPA 38.05.04.042.05(b) along with meeting Drug Enforcement Administration (DEA) requirements. Furthermore – this device/vendor has its own proprietary hardware, software, and system architecture, there is no standardization from 1 vendor to the next, systems and parts are not directly interchangeable, making an apples-to-apples competitive bid difficult.

Key elements of DEA Requirement are:

• Registration and Security: Automated dispensing systems in long-term care facilities must be registered with the DEA. Storage equipment (e.g., cabinets, safes) must be secure, with access limited to authorized personnel.

• Recordkeeping: Separate, detailed records must be maintained for all drugs placed into and dispensed from the machine.

• Inventory: A physical inventory of all controlled substances in the equipment must be conducted at least every two years.

• Environmental Controls: Equipment must maintain appropriate temperature, light, humidity, and ventilation for medication storage.

• Inspection: Upon receipt, equipment and containers must be examined for damage or potential contamination.

• Specific Restrictions: The DEA prohibits pharmacies from using intermediaries (like nurses) to transport controlled substances directly to a patient's home for administration.

Alternatives:

IDVS searched online for any medication management systems that the agency could find that would meet the facilities specific need and would allow IDVS to purchase the equipment rather than lease it. IDVS found alternatives to lease different options, however, these searches did not offer the opportunity to purchase. IDVS leadership at the Veterans Home attended a national conference that had a trade show where leadership met with various vendors to search for alternatives but did not find anyone at the trade show that worked specifically with the type of medication management system the agency is looking for. The agency found 1 similar device called a Capsa NexsysADC, however what sets the Phoenix StatSafe apart is its ability to lock each individual cube within each drawer. The agency further investigated commercial tool boxes that were lockable, but they did not have the individual locking compartments nor the tracking capabilities the agency was looking for.