A0054: Medication records (MAR)

AHCA cited A0054 196 times at 182 of Florida’s 1,171 small ALFs between July 2023 and July 2026. It’s the seventh most cited tag.

What a surveyor looks at

59A-36.008(5), F.A.C.

A0054 is the medication observation record, the sheet where every dose gets initialed. Under rule 59A-36.008(5), you keep one for each resident your staff help with medication. The same rule asks for the listing behind a nurse-filled pill organizer, and a physician’s yearly evaluation of any medication used as a chemical restraint. The classic citation is a blank box, because a dose with no initials is a dose nobody can account for.

If you’ve got an older guide that calls this 59A-36.008(3), it’s out of date. The rule was renumbered in June 2025.

The paper this tag asks for

There are 4 documents under this tag, and each one applies only when something is true of your home or a resident. Having every one of them is not the same as passing a survey, because a surveyor also reads what’s in them and watches your home run.

Documents a small Florida ALF needs under A0054 only when a condition is true.
Only when it applies	Renews
Medication observation record59A-36.015(3)(h)The home manages a pill organizer, helps with self-administration, or administers medication.	When it changes
Federal CLIA certificate59A-36.008(4)(d)Facility staff perform laboratory tests for residents, blood glucose testing included. Not needed if residents test themselves, or if a third party or facility staff assist using the resident's own equipment.	Date printed on it
Medication listing59A-36.008(5)(a)The resident uses a nurse-managed pill organizer and the home did not keep the original labelled container.	When it changes
Chemical restraint annual physician evaluation59A-36.008(5)(c)The resident takes a medication that serves as a chemical restraint.	Every year

The rule’s own words

Medication observation record, 59A-36.015(3)(h), F.A.C.: (h) For facilities that manage a pill organizer, assist with self-administration of medications or administer medications for a resident, copies of the required medication records maintained pursuant to Rule 59A-36.008, F.A.C.
Federal CLIA certificate, 59A-36.008(4)(d), F.A.C.: A valid copy of the federal CLIA Certificate must be maintained in the facility.
Medication listing, 59A-36.008(5)(a), F.A.C.: For residents who use a pill organizer managed in subsection (2), the facility must keep either the original labeled medication container; or a medication listing with the prescription number, the name and address of the issuing pharmacy, the health care provider’s name, the resident’s name, the date dispensed, the name and strength of the drug, and the directions for use.
Chemical restraint annual physician evaluation, 59A-36.008(5)(c), F.A.C.: For medications that serve as chemical restraints, the facility must, pursuant to Section 429.41, F.S., maintain a record of the prescribing physician’s annual evaluation of the use of the medication.

What Alfie does here

This is the one record Alfie makes instead of asking you for. Caregivers mark each dose on the tablet as it happens, so a dose nobody recorded shows up the same day. When a surveyor wants paper, you print the month.

We don’t type in your old paper sheets. They stay in your binder, and Alfie’s record starts the day you do.

If you’ve just been cited for A0054, the plan of correction is yours to write, and Alfie won’t write it for you. Where Alfie helps is the next survey, so the same paper isn’t missing again.

How Alfie works$149 a month for the whole home. Setup done for you.

The other nine

All 25 tags, and how we counted them, are on the citations page. Every document in one list, sorted by file, is on the documents page.