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Medication Aides: Nursing Homes and Hospices

To give medications to Wisconsin nursing home residents and hospice patients, unlicensed staff must meet certain requirements. This page describes those requirements. It also provides information for instructors of medication aide training programs.


Unlicensed staff may give medications to nursing home residents and hospice patients if they've completed a training program approved by the Wisconsin Department of Health Services (DHS).

Medication aide programs and requirements

For a list of approved programs throughout the state, see Medication Aide: Approved Programs.

Contact a specific program for information. Each program can provide details on its times, schedule, cost, and how to enroll.

To complete the program and become a medication aide, you must:

  1. Be at least 18 years of age.
  2. Have a high school diploma or high school equivalency diploma.
  3. Be current on the Wisconsin Nurse Aide Registry.
  4. Be current on the federal nurse aide directory.
  5. Have at least 2,000 hours of experience in direct patient care within the past three years.
  6. Have worked at least 40 hours within the past 90 days with residents receiving medications.
  7. Be recommended in writing by the director of nursing and the administrator of the agency where you'll be working.
  8. Be recommended in writing by two licensed charge nurses under whose licenses you'll be giving medications.

Program and requirement FAQs (frequently asked questions)

To verify a medication aide you would:

  1. Verify the applicant is a nurse aide on the nurse aide registry.
  2. Verify the applicant took medication aide training.
  3. Verify the applicant has worked 100 hours each calendar year as a medication aide and has four hours of medication training each calendar year.

To maintain medication aide status:

  • Complete four hours of pharmacy-related in-service and 100 hours of work each calendar year.
  • Keep three full years of records showing they completed the 100 hours of work and four hours of in-service.

For work hours: A schedule, pay stub, or letter from payroll can document hours of work as a medication aide.

For in-service hours: The hours can be a single four-hour class or several 10- to 15-minute sessions to total four hours in a calendar year. Document the type of training provided, how long, who provided it, and a witness who can confirm your attendance.

If requirements haven't been met or records maintained, contact the DQA pharmacy consultant to find out how to get reinstated.

The person is no longer eligible to be a medication aide and must contact DQA.

Nursing students and nursing graduates are unlicensed. To give medications in a nursing home, the student or graduate:

  • Must be on the Wisconsin Nurse Aide Registry as a nurse aide.
  • Must have successfully completed a medication administration course (often pharmacology with a nurse clinical).
  • Must be active in nursing school with no more than a one-year break or have graduated less than a year ago. If it's been more than one year since attending or graduating nursing school, the person should apply to take the Challenge Exam to become a medication aide.

Medication aides are unlicensed and work under delegation of an RN (registered nurse). In the base course, medication aides aren't taught:

  • How to give injections.
  • Any procedure done through a tube.
  • How to use nebulizers.
  • How to give as-needed medications (PRNs).

RNs delegating tasks to medication aides have the responsibility and authority to decide what the aide can and cannot do. The RN may decide to delegate a task that wasn't taught to the aide (insulin injections, for example). If so, the RN must ensure the medication aide is trained, competent, and supported whenever they need help.

Medication aides work under an RN. The RN will determine what level of supervision is needed, based on what they are delegating and the circumstances. For example, a medication aide with little experience giving medications to a resident with a changing condition may need an RN on site. An experienced medication aide giving routine medications to a resident who hasn't had changes in condition may not need an RN to be on site.

Training exemptions

Certain training and experience can allow a person to be exempt from medication aide training. Examples include:

  • Nursing students who have left school for over 1 year.
  • Graduate nurses who don't hold a license and graduated over 1 year ago.
  • Nurse aides who've worked as medication aides in nursing homes in other states.

If you may meet a training exemption, review and complete the Challenge Exam Application for Nurse Aide / Medication Aide F-62586 (Word). Fill out the Application Information and Release section, and mail the form to DQA.

If the training received is equal to the medication aide training program, you may be exempt from the training course and required only to take a written exam. The written exam is 100-150 questions of multiple choice, fill in the blank, true/false, and matching. The textbook used for the course is Hartman's Complete Guide for the Medication Aide.

Training exemption FAQs

Nursing students who have completed a medication administration course, usually nursing pharmacology with a lab or clinical, and who have left school for more than one year but less than five years can apply to test out of the medication aide training program. To do so, apply for the Challenge Exam, F-62586 (Word).

If a person has had medication administration training in the past, they can apply to test out of the medication aide program.

To test out, use the Challenge Exam Application, F-62586 (Word) and send the required materials to the DQA pharmacy consultant. The pharmacy consultant will review the application. If the applicant is eligible to test out, the consultant will send a letter to the applicant. The letter will explain what the applicant needs to do. All applicants must take a written final exam. Some also need to complete a lab practicum or clinical rotation. The pharmacy consultant will contact the program providing the exam to ensure they're willing to work with the applicant.

DQA has to confirm your past training with colleges, training programs, or other state registries. They often require a written release to provide that information. In the blank sections, list the name of the registry or school you attended that will need to release your information.

A nursing school graduate who is one year post graduation, who is current on the nurse aide registry can apply to test out of the medication aide training program. To apply, use the Challenge Exam Application, F-62586 (Word).

No, this person may not test out. They must complete a medication aide training program.

Medical assistants may apply to test out of the medication aide training program. However, not all medical assistants received complete pharmacy training. Many won't be able to pass the Challenge Exam.

For instructors

This section is for instructors or administrators of medication aide programs.

Instructor FAQs

When a student successfully completes the program, their nurse aide registry information must be updated to show they are now a medication aide. The instructor will complete a DQA online survey form. The medication aide status will be updated on the registry within 10 business days after the form is submitted.

For access to the online survey form, contact Doug Englebert:

Some students may have experience or skills that make them a good candidate for your program. If such a student doesn't have the 2,000 hours, contact the DQA pharmacy consultant. Students are assessed for eligibility on a case-by-case basis.

The four-hour training must be about medications. It can be about techniques for giving drugs, new medications, or areas where improvement is needed.

No, you do not need to submit them to the registry.

No. Some routes of administration may not be available at the time. Students should complete all routes available or those routes they'll be expected to complete when working.

Skills not tested should be left blank on the skill checklist.

If a medication aide later will give drugs in ways not completed on the check list, the delegating RN must assure the medication aide is competent.

Nursing students aren't required to test out of the program. A nursing student can give medications in a nursing home if they:

  • Are enrolled in a nursing program and taking nursing courses, with no break of more than one year between courses.
  • Have passed the medication administration course of an accredited school of nursing. The nursing home must have a record that the student completed the course.

If not actively taking nursing courses, the nurse aide must become a medication aide to give medications in a nursing home. To do so, apply for the Challenge Exam, F-62586 (Word).

To maintain medication aide status:

  • Complete four hours of pharmacy-related in-service and 100 hours of work each calendar year.
  • Keep three full years of records showing they completed the 100 hours of work and four hours of in-service.

Contact us

If you have other questions, contact Doug Englebert, DQA pharmacy practice consultant:

Last revised February 14, 2024