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The Control Substance Inventory Michigan form is an essential document for any facility that handles controlled substances. This form must be completed annually between April 1 and June 30, ensuring compliance with state regulations. Each registered location needs its own inventory, highlighting the importance of maintaining accurate records. Once filled out, the form should be mailed to the Bureau of Health Professions in Lansing, MI, and a signed copy must be kept on-site for reference. Notably, this form can also fulfill the biennial inventory requirement set by the DEA, making it a crucial tool for legal compliance. The inventory details include the date of the count, the name and address of the DEA registrant, and specific information about each controlled substance, such as its container type and quantity. For Schedule I and II substances, special care is required, as they must be documented separately. It is vital that the inventory is conducted by a qualified individual and witnessed by another, ensuring accountability and accuracy in the reporting process.
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Michigan State University
Annual Controlled Substance Inventory Form
Inventory must be performed between April 1 and June 30 of each year. A separate annual inventory is required for each registered location. Mail to: State of Michigan, Bureau of Health Professions‐ Health and Regulatory Division, Annual Inventory, 6546 Mercantile Way, Suite 2, P.O. Box 30454, Lansing, MI 48909. Retain a signed and completed copy of this form at the licensed location. The completed form can serve as the biennial inventory required by the DEA.
Date:
Start of day |
End of day |
MI Licensee/DEA Registrant Name:
MI Licensee/DEA Registrant Address:
DEA Registration #:
State of MI Controlled Substance ID #:
DEA Schedule*
Controlled Substance
Container Unit Type (Vial, syringe, patch, etc.)
Container Quantity
Container Volume
Concentration
*Schedule I and II controlled substances must be separated from all other substances or places on a separate form.
Inventory performed by: _________________________________ |
____________________________________________ |
Print Name |
Signature |
Inventory witnessed by: _________________________________ |
____________________________________________ |
Print Name |
Signature |
|
Page: ___ of_ __ |
Form Specifications
| Fact Name | Description |
|---|---|
| Inventory Period | The inventory must be conducted annually between April 1 and June 30. |
| Location Requirement | A separate inventory form is necessary for each registered location. |
| Submission Address | Mail the completed form to the Bureau of Health Professions at the specified Lansing address. |
| DEA Compliance | This form can fulfill the biennial inventory requirement set by the DEA. |
Control Substance Inventory Michigan: Usage Guidelines
Completing the Control Substance Inventory Michigan form is an essential task for maintaining compliance with state regulations. This process ensures that all controlled substances are accurately accounted for and properly documented. Following the steps below will guide you through filling out the form correctly.
- Gather Necessary Information: Before starting, collect all relevant details, including your DEA registration number and the specific controlled substances you will inventory.
- Fill in the Date: Indicate the date on which the inventory is being conducted. Choose either the start or end of the day for accuracy.
- Enter Licensee Information: Provide your MI Licensee/DEA Registrant Name and Address. Make sure this information matches your official records.
- Input DEA Registration Number: Write down your DEA Registration Number clearly in the designated space.
- Complete State of MI Controlled Substance ID: Include your State of MI Controlled Substance ID number.
- Specify DEA Schedule: Indicate the DEA Schedule of the controlled substances being inventoried. Remember that Schedule I and II substances must be documented separately.
- Detail Container Information: For each controlled substance, fill out the following:
- Container Unit Type (e.g., vial, syringe, patch)
- Container Quantity (how many containers you have)
- Container Volume Concentration (specify the volume and concentration of the substance)
- Document Inventory Personnel: Sign and print your name in the "Inventory performed by" section.
- Witness Signature: Have another person witness the inventory. They should sign and print their name in the "Inventory witnessed by" section.
- Page Number: Fill in the page number if applicable, indicating which page of the inventory this is.
Once you have completed the form, mail it to the specified address in Lansing, MI. Retain a signed copy at your licensed location, as it may also serve as the biennial inventory required by the DEA. Ensure you complete this process between April 1 and June 30 each year for compliance.
Your Questions, Answered
What is the purpose of the Controlled Substance Inventory Michigan form?
The Controlled Substance Inventory Michigan form is used to document the inventory of controlled substances at registered locations. It helps ensure compliance with state regulations and can also fulfill the biennial inventory requirement set by the DEA.
When should the inventory be performed?
The inventory must be conducted annually between April 1 and June 30. This time frame is set to maintain consistency and compliance with state regulations.
Do I need to submit a separate form for each location?
Yes, a separate annual inventory form is required for each registered location. This ensures that each facility's controlled substances are accurately accounted for and reported.
Where do I send the completed form?
Mail the completed form to the State of Michigan, Bureau of Health Professions‐ Health and Regulatory Division, Annual Inventory, 6546 Mercantile Way, Suite 2, P.O. Box 30454, Lansing, MI 48909.
What should I do with a signed copy of the form?
It is important to retain a signed and completed copy of the form at the licensed location. This copy serves as proof of compliance and can be referenced in future audits or inspections.
What information is required on the form?
The form requires details such as the date of the inventory, the name and address of the licensee or DEA registrant, DEA registration number, state-controlled substance ID number, and specifics about the controlled substances being inventoried, including type, quantity, and concentration.
How should Schedule I and II substances be handled on the form?
Schedule I and II controlled substances must be separated from all other substances. They should either be documented on a separate form or clearly identified to ensure compliance with regulations.
Who should perform and witness the inventory?
The inventory should be performed by a qualified individual, whose name and signature must be recorded on the form. Additionally, a witness is required to sign and print their name, confirming that the inventory was conducted accurately.
Common mistakes
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Not Performing Inventory Within the Required Dates: The inventory must be conducted between April 1 and June 30 of each year. Failing to adhere to this timeline can result in compliance issues.
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Submitting a Single Inventory for Multiple Locations: Each registered location requires a separate annual inventory. Combining inventories can lead to inaccuracies and potential legal repercussions.
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Incorrectly Filling Out the DEA Registration Number: Ensure the DEA Registration Number is accurate. An error here can invalidate the entire form.
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Forgetting to Retain a Signed Copy: It is essential to keep a signed and completed copy of the form at the licensed location. This serves as proof of compliance.
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Not Separating Schedule I and II Substances: Schedule I and II controlled substances must be separated from all other substances or documented on a separate form. Mixing them can lead to regulatory issues.
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Neglecting to Include All Required Information: Ensure all fields, such as the MI Licensee/DEA Registrant Name and Address, are filled out completely. Missing information can delay processing.
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Failing to Document the Inventory Witness: The form requires a witness to the inventory. Not including this information can raise questions about the inventory's validity.
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Using Incorrect Container Types: Be precise when identifying the container unit type (e.g., vial, syringe, patch). Incorrect entries can lead to discrepancies in the inventory.
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Overlooking Container Quantity and Volume: Accurately report the container quantity and volume concentration. Mistakes here can result in significant compliance issues.
Documents used along the form
The Controlled Substance Inventory Michigan form is essential for maintaining compliance with state regulations. However, several other documents are often used in conjunction with this form to ensure comprehensive record-keeping and regulatory adherence. Below is a list of related documents that may be required.
- Controlled Substance Registration Application: This document is necessary for individuals or entities seeking to legally handle controlled substances. It includes detailed information about the applicant and the intended use of the substances.
- Biennial Inventory Form: Similar to the annual inventory, this form is specifically required by the DEA and must be completed every two years. It provides a snapshot of controlled substances on hand at a given time.
- Controlled Substance Disposal Form: When disposing of controlled substances, this form is required to document the method and quantity disposed of. It ensures compliance with state and federal disposal regulations.
- Order Forms for Controlled Substances: These forms are used to order controlled substances from suppliers. They ensure that all transactions are documented and compliant with regulatory requirements.
- Record of Receipt of Controlled Substances: This document is used to confirm the receipt of controlled substances ordered. It includes details such as quantity, date received, and supplier information.
- Controlled Substance Transfer Form: When transferring controlled substances between locations or entities, this form documents the details of the transfer, including quantities and involved parties.
- Incident Report Form: If there is a discrepancy or loss involving controlled substances, this form is used to report the incident. It helps in investigating and resolving issues promptly.
- Inventory Adjustment Form: This form is utilized to document any changes in inventory levels, such as corrections or adjustments due to errors or discrepancies found during audits.
- Training Records for Controlled Substances: Documentation of staff training regarding the handling, storage, and disposal of controlled substances. This is crucial for compliance and safety protocols.
Maintaining accurate records and completing the necessary forms is vital for compliance with both state and federal regulations. Failure to do so can result in penalties or loss of licensure. It is important to stay informed about all required documentation and ensure that all forms are completed accurately and timely.
Similar forms
The Control Substance Inventory Michigan form shares similarities with several other documents related to controlled substances. Below is a list of these documents and their corresponding similarities:
- DEA Form 222: This form is used for ordering Schedule I and II controlled substances. Like the Michigan inventory form, it requires accurate documentation of controlled substances and is essential for regulatory compliance.
- Biennial Inventory Form: This form is required by the DEA every two years. Similar to the Michigan inventory form, it must detail the quantities and types of controlled substances held by the registrant.
- Controlled Substance Registration Application: This document is necessary for obtaining a license to handle controlled substances. It shares the requirement for detailed information about the registrant and their intended use of the substances.
- Controlled Substance Disposal Form: This form documents the disposal of controlled substances. Like the inventory form, it requires precise record-keeping to ensure compliance with regulations.
- Prescription Records: These records track the dispensing of controlled substances to patients. They are similar in that they must be meticulously maintained to ensure accountability and compliance with legal standards.
- Monthly Controlled Substance Usage Report: This report summarizes the use of controlled substances over a month. It parallels the inventory form in its focus on accurate tracking and reporting of controlled substance quantities.
- Incident Report for Controlled Substances: This document is used to report any discrepancies or issues related to controlled substances. It shares the need for thorough documentation and accountability, akin to the inventory process.
- State-Specific Controlled Substance Inventory Forms: Many states have their own inventory forms that require similar information. These documents ensure compliance with state regulations, much like the Michigan form does.
Dos and Don'ts
When filling out the Control Substance Inventory Michigan form, it is essential to adhere to specific guidelines to ensure accuracy and compliance. Here are seven things you should and shouldn't do:
- Do perform the inventory between April 1 and June 30 each year.
- Do complete a separate inventory for each registered location.
- Do mail the completed form to the appropriate address in Lansing, MI.
- Do retain a signed and completed copy of the form at the licensed location.
- Do ensure that Schedule I and II controlled substances are separated from other substances.
- Don't forget to include the DEA Registration number and State of MI Controlled Substance ID number.
- Don't neglect to have the inventory witnessed and signed by another person.
Misconceptions
Misconceptions about the Control Substance Inventory Michigan form can lead to confusion. Understanding the facts can help ensure compliance and accuracy. Here are four common misconceptions:
- Only one inventory is needed for all locations. Each registered location must conduct a separate annual inventory. This means if you operate multiple locations, you will need to complete a distinct form for each one.
- The inventory can be performed at any time during the year. The inventory must be conducted between April 1 and June 30 each year. Adhering to this timeline is crucial for meeting state requirements.
- The completed form is only for state records. While the form is required by the state, it can also serve as the biennial inventory required by the DEA. Keeping a signed and completed copy at the licensed location is essential.
- Controlled substances can be mixed on the inventory form. Schedule I and II controlled substances must be separated from all other substances. If you have these substances, they must be listed on a separate form to ensure proper tracking and compliance.
Key takeaways
When filling out the Control Substance Inventory Michigan form, consider these key takeaways:
- Timing is crucial. The inventory must be conducted between April 1 and June 30 each year.
- Separate forms for each location. Each registered location requires its own annual inventory form.
- Mailing address matters. Send the completed form to the Bureau of Health Professions at the specified address in Lansing, MI.
- Keep a copy. Retain a signed and completed copy of the form at the licensed location for your records.
- DEA compliance. The completed form can also fulfill the biennial inventory requirement set by the DEA.