Level I Medication Aide (LIMA)

The Level I Medication Aide (LIMA) training program prepares individuals for employment as a LIMA in residential care facilities (RCFs) and assisted living facilities (ALFs).

The program is designed to teach skills in medication administration by the following routes: oral, rectal, vaginal, otic, ophthalmic, nasal, topical, transdermal, buccal, sublingual, aerosol, nebulizer, and oral metered dose inhalers.

The curriculum content is a minimum of 16 hours which includes procedures and instructions in the following areas: residents rights; fundamental human body systems; common medical terminology and abbreviations; medications classifications and their implications; observing and reporting possible medication reactions; techniques of medication administration by all routes listed above; documentation, including telephone orders, medication administration records (MAR’s), and leaves of absence; acquiring, storing and securing medications; medication reference resources; and infection control.

A student shall not administer medications without the instructor present until he or she successfully completes the course and obtains a copy of the examination score sheet.

LIMA Biennial Update Training Program

Level I Medication Aides shall participate in a minimum of four (4) hours of medication administration training every two (2) years in order to administer medications in an RCF or ALF. The training shall be:

  • Offered by an approved instructor and
  • Documented on Level I Medication Aide Biennial Training form, MO 580-2973 (12/10), and kept in the employee’s personnel file. (The department will also accept DMH’s Medication Aide Bi-Annual Training Form MO 650-8730 (12/00) incorporated by reference in the rule as acceptable documentation.)

Level I Medication Aides are responsible to ensure that the department is provided with copies of the completed Level I Medication Aide Biennial Training forms documenting completion of the required biennial training by the anniversary date of the initial Level I Medication Aide certificate.

Level I Medication Aides who fail to submit to the department the documentation required by this rule by the biennial anniversary date of issue of their original LIMA certification will be removed from the LIMA active registry and will not be eligible to be employed as a LIMA in an RCF or ALF.

Any LIMA after having been removed from the active registry for failing to provide to the department the documentation required by this rule, may be reinstated to the active registry by providing proof of a completed biennial training update at any time except any individual who has been off the active registry for more than five (5) years shall retake the course or s/he may challenge the examination if s/he meets the requirements.

LIMA Biennial Update Form

LIMA Inactive/Expired Status Information

Any Level I Medication Aides after September 30, 2012 shall complete the Biennial Training Update (Update is a total 4 hours every 2 years). See Biennial Update Training Program.

Level I Medication Aides are responsible to ensure that the department is provided with copies of the completed Level I Medication Aide Biennial Training forms documenting completion of the required biennial training by the anniversary date of the initial Level I Medication Aide certificate.

Any Level I Medication Aide, who has not completed the update and returned the required forms, will be removed from active status (become Inactive) on the registry. To be reinstated to the active registry the LIMA must provide the required documentation as stated above.

Any individual who has been inactive on the registry for more than five (5) years (meaning a training update form was not received over a 7 year period) will become Expired and must retake the course to receive LIMA certification.

Per regulation 19 CSR 30-84.030 revised November 30, 2012, Level I Medication Aides certified on or before September 30, 2012 shall have until September 30, 2014, to comply with the biennial training requirements required by the rule. If the individual has not completed the biennial training before September 30, 2014 then he or she will have their name removed from the LIMA registry and will not be eligible to be employed as a LIMA in an RCF or ALF. Any LIMA after having been removed from the active registry for failing to provide to the department the documentation required by this rule, may be reinstated to the active registry by providing proof of a completed biennial training update at any time except any individual who has been off the active registry for more than five (5) years shall retake the course or s/he may challenge the examination if s/he meets the requirements.

Department of Mental Health (DMH) Medication Aide Certification Information

A Medication Aide who has been certified by DMH, and has maintained biennial training updates, can apply for a LIMA certification. The individual must contact a DHSS Certifying Agency, and provide to them the items needed per regulation, to have a LIMA certification issued to them.

Information on DMH Medication Aides can be obtained on the DMH Website.

DMH Update Form can be obtained here.

LIMA Challenge

State regulation 19 CSR 30-84.030 (7) (C) allows for individuals, who meet one or more of the following state regulation requirements, to challenge the Level I Medication Course after submitting the required documentation.

The following individuals may qualify as Level I Medication Aides by successfully challenging the final examination:

  • Individuals either enrolled in or who have been enrolled in a professional nursing school or in a practical nursing program who have completed the medication administration or pharmacology course and who have letters of endorsement from the directors of their respective programs.

Those individuals meeting the above requirement must email a written request to cnaregistry@health.mo.gov. Each request must include a clear copy of the individual's social security card, return address, daytime telephone number, letter of endorsement, and a copy of their transcript.