I'm a MR/DD caregiver at a contract agency (I presently work in a supported living home, just one person, but had LOTS of group home med admin experience at my previous employer) in Missouri, and as Mschrisco pointed out, the certification procedure is pretty skimpy IMO. No, thats not quite right. The recert is what sucks! Its a)easy to forget a lot of skills b) the company has the nasty habit of changing policy (something stupid like using a different color of highlighter or initialing meds one at a time before actually passing them) and c) too many people just don't pay attention to details, which is what matters most.
I can't tell you how many med errors I've had to followup on, chasing phantom doctors for instructions, QMRP's that ignore repeated pages, incident reports out the wazoo, and even state investigations. I'm convinced that med admin at group homes is one of the Nine Levels of Caregiving Hell. Worst time for me was last year at my previous employer, working a group home with 9 clients (hate that term), often shorthanded (usually 2 staff) or other staff just slacking off, 120 meds at AM pass, ranging from long term psychotropics to breathing treatments to topicals everywhere, combined with frequently combative and violent individuals who had no business in our facility (blame money, politics and the Q for that) and the utterly unreasonable expectation that it all had to be done in 15 minutes with perfect paperwork so you can now go run and change/shower/dress 4 or 5 frequently pissy individuals, cook meals for them and do 10 loads of laundry all by 9:00 am. My new job doesn't pay well but thank God we don't have group homes!
FYI - I'm certified as a Level 1 Med Admin aide, separate cert in insulin admin. There's MANDT, CPR/1st aid, health and safety as well but again, IMO its a joke. I think most agencies simply can't afford to provide more instruction and training in general, and when funding is cut or frozen, the first thing agencies use the X-acto knife on besides benefits is training. A damn shame IMO