Control of controlled medications

[SolaireSolstice]

I am doing a presentation about facility implimentation of controls to prevent the loss/theft of controlled medications. I know in many LTC facilities, they use "narcotic boxes" and "pass the keys" and do narcotic counts. (I work in a hospital with e-mar and a Pixis, so forgive my unfamiliarity of this type of system). Does the narcotic count happen at every shift change? What happens if the count is "off"? I've read threads on here about this but I just want to be sure I have the exact scenario down.

[Candyheart]

Of course the administration doesn't care, they don't have to count it or get in trouble if the count is off. If the drawer gets to difficult to count, people will quit counting it, it will be off and some poor new by the book nurse will count it find it off then there will be big trouble. I've seen expired narcs, narcs that belong to long dead residents, 2 stuffed full narc drawers. Just land mines waiting to explode on some float nurse about 0630, at the beginning of a 300 pill med pass. I hate this outdated system