The LTC facility that I recently worked at had you punch out the pill that corresponded with the date and would have a separate card for each time slot (TID=3 cards; QID =4 cards, etc.). However, most of the nurses wouldn't follow the rules! They would punch out the meds wherever they deemed fit to punch them out, creating mass confusion! Even after numerous inservices. I'm halfway OCD so I memorized how many pills were left on the card when I was going to have a day off. Most of the time when I came back the same amount of pills were still on the card. Their excuse was they punch differently than me. It was such a problem I started writing how many pills were left on the card on the back of the card real tiny. Nothing never got done after it was reported! It was like a big waste of breath. So I just concentrated on the pills I punched out to make sure they were correct!