In our LTC facility pills are disolved and flushed, injectables are squirted into a cup of water, and flushed, patches are cut up and put in sharps container, liquids are poured into a cup of water and flushed. All witnessed by the DON or her designee, which is the supervisor, mds coordinator, nurse manager, or the staff develpment nurse. This is the policy for when we have to waste a lot. Our residents usually have a 30 day supply at a time and if they die, are discharged, or have a change in med. Another nurse is fine if the med is dropped. Because having something hang around from Friday night until Monday morning just isn't cool. All I know is somedays the fishes are real happy.