Can a PSW Give Medication in Ontario? What You Can and Cannot Do

Medication assistance is one of the most important — and most misunderstood — areas of PSW practice. A lot of what circulates about it is out of date: O. Reg. 79/10 was revoked on April 11, 2022, the long-term care rule now sits in O. Reg. 246/22 s. 140 as amended by O. Reg. 66/23, and training material written before those changes still says the opposite of what the regulation now says. Getting it wrong on a practice question costs you a mark. Getting it wrong at work can cost a client their health.

This guide sets out what a PSW may do with medication in Ontario, setting by setting: what assistance means, when a trained PSW may administer a drug, what needs a delegation, the nine rights of assisting with medication, and what to report and to whom. Every rule below is tied to the law or the standard it comes from, with the status of each source named.

Short answer (checked September 16, 2026): By default a PSW assists with medication under the client's plan of care, and in an Ontario long-term care home what a trained PSW may do beyond that is set by O. Reg. 246/22 s. 140. Where the administration is not a controlled act, a PSW may administer a drug when every condition in s. 140(3)(b)(ii) is met. Where the administration is itself a controlled act, s. 140(3)(a) applies instead: the person must be "authorized to perform that act under a health profession Act, the Regulated Health Professions Act, 1991 or any relevant regulation" or "exempted from the prohibition on the performance of the controlled act by a regulation made under" the RHPA. Injections and inhalations are controlled acts.

Sources: O. Reg. 246/22 under the Fixing Long-Term Care Act, 2021 and O. Reg. 166/11 under the Retirement Homes Act, 2010 (law; checked September 16, 2026); the Regulated Health Professions Act, 1991 (law; checked September 17, 2026); Ontario's Personal Support Worker Standard, January 2022 (a training standard for PSW programs, not law; checked September 12, 2026); College of Nurses of Ontario practice documents (guidance that binds nurses; checked September 12, 2026). This is exam-preparation education, not clinical or legal advice — your plan of care and your employer's policies govern what you do.

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Can a PSW give medication in Ontario?

In everyday language, "give" covers two different things — assisting and administering — and the law treats them differently.

The honest answer is that it depends on the setting and on whether the act involved is a controlled act. Start with the default, which does not change anywhere: assistance.

Ontario's PSW training standard puts the medication outcome this way — graduates "assist the client with medication following the client's plan of care, and if a delegated act, under the supervision of a regulated health professional or done by exception under the most accountable person and in accordance with all applicable legislation and employer policies" (VLO 9, January 2022). Assistance is physical help with a medication that has already been prescribed and prepared for that client, and the plan of care is the reference point.

Three distinctions do most of the work on this page, and they are not interchangeable. Prescribing a drug is a controlled act under section 27(2) of the RHPA and never sits with a PSW. Choosing or changing a dose is the prescriber's decision — in a long-term care home the regulation requires drugs to be administered "in accordance with the directions for use specified by the prescriber". Administering is the act of giving a prepared, prescribed drug to the resident or client, and whether a PSW may do it depends on the setting's own regulation. Delegation is something else again: a regulated professional temporarily granting a PSW the authority to perform a specific controlled act.

Long-term care homes

The rule is O. Reg. 246/22 under the Fixing Long-Term Care Act, 2021. It splits on the controlled-act test. Where the administration is a controlled act — an injection, for example — the licensee must ensure the person doing it is "authorized to perform that act under a health profession Act, the Regulated Health Professions Act, 1991 or any relevant regulation" or "exempted from the prohibition on the performance of the controlled act by a regulation made under" the RHPA. Where the administration does not involve a controlled act, section 140(3)(b)(ii) names the personal support worker directly:

"a personal support worker who has received training in the administration of drugs in accordance with written policies and protocols developed under subsection 123 (2), who, in the reasonable opinion of the licensee, has the appropriate skills, knowledge and experience to administer drugs in a long-term care home, who has been assigned to perform the administration by a member of the registered nursing staff of the long-term care home and is under the supervision of that member in accordance with any practice standards and guidelines issued by the College of Nurses of Ontario and who, (A) meets the requirements set out in subsection 52 (1) or who is described in subsection 52 (2), or (B) is an internationally trained nurse who is working as a personal support worker"

Read that as one continuous condition, not as a three-word summary. All of the following must hold at once:

1. Training in the administration of drugs, in accordance with the home's written policies and protocols developed under subsection 123(2);
2. The licensee's reasonable opinion that the worker has the appropriate skills, knowledge and experience to administer drugs in a long-term care home;
3. Assignment to perform the administration by a member of the registered nursing staff of the home;
4. Supervision by that same member, in accordance with any practice standards and guidelines issued by the College of Nurses of Ontario; and
5. Eligibility — either meeting the hiring qualification in section 52(1) (registration with the Health and Supportive Care Providers Oversight Authority in the personal support worker class, or the licensee's determination that the person would meet the registration requirements set out in O. Reg. 217/24) or being described in section 52(2), or being an internationally trained nurse working as a personal support worker, as section 140(9) defines that term.

Conditions 1 to 4 apply under either eligibility route. Two further limits sit around the whole clause: no drug may be used by or administered to a resident unless it has been prescribed for that resident, and a resident may only self-administer where the prescriber has approved it in consultation with the resident.

You will still find Ontario's January 2022 PSW training standard saying that "personal support workers are not allowed to administer medication to clients in long-term care home settings". That sentence and its footnote rest on section 131 of O. Reg. 79/10 under the Long-Term Care Homes Act, 2007 — a regulation that carries the note "This Regulation was revoked on April 11, 2022" — and the rule quoted above has replaced it. The training standard governs what PSW programs teach; it is not the law that governs a long-term care home. Course material and practice questions written to the January 2022 standard may still carry that sentence, so where your program's material and the current regulation point different ways, ask your instructor which source and version your assessment follows.

Retirement homes

Retirement homes run on a different regulation, O. Reg. 166/11 under the Retirement Homes Act, 2010. Section 29 requires that "neither the licensee nor a staff member administers a drug to a resident in the home unless the licensee or the staff member has received training in the procedures applicable to the administration of the drug", and that "a member of a College, as defined in the Regulated Health Professions Act, 1991, or an exempted out of province health professional supervises the administration of the drug or other substance to the resident in the home". Note the wording: the section speaks about staff members, not about personal support workers — it is not a PSW-specific permission, and it does not displace the controlled-act rules.

Home and community care

Home-care law does not settle this one way or the other, and that is worth saying plainly. The statutory definition of "personal support services" in O. Reg. 187/22 lists personal hygiene activities, routine personal activities of living, assisting a patient with those activities, and training a person to carry them out or assist with them — with no medication element. Ontario's public home-and-community-care page lists "help to take medications" under nursing care. That is an absence in the definition, not a prohibition on assisting: what you may do in a client's home comes from the plan of care, your employer's policies and the controlled-act rules above.

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The nine rights of assisting with medication

Ontario's PSW training standard defines "the rights of assisting with medications" as the "procedures and checks" that help clients take medications accurately and safely, and lists nine of them — commonly called the 9 rights of medication, though the standard's own term is the rights of assisting with medications. The standard credits the list to Sorrentino et al., Mosby's Canadian Textbook for the Support Worker (4th edition, 2018) — so this is a training convention adopted by Ontario's standard, not a checklist written into legislation. Note the name, too: the standard says the rights of assisting with medications, never the rights of administration. If you want to test the nine rights on scenario items, our 15 free PSW practice questions with a rationale after every answer include medication-safety questions.

1. Right Person — Confirm who you are helping before anything else, using the identification procedure your employer sets. Never assume, even with clients you know well.

2. Right Medication — Verify that the medication matches what is listed on the medication administration record (MAR) or the pharmacy label. If the name, appearance, or packaging looks different from what you expected, stop and check with the registered staff or most accountable person.

3. Right Dose — Confirm that the amount matches the order. If a blister pack contains a different number of pills than expected, or if the dose looks different from usual, report it before proceeding.

4. Right Time — Give the medication at the time specified in the plan of care or the medication administration record (MAR), and follow your employer's policy on how much latitude there is around it. Some medications are tied to meals, before, with or after food.

5. Right Route — Confirm how the medication is to be taken. Ontario's training standard names the routes a PSW is trained to assist with: "oral, rectal, ear, eye, nose, topical, inhalation and subcutaneous". Two of those need care: inhalation and injection are controlled acts under section 27(2) of the RHPA, so assisting with them is governed by the exception and delegation rules further down this page. The route is set by the prescriber's order. If the route on the MAR does not match what you were told or what the product allows, stop and report it to the registered staff or most accountable person before you assist.

6. Right Day — Confirm the medication is actually due today. Weekly, alternate-day, and tapering schedules make "right time on the wrong day" a real error — check the MAR date, not just the clock.

7. Right Reason — Understand why the medication has been prescribed. You do not need to know pharmacology in depth, but knowing that a medication is for blood pressure, pain, or anxiety helps you observe for expected effects and potential problems.

8. Right Expiry Date — Check that the product has not passed its expiry date before you assist. An expired medication may be ineffective or unsafe — report it to the registered staff or most accountable person and follow your employer's policy; do not discard it yourself.

9. Right Documentation — Record what you assisted with, when, the client's response, and any refusal or concern, following your employer's documentation policy for when and where it is recorded.

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What medication assistance can a PSW do?

Ontario's training standard defines assisting with medication as "the provision of physical assistance to clients in taking their medications", and gives three examples: "opening the container for the individual, providing a glass of water to drink while taking the medication, and/or placing the medication pack in a client's hand". These are examples given in the training standard's glossary. Everything else on this list comes from the plan of care and your employer's policy, so check both before you assume:

• Open a container or blister pack the client cannot open themselves
• Provide a glass of water for the client to drink while taking the medication
• Place the medication pack in the client's hand
• Observe the client take the medication, and stay with them if the plan of care says to
• Assist with oral, rectal, ear, eye, nose and topical medications as the plan of care sets out — six of the eight routes Ontario's training standard names. One qualification on the rectal route: putting an instrument, hand or finger beyond the anal verge is a controlled act under paragraph 6 of section 27(2), and CNO's table treats paragraph 6 for a paid care provider as permitted by the exception "if part of routine activity of living; otherwise requires delegation"
• Inhalation and subcutaneous routes are different. Administering a substance by injection or inhalation is a controlled act (RHPA s. 27(2), paragraph 5), so the routine-activities exception in section 29(1)(e), another statutory exception such as section 29(1)(a) first aid in an emergency — only within your training and your employer's emergency protocol — or a delegation has to be in place before it is yours to do
• Document what you assisted with, on the form and at the time your employer's policy requires
• Observe and report any change in the client's behaviour or condition after medication assistance, to the registered staff or most accountable person
• Follow your employer's storage and handling policy — where medications are kept, who has access and what to do with an expired or damaged product are set by the regulation for your setting and by your employer, not by a rule of thumb

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Where the limits come from

What limits a PSW with medication is the RHPA's controlled acts, the regulation for your setting, your employer's policy and the plan of care. Here is each limit with the rule behind it:

• Prescribing, dispensing, selling or compounding a drug is a controlled act in its own right (RHPA s. 27(2), paragraph 8), and there is no routine-activities exception for it. The College of Nurses of Ontario also lists dispensing a drug among the controlled acts a nurse cannot delegate at all, so it is not available to a PSW by that route either.
• Choosing or changing a dose belongs to the prescriber. In a long-term care home the regulation requires that no drug is used by or administered to a resident unless it has been prescribed for that resident, and that drugs are administered "in accordance with the directions for use specified by the prescriber".
• Injections and inhalations are controlled acts (RHPA s. 27(2), paragraph 5). A PSW reaches them through the routine-activities exception in section 29(1)(e), through another statutory exception such as section 29(1)(a) first aid in an emergency — only within your training and your employer's emergency protocol — or through a delegation; see the delegation section below.
• Performing a procedure on tissue below the dermis or below the surface of a mucous membrane is a controlled act (paragraph 2) that the routine-activities exception in section 29(1)(e) does not reach, because that exception covers only paragraphs 5 and 6. Paragraph 2 is written around a procedure on the tissue itself; administering a substance by injection is named separately in paragraph 5, which the section 29(1)(e) exception can reach where the injection is genuinely part of assisting this client with their routine activities of living — the insulin section below works that case through. CNO's table is explicit for paid care providers: "Not included in exception; requires delegation". Another statutory exception, such as section 29(1)(a) first aid or temporary assistance in an emergency, can still apply on its own terms — and only within your training and your employer's emergency protocol.
• Putting an instrument, hand or finger past one of the body openings the Act lists, or into an artificial opening, is paragraph 6. CNO's table for paid care providers lists it as permitted "if part of routine activity of living", and "otherwise requires delegation" — CNO's table describes routine care; the other section 29(1) exceptions, such as emergency first aid, are separate.
• Medication given through a feeding tube or an intravenous line is not the routine oral and topical assistance described above. Whether any part of it is yours to do depends on the exact task, on which controlled act or exception applies to it, on the legislation for your setting, on the client's plan of care, on your own training and competence, and on your employer's policy — with a delegation where one is required. Ask before you start, rather than reasoning by analogy from a task that looks similar.
• Deciding whether a PRN dose is needed is a clinical decision. The PSW role is to observe and report, and the training standard makes reporting changes after medication assistance part of the job.
• Anything your plan of care or your employer's policy does not authorize — crushing or splitting a tablet, repackaging, taking an instruction that did not come through your employer's process — waits until you have direction. Ontario's standard is built on working "in accordance with all applicable legislation, standards, employer job descriptions, policies, procedures and guidelines".

One more rule cuts across all of them. Where assistance with medication involves a controlled act, Ontario's training standard routes it straight back to the statute: "such assistance must be carried out in accordance with the Regulated Health Professions Act, 1991".

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Delegation vs assignment for medication

These two words get used interchangeably on the floor. They are not the same, and only one of them is about controlled acts. Our scope guide works the same distinction through the whole PSW role in delegation vs assignment for PSWs.

Assignment is the everyday one. The College of Nurses of Ontario defines assigning as "the act of determining or allocating responsibility for particular aspects of care to another individual", and notes that it "includes assigning procedures that may or may not be a controlled act". Helping a client take a prescribed, dispensed oral medication is not a controlled act, so it is assigned, not delegated. In a long-term care home, "assigned to perform the administration by a member of the registered nursing staff" is written into the regulation itself.

Delegation only ever concerns controlled acts. CNO: "Delegation occurs when a regulated health professional (delegator), who is legally authorized and competent to perform a controlled act, temporarily grants their authority to perform that act to another individual (delegatee)." Four things follow from that:

• The delegating nurse owns the decision. "A nurse who delegates a controlled act is responsible for the decision to delegate and for ensuring the delegatee is competent to perform the controlled act."
• Authority is not competence. "Although a UCP may have the authority to perform a procedure through an exception, delegation or because the procedure is not a controlled act, that does not mean that the UCP is competent to perform the procedure or that it is appropriate for the UCP to perform it."
• It cannot be passed on. Nurses cannot delegate a controlled act that was delegated to them, which CNO calls sub-delegation — and a delegation made to one PSW for one client is not authority for anyone else.
• Some acts cannot be delegated at all. CNO's restriction list names dispensing a drug, alongside psychotherapy as the Act defines it.

Section 28 of the RHPA adds the outer frame: a delegation must be made in accordance with the regulations under the delegating professional's own health profession Act. And supervision, in CNO's words, is "the monitoring and directing of specific activities of UCPs" — clinical monitoring, not line management.

If you do not feel competent to perform a delegated act for this client today, say so before you start. That conversation is the point of the competence requirement.

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Reporting and medication errors

Reporting is part of the medication-assistance role itself, not an extra. Ontario's training standard tells graduates to "identify changes, as instructed, in the client's behaviours and/or condition, as a result of medication assistance, and report changes to the registered staff or most accountable person", and to "identify and seek out resources, including supervisor and/or registered staff, to discuss or clarify assistance with medication". These are the error patterns worth recognizing before they happen, and there are more exam-specific ones in our guide to common NACC PSW exam mistakes.

If something goes wrong

Split what you do into two paths, because they are not the same.

If the client is in distress or in danger — struggling to breathe, collapsing, unresponsive, or showing any change that worries you — follow your employer's emergency protocol, which tells you when to call emergency services and who else to alert. Get help first. Do not wait for a return call, and do not wait to finish documenting.

Otherwise, report straight away through your reporting path:

1. Stay with the client and note exactly what you see — how they look, how they are breathing, what they say, what changed
2. Report immediately to the registered staff or most accountable person, even if the client seems fine
3. Document exactly what happened, when, and what you did
4. Never hide it. Concealing a medication error puts the client at risk and is a serious professional and ethical failure
5. Take part in the review. The team reviews incidents to prevent the next one, not to punish

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PRN medications: who decides?

PRN (pro re nata, or "as needed") medications are prescribed to be given only when certain symptoms are present — for example, acetaminophen for pain, lorazepam for anxiety, or an antacid for heartburn.

Deciding whether a PRN dose is needed is a clinical decision, and it is not the PSW's to make. Your part is the one the training standard describes: observe, and report what you have seen to the registered staff or most accountable person, seeking them out when a medication situation is unclear. Report what the client said and what you observed, and follow the direction you are given.

In home care, where no registered staff member is in the building, the reporting path is the same one your employer has given you — but the emergency path is separate. If the client is in distress or you think this is an emergency, follow your employer's emergency protocol and call emergency services. Do not sit and wait for a call back.

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Insulin and injections: where the line sits

Insulin is the case that sits closest to the line, so it is worth working through slowly.

• An insulin injection is a controlled act: "administering a substance by injection or inhalation" is paragraph 5 of section 27(2) of the RHPA.
• That means a PSW can reach it through what CNO describes as two doors: "through an exception or when an individual who has the authority to order or perform the act delegates this authority to the UCP".
• Door one, the exception. Section 29(1)(e) covers a paragraph 5 act done "in the course of assisting a person with his or her routine activities of living". CNO supplies the test: "a procedure is considered to be a routine activity of living when its need, response and outcome have been established over time and are predictable." CNO's summary describes the routine-care case; section 29(1) also holds other exceptions, such as first aid or temporary assistance in an emergency under section 29(1)(a), which are not a licence to perform a controlled act outside your training or your employer's emergency protocol.
• Door two, delegation. A regulated professional who is authorized and competent temporarily grants the authority, owns the decision, and must ensure the delegatee is competent. It is person-specific and cannot be passed on.
• In a long-term care home, an administration that is a controlled act is confined by regulation to a person "authorized to perform that act under a health profession Act, the Regulated Health Professions Act, 1991 or any relevant regulation" or "exempted from the prohibition on the performance of the controlled act by a regulation made under" the RHPA — the PSW clause in section 140(3)(b)(ii) applies only where the administration does not involve a controlled act.
• Either way, your training and your employer's policy decide whether the door is actually open to you, and the plan of care sets out what you are to watch for and report.
• Whatever the authority question, the safety answer does not change. Report any change you notice after assisting with medication to the registered staff or most accountable person, and if the client is in distress or in danger, follow your employer's emergency protocol and call emergency services before anything else.

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Key Takeaways

• Assistance is the default everywhere. Ontario's training standard frames the PSW medication outcome as assisting the client, following the plan of care.
• "A PSW can never administer medication" is no longer true in Ontario. In a long-term care home, O. Reg. 246/22 s. 140(3)(b)(ii) provides for it where no controlled act is involved — and only with training, the licensee's reasonable opinion, an assignment from registered nursing staff, that member's supervision, and one of the two eligibility routes: meeting section 52(1) or being described in section 52(2), or being an internationally trained nurse working as a personal support worker (s. 140(9)).
• Retirement homes and home care are different again. The retirement-homes regulation speaks about trained staff members supervised by a College member; home-care law defines personal support services without a medication element.
• Injections and inhalations are controlled acts. They need the routine-activities exception in section 29(1)(e), another statutory exception such as section 29(1)(a) first aid in an emergency — only within your training and your employer's emergency protocol — or a delegation; a procedure below the dermis is never covered by the routine-activities exception and needs a delegation or one of those other exceptions.
• The nine rights of assisting with medication come from Ontario's training standard, which credits them to a textbook — treat them as a professional checklist, not as legislation.
• Administering is not prescribing, and it is not choosing a dose. Those belong to the prescriber.
• Observe and report. Changes after medication assistance go to the registered staff or most accountable person; if a client is in danger, your employer's emergency protocol comes first.

For a broader understanding of your scope of practice as a PSW, see our guide on PSW scope of practice in Ontario. For exam-specific strategies, check out how to pass the NACC PSW exam.

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Sources

• Law — O. Reg. 246/22, ss. 52 and 140, under the Fixing Long-Term Care Act, 2021, checked September 16, 2026 (consolidation period January 1, 2026; e-Laws currency date September 11, 2026).
• Law — Regulated Health Professions Act, 1991, ss. 27, 28 and 29, checked September 17, 2026.
• Law — O. Reg. 166/11, s. 29, under the Retirement Homes Act, 2010, checked September 16, 2026.
• Law — O. Reg. 187/22, definition of "personal support services", checked September 16, 2026.
• Law — O. Reg. 79/10, revoked April 11, 2022, checked September 12, 2026.
• Ontario PSW training standard (not law) — Ministry of Colleges and Universities, Personal Support Worker Standard, January 2022 (PDF), vocational learning outcome 9 and glossary, checked September 12, 2026.
• CNO guidance (binds nurses) — College of Nurses of Ontario, Working With Unregulated Care Providers (PDF) and Scope of Practice (PDF), both checked September 12, 2026.
• Ontario government guidance (not law) — Home and community care, checked September 16, 2026.

This is exam-preparation education, not clinical or legal advice. What you may do with medication is governed by the law for your setting, your employer's policies and the client's plan of care. PSW Leap is not affiliated with NACC.

Frequently Asked Questions

Can a PSW administer medication in Ontario?

Sometimes, and the setting decides. The default is assistance: helping the client take medication that has been prescribed, following the plan of care. In an Ontario long-term care home, O. Reg. 246/22 s. 140(3)(b)(ii) lets a PSW administer a drug where the administration is not a controlled act, provided the worker has training under the home's written policies and protocols, the licensee reasonably considers the worker to have the appropriate skills, knowledge and experience, a member of the registered nursing staff has assigned the administration and supervises it under College of Nurses of Ontario standards, and the worker meets the section 52 hiring qualification or is an internationally trained nurse working as a PSW. Retirement homes have their own rule, and home-care law does not define medication as part of personal support services.

What are the nine rights of assisting with medication?

Ontario's PSW training standard (January 2022) lists nine: the right person receives the right medication, in the right dose, by the right route, at the right time, on the right day, for the right reason and with the right expiry date, and the right documentation must be completed. The standard credits the list to Mosby's Canadian Textbook for the Support Worker (4th edition, 2018), so treat it as a training convention adopted by Ontario's standard, not as a checklist written into law. The standard's own term is the rights of assisting with medications.

Can a PSW give insulin?

An insulin injection is a controlled act. Administering a substance by injection is listed in section 27(2) of the Regulated Health Professions Act, so a PSW needs a statutory exception or a delegation before it is theirs to do. The routine-activities exception in section 29(1)(e) covers injection or inhalation when it is genuinely part of assisting someone with their routine activities of living; section 29(1) holds other exceptions, such as first aid or temporary assistance in an emergency under section 29(1)(a), which reach no further than your training and your employer's emergency protocol; and a delegation comes from a regulated professional who is authorized and competent to perform the act. The College of Nurses of Ontario says a procedure counts as a routine activity of living when its need, response and outcome have been established over time and are predictable, and that authority is not the same as competence. Your employer's policy and your training decide whether any of those is open to you.