Purpose Statement
This article explains how authorized supervisors perform a Custody Exchange Override for a controlled substance Med Kit when the provider currently recorded in custody is no longer available to complete a standard Custody Exchange.
The override allows an authorized user to intervene between the previous custodian and the new receiving provider, document why custody is being overridden, verify the security and available medication inventory when required, and complete the applicable signature process so possession can be reassigned accurately.
A Custody Exchange Override is performed only from Med Kits. It cannot be initiated from the Medications Dashboard.
Background Information
A Custody Exchange Override is a supervisory workflow used when the provider currently recorded as having custody of a controlled substance Med Kit cannot participate in the normal Custody Exchange process.
One situation where an override may be necessary occurs when providers begin a Custody Exchange but must interrupt the workflow and select Save as Draft. A saved Custody Exchange resumes as a standard medication Count rather than continuing the original exchange. As a result, completing the resumed Count does not transfer custody, and the original provider may remain recorded as possessing the Med Kit.
The override workflow is associated with the Exclusive Possession setting in Medications > Setup. When Exclusive Possession is enabled, only the user currently recorded as possessing the Med Kit can initiate a standard Custody Exchange. Users who do not have possession do not see the Custody Exchange controls unless they have the applicable override permissions.
To perform a Custody Exchange Override when Exclusive Possession is enabled, the authorized user needs:
- Override Exclusive Possession — Allows the user to access the applicable custody controls when another user has possession.
- Possession Override — Allows the user to override the existing custody assignment.
A Custody Exchange Override is available only from the applicable controlled substance Med Kit. Regardless of permissions, users cannot initiate an override from the Medications Dashboard. The Start Exchange button on the Dashboard does not provide access to the override workflow.
When Exclusive Possession is disabled, the Custody Exchange controls follow the standard Custody Exchange workflow rather than presenting the supervisory override process. Users who do not currently possess the Med Kit may require Meds - Global Custody Exchange to initiate the standard exchange, but that permission does not create a Dashboard or Med Kit Custody Exchange Override workflow.
During the override, the supervisor documents the reason for intervention and verifies the Med Kit's security. For seal-secured kits, the physical seal number is compared with the seal recorded in First Due. A matching seal may allow the supervisor to continue directly to the signature process, while a mismatched seal requires Break and Count.
When a physical Count is required, only medication inventory that is currently present is displayed. Medication Forms with a current quantity of 0 do not appear during the Count because there is no medication to physically verify.
The supervisor acts as the intermediary transferring possession from the unavailable provider to the new receiving provider. The supervisor and receiving provider complete the applicable authentication and signature requirements before the new provider becomes the recorded custodian.
Required Permissions
Users performing a Custody Exchange Override need the applicable access and permissions, including:
- Access to the Medications module.
- Access to the applicable controlled substance Med Kit.
- Meds - Custody Exchange — Applicable custody exchange access.
- Override Exclusive Possession — Allows access to custody controls when another user possesses the Med Kit and Exclusive Possession is enabled.
- Possession Override — Allows the authorized user to override the existing custody possession.
Signature authentication requirements depend on agency configuration and may include a PIN, First Due password, and/or signature.
Video
Medications Par Management
Par management allows medication inventory within Med Kits to be organized and monitored at the pouch level. If a Custody Exchange Override requires Break and Count, the supervisor physically verifies the medication inventory currently present within each applicable pouch before custody is reassigned.
When the same Medication Form has inventory in multiple pouches, each pouch's available inventory is maintained and verified separately. This allows the supervisor and receiving provider to distinguish the physical location of the inventory being transferred into the new provider's custody.
Par represents the configured stocking level for a Medication Form within the pouch. Min represents the configured minimum inventory threshold.
Medication cards use the current inventory-status logic:
- Red — Restock Needed: Available quantity is below Min.
- Yellow — Monitor: When both values are configured, available quantity is at or above Min and at or below Par.
- Yellow — Monitor when Min is not configured: Available quantity is at or below Par.
- Light Gray — Well Stocked: Available quantity is above the applicable monitoring threshold.
- Light Gray — No thresholds configured: The medication card appears light gray when neither Par nor Min is configured.
Inventory that is exactly at Min remains yellow when both Par and Min are configured. It does not become red until inventory drops below Min.
If Par and Min are configured at the same value, inventory at that value also remains yellow and turns red only after the quantity drops below Min.
Medication Forms at quantity 0 do not appear during the Count portion of a Custody Exchange Override because there is no physical medication inventory to verify.
The Medication Form can remain visible when viewing the Med Kit, where it may display red Restock Needed, but it is unavailable for medication actions until inventory is added through an applicable Receive or Transfer workflow.
Step-by-Step Guide
1. Open Med Kits
- Select the First Due logo in the upper-left corner.
- Open the Medications module.
- Select Med Kits.
Locate the controlled substance Med Kit requiring the custody override.
2. Confirm That an Override Is Required
Review the provider currently displayed as having custody of the Med Kit.
A Custody Exchange Override may be appropriate when that provider cannot participate in the standard Custody Exchange.
Examples include:
- A Custody Exchange was interrupted and saved as a draft.
- The recorded custodian left before the custody transfer could be completed.
- The current custodian is otherwise unavailable to initiate and complete the standard exchange.
Important Note:
When the Count portion of a Custody Exchange is saved as a draft, resuming it opens a standard medication Count. Completing that Count does not complete the original Custody Exchange or change the recorded custodian.
3. Confirm Exclusive Possession Is Enabled
Review the agency's Exclusive Possession configuration in Medications > Setup.
When Exclusive Possession is enabled:
- Only the current custodian can initiate a standard Custody Exchange.
- Users who do not possess the Med Kit do not see the custody controls unless they have Override Exclusive Possession.
- An authorized user also needs Possession Override to override the existing custody assignment.
When Exclusive Possession is disabled, the system follows the standard Custody Exchange workflow rather than the Custody Exchange Override workflow.
Important Note:
Meds - Global Custody Exchange allows applicable standard Custody Exchange behavior when Exclusive Possession is disabled. It does not provide access to the Custody Exchange Override workflow.
4. Open the Custody Override
From the applicable controlled substance Med Kit, select one of the available Custody Exchange controls.
For a user who does not currently have possession, the controls are visible under Exclusive Possession only when the user has Override Exclusive Possession permission.
Select Override Custody.
The user also needs Possession Override permission to override the existing custody assignment.
Warning:
Use Override Custody when the recorded custodian cannot participate in the normal custody transfer. When the current custodian is available, use the standard Custody Exchange workflow instead.
The user initiating the Override Custody workflow will become the Transferring Provider.
5. Select the Override Reason
Select the reason that best explains why custody must be overridden.
Available reasons include:
- Medical / Emergency — Employee medical or personal emergency requiring the provider to leave.
- Operational / Duty — Operational needs, duty changes, or unit reassignment.
- Administrative — Administrative or policy-driven circumstances.
- Other — Another situation requiring supervisory intervention.
Select the option that most accurately reflects the circumstances.
6. Enter Comments
Enter additional information in the Comments field as appropriate.
When Other is selected, provide the required explanation.
Tip:
Use comments to provide enough context for an administrator reviewing the custody history later to understand why supervisory intervention was required.
7. Continue the Override
Select Override Custody to continue.
For a seal-secured controlled substance Med Kit, the workflow prompts for the physical seal number.
8. Enter the Current Seal Number
Enter the seal number physically present on the Med Kit.
Select the Plus (+) control and continue.
The system compares the entered seal number with the seal currently recorded for the Med Kit.
9. Report a Seal Occurrence if Necessary
Select Report when a seal occurrence needs to be documented.
Complete the applicable occurrence information and send the report according to the available workflow.
Occurrence documentation provides additional context around the seal discrepancy and becomes part of the medication activity available for later review.
10. Continue When the Seal Matches
When the physical seal matches the seal recorded in First Due, choose between:
- Sign — Continue the custody override without breaking the seal.
- Break and Count — Break the seal and physically verify the medication inventory before continuing.
Follow agency policy when determining whether physical inventory verification is appropriate.
11. Break and Count When the Seal Does Not Match
If the entered seal does not match the seal recorded in First Due, the workflow requires Break and Count.
Break the seal and complete the physical medication verification before proceeding with the custody override.
During the Count:
- Review each applicable pouch.
- Verify medication inventory that is physically present.
- Review Medication Form, quantity, expiration date, lot number, and serial number when applicable.
- Use the applicable verification controls to identify whether the physical inventory matches the system inventory.
Medication Forms with a current quantity of 0 do not appear because there is no physical inventory to verify.
Info:
See Performing Medication Counts for additional information about medication verification and controlled substance discrepancies.
12. Review Par and Min Information During the Count
When Par and Min information is displayed, use it as an additional inventory-status reference.
Under the current logic:
- Inventory at Min remains yellow when both Par and Min are configured.
- Inventory below Min displays red Restock Needed.
- Inventory above the applicable Par monitoring range displays light gray.
Par and Min indicators do not replace physical verification of the medication inventory.
Warning:
A Medication Form already recorded at quantity 0 is not a Count discrepancy. It is excluded from the physical Count because First Due already records that no inventory is present.
13. Document Medication Discrepancies When Applicable
If First Due expects medication inventory to be present but the physical medication does not match the system record, identify the discrepancy using the applicable verification controls.
For controlled substances, the discrepancy can create an Occurrence Issue and applicable occurrence-reporting behavior.
An Occurrence Issue identifies that a discrepancy exists. It does not determine why the discrepancy occurred.
Follow agency procedures and review the medication event history when additional investigation is needed.
14. Authenticate the Supervising Provider
Continue to the override signature workflow.
The supervising provider completes the agency-configured authentication and signature requirements.
Depending on agency configuration, this may include:
- A four-digit PIN.
- The user's First Due account password when a PIN is required but one has not been configured.
- A signature filled from the user's saved profile signature, when allowed.
- A manually entered signature.
The supervisor is acting as the intermediary for the unavailable custodian and is not required to become the new custodian.
15. Select the Receiving Provider
Select the provider who will take custody of the controlled substance Med Kit.
Verify the receiving provider carefully before continuing.
16. Authenticate the Receiving Provider
The Receiving Provider completes the applicable agency authentication and signature requirements.
Depending on agency configuration, this may include:
- PIN
- First Due password
- Saved profile signature
- Manually entered signature
17. Complete the Custody Override
After the supervisor and Receiving Provider have completed the required authentication and signatures, select Save.
The Custody Exchange Override is completed, and the Receiving Provider becomes the recorded custodian of the Med Kit.
Review the Med Kit custody information to verify that the new provider is displayed.
Best Practices
- Use Custody Exchange Override only when the current recorded custodian cannot participate in a standard Custody Exchange.
- Perform the override directly from Med Kits. Custody Exchange Overrides cannot be initiated from the Medications Dashboard.
- Understand that Start Exchange on the Dashboard is not an override control and does not become available for overrides based on supervisory permissions.
- Limit Override Exclusive Possession and Possession Override permissions according to the agency's intended supervisory custody workflow.
- Remember that both permissions serve a role when an authorized user needs to override another person's custody under Exclusive Possession.
- Avoid Save as Draft during normal Custody Exchanges whenever possible. A resumed Custody Exchange draft becomes a standard Count and may leave the original provider recorded in possession.
- Verify that Exclusive Possession is enabled when determining whether the override workflow should be available.
- Select the override reason that most accurately describes the circumstances.
- Add clear comments when additional context would improve the custody history.
- Verify the physical seal before deciding whether to proceed directly to signatures or complete Break and Count.
- Physically verify all displayed pouch-level inventory when a Count is required.
- Remember that zero-quantity Medication Forms do not appear during the Count because there is no physical inventory to verify.
- Use Par and Min colors as inventory-status references only. Inventory at Min remains yellow; red Restock Needed begins below Min.
- Review Occurrence Issues and inventory discrepancies in context with the associated medication history.
- Confirm the Receiving Provider before completing authentication and signatures.
- Verify that the Receiving Provider is displayed as the new custodian after completing the override.
Troubleshooting & FAQs
When should I perform a Custody Exchange Override?
Use a Custody Exchange Override when Exclusive Possession is enabled, the provider currently recorded as possessing the controlled substance Med Kit is unavailable, and a standard Custody Exchange cannot be completed.
Can I perform a Custody Exchange Override from the Medications Dashboard?
No. Custody Exchange Overrides can only be initiated from the applicable Med Kit. Regardless of permissions, users cannot perform an override from the Dashboard.
Will supervisory permissions make Start Exchange appear on the Dashboard for an override?
No. Start Exchange is not used for Custody Exchange Overrides. Override functionality is accessed from the applicable Med Kit.
Why might an override be needed after a Custody Exchange was saved as a draft?
A saved Custody Exchange resumes as a standard medication Count rather than continuing the original custody transfer. Completing that Count does not transfer custody, so the original provider may remain recorded as possessing the Med Kit.
Why don't I see the Custody Exchange controls when another user has possession?
When Exclusive Possession is enabled, users who do not possess the Med Kit do not see those controls unless they have Override Exclusive Possession permission.
Why can I see the custody controls but still not complete an override?
Accessing the controls and overriding the existing possession are separate permissions. In addition to Override Exclusive Possession, the user needs Possession Override to override the existing custody assignment.
What permissions are required to perform the override?
The authorized user needs the applicable Medications and Med Kit access, Meds - Custody Exchange, Override Exclusive Possession, and Possession Override.
Does Meds - Global Custody Exchange allow me to perform an override?
No. Meds - Global Custody Exchange applies to standard Custody Exchange behavior when Exclusive Possession is disabled. Custody Exchange Override uses the Exclusive Possession override permissions and is initiated from Med Kits.
What happens when Exclusive Possession is disabled?
The custody controls follow the standard Custody Exchange workflow rather than presenting Override Custody.
What does Exclusive Possession do?
When enabled, only the provider currently recorded as possessing the controlled substance Med Kit can initiate a standard Custody Exchange. Authorized users with the applicable override permissions can intervene when that provider is unavailable.
Do I need to perform a full Count during every override?
Not necessarily. For a seal-secured Med Kit, a matching physical seal can allow the workflow to proceed to signatures without breaking the seal. A mismatched seal requires Break and Count.
What happens if the physical seal does not match First Due?
The workflow requires Break and Count so the available medication inventory can be physically verified before the custody override continues.
Can I report a seal discrepancy during the override?
Yes. Use Report when occurrence documentation is appropriate within the seal-verification workflow.
Why doesn't a zero-quantity Medication Form appear during Break and Count?
A Medication Form with a current quantity of 0 has no physical inventory to verify, so it does not appear during the Count. It can remain visible when viewing the Med Kit but is unavailable for medication actions until inventory is replenished.
Is a zero-quantity Medication Form automatically a discrepancy?
No. If First Due already records the quantity as 0, the system is not expecting physical medication to be present during the Count. A discrepancy occurs when the physical inventory does not match inventory First Due records as present.
Why is medication at Min still yellow during the Count?
Under the current Par and Min logic, inventory at Min remains in the yellow monitoring state. The red Restock Needed condition begins when inventory falls below Min.
Who signs during a Custody Exchange Override?
The authorized supervisor completes the intermediary portion of the workflow, and the new Receiving Provider completes the receiving portion.
Does the unavailable provider need to sign the override?
No. The override allows an authorized supervisor to intervene when the currently recorded custodian is unavailable.
Why does the supervisor sign if they are not keeping the Med Kit?
The supervisor is acting as the intermediary for the custody transfer. The selected Receiving Provider becomes the recorded custodian when the override is completed.
What authentication is required?
Authentication depends on agency configuration and may include a PIN, First Due password, a saved profile signature, and/or a manually entered signature.
What happens after the override is completed?
The selected Receiving Provider becomes the recorded custodian of the controlled substance Med Kit.