Medication Storage, Labeling, and Security Deficiencies
Penalty
Summary
Surveyors identified multiple deficiencies related to the storage, labeling, and security of medications for several residents. One resident, with diagnoses including dementia and atherosclerotic heart disease, was found to be storing two bottles of Flonase nasal spray in his nightstand drawer and self-administering the medication without a physician's order or assessment for self-administration. The resident reported using the medication more frequently than prescribed, and staff confirmed there was no care plan or interdisciplinary team discussion regarding self-administration. The facility's policy required medications to be stored in locked compartments and only accessible by authorized staff, which was not followed in this case. Another resident, with epilepsy and psychosis, had Lorazepam, a controlled medication, stored in a medication refrigerator alongside non-controlled medications. Although the refrigerator and storage room were locked, the controlled medication was not kept in a separately locked compartment as required by facility policy and federal regulations. The DON acknowledged the importance of separate storage for controlled substances to prevent diversion and ensure proper tracking. Additionally, a third resident with diabetes was found to have insulin pens (Novolog FlexPen and Glargine) stored in the medication cart without expiration or discard dates labeled, despite being opened beyond the recommended 28-day period. The pens were administered past their effective date, and staff confirmed that expired medications had been given to the resident. Facility policy required proper labeling and immediate disposal of expired medications, which was not adhered to in this instance.