Failure to Secure Resident Medications According to Facility Policy
Penalty
Summary
Surveyors found that the facility failed to ensure medications and biologicals were properly secured for multiple residents. Observations revealed that several residents had various medications, including prescription and over-the-counter drugs, stored openly on bedside tables, nightstands, and in bathrooms. These included bottles of chlorpheniramine, sodium carboxymethylcellulose, ketotifen fumarate, povidone, aluminum hydroxide/magnesium hydroxide/simethicone, nystatin, miconazole nitrate, Tylenol, Systane eye drops, antifungal powder, albuterol sulfate, and medicated shampoo. In some cases, residents reported that they used these medications themselves, while in other cases, staff had placed the medications in the rooms, and residents did not self-administer them. Facility staff, including the DON and RNs, were unaware that these medications were unsecured and accessible at the bedside. Review of facility policies indicated that medications should be locked whenever unattended, and that self-administered medications must be stored in a locked, permanently affixed box in the resident's room if requested to be kept at bedside. Physician orders for some residents allowed self-administration, but the required secure storage was not provided. In one instance, a resident had a medication at bedside without a corresponding physician order. The facility's failure to follow its own medication storage policies resulted in unsecured medications being accessible in resident rooms.