Failure to Secure Medication Storage Areas
Penalty
Summary
The facility failed to ensure that all drugs and biologicals were stored securely in accordance with professional standards and its own policies. On one unit, a medication cart was observed unlocked and unattended in a hallway, with staff and others passing by. The nurse responsible for the cart acknowledged that it should have been locked but stated she was distracted and forgot to secure it. Additionally, both the 2nd and 3rd floor medication rooms were found unlocked and unattended at various times, with no licensed staff in the immediate vicinity. In one instance, a nurse was able to open the medication room door without a key, confirming it was not properly secured. The facility's policy requires all medication storage areas, including carts and rooms, to be locked when not in use or under direct supervision. The survey also found that the over-the-counter (OTC) medication room on one unit was unlocked and accessible, with shelves of medications available to anyone passing by. Nurses and the Director of Nursing confirmed that these areas should have been locked at all times when unattended. The report notes that several residents on the affected units had diagnoses of Alzheimer's disease or dementia, increasing the potential for residents to access and ingest medications if storage areas are not properly secured.