Failure to Properly Store and Label Medications in Medication Carts
Penalty
Summary
Surveyors identified multiple failures in the facility's medication storage and labeling practices across all four medication carts reviewed. Observations revealed that multi-dose medications, such as inhalers, insulin pens, ophthalmic drops, and nasal sprays, were frequently found without required open dates or expiration dates. In several instances, medications belonging to residents who had been discharged remained in the carts, and loose, unidentified tablets were discovered in various drawers. These findings were corroborated by interviews with nursing staff, who acknowledged the lack of proper dating and, in some cases, uncertainty regarding the facility's policy on medication dating. Record reviews of the facility's 'Storage of Medications' and 'Medication Administration' policies indicated that medications and biologicals are to be stored securely and dated upon opening, with certain medications requiring a shorter expiration period once opened. Despite these policies, surveyors observed opened containers of blood sugar testing strips, insulin pens, and other multi-dose medications without any indication of when they were opened or when they should be discarded. Staff interviews confirmed that these items were in use without adherence to the documented procedures for dating and discarding. The deficiency was further evidenced by the presence of medications for residents no longer residing in the facility, as well as loose tablets found in medication carts without identification or proper storage. Staff members, including RNs and LPNs, were unable to provide consistent explanations for the lack of dating or the continued presence of medications for discharged residents. These actions and inactions directly contravened the facility's own policies and accepted professional standards for medication storage and labeling.