Failure to Label Insulin Pens and Remove Expired Medications
Penalty
Summary
Surveyors observed that the facility failed to ensure medications were labeled in accordance with accepted professional standards and that expired medications were removed from inventory. Specifically, insulin pens in one of two medication carts were found without the date they were opened, and expired Bisacodyl suppositories were present in both a medication cart and the medication room. The facility's policy required medications to be discarded by their expiration date or earlier, and insulin pens to be dated when opened to ensure proper disposal after 28 days. Staff interviews confirmed that the usual practice was to date insulin pens and discard expired medications, but these procedures were not followed in the instances observed. Medical record reviews showed that one resident had been receiving Lantus insulin daily since early April, and another had received Novolog insulin as needed multiple times in May. The lack of labeling on the insulin pens made it unclear whether they were within the safe usage period. The presence of expired Bisacodyl suppositories in both the medication cart and medication room further demonstrated a lapse in medication management and inventory control.