Medication Storage and Labeling Deficiencies
Penalty
Summary
Surveyors identified multiple deficiencies in the facility's medication storage and labeling practices for five residents. In the medication storage room, two opened bottles of Lorazepam for two residents were found without labels indicating the date opened or expiration, making it unclear when they should be discarded. Additionally, an opened and expired bottle of Amoxicillin for another resident was found in the refrigerator, with the expiration date clearly passed. On a medication cart, a bottle of Morphine Sulfate liquid for a resident was opened and unlabeled, with no indication of the date it was first used or when it should expire. Staff interviews confirmed that the expected practice is to label medications with the date opened, but this was not consistently followed. Further observations revealed that prescribed Nystatin powder was left unattended on a resident's bedside table. The resident reported that CNAs applied the powder after showers, but there was no assessment found for self-administration of medications, which is required by facility policy for bedside medication storage. The facility's policies require that all medications be labeled with the date opened and expiration, and that expired medications be promptly removed and destroyed. Monthly pharmacy reviews had previously identified similar issues, including undated and expired medications, but these problems persisted at the time of the survey. Interviews with nursing staff and the Director of Nursing confirmed that the facility's expectations were not met regarding medication labeling and storage. Nurses acknowledged that medications should be labeled upon opening and that expired medications should be discarded immediately. The Director of Nursing stated that nurses on each shift are responsible for monitoring medication refrigerators for expired drugs, and that pharmacy reviews are conducted monthly. However, the ongoing presence of unlabeled and expired medications, as well as improper bedside storage without proper assessment, demonstrated a failure to adhere to established policies and professional standards.