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F0761
E

Medication Labeling, Storage, and Expiration Deficiencies

Carmichael, California Survey Completed on 04-24-2025

Penalty

Fine: $26,685
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

Surveyors identified multiple failures in the facility's medication management practices during observations and interviews. Several multi-dose medications, including Tubersol, blood glucose test strips, and budesonide inhalation solution, were found opened and not labeled with the date of opening or discard date, despite manufacturer instructions and facility policy requiring such labeling. Additionally, expired medications such as ceftriaxone were present in storage areas, and some medications lacked pharmacy labels to identify the intended resident, including insulin pens, Sea Aloe supplement, and nitroglycerin tablets. Further inspection of medication carts revealed that prescription medications with different routes of administration, such as transdermal patches and oral medications, were stored together, contrary to facility policy. Loose pills were also found in medication drawers, and staff confirmed these should have been disposed of properly. Inhalers and other medications with limited stability after opening were not labeled with opened dates, as required by manufacturer guidelines and facility procedures. Interviews with staff, including the Infection Preventionist and a licensed nurse, confirmed awareness of the labeling and storage requirements, but acknowledged the deficiencies observed. The Director of Nursing also confirmed that medications should be labeled with at least the resident's name and that expired or loose medications needed to be removed and disposed of. Facility policies reviewed by surveyors supported these requirements for proper labeling, storage, and disposal of medications.

Plan Of Correction

Corrective Action for Affected Residents: On 4/21/25, the following immediate actions were taken: All corrective action to be completed by 5/26/25 F 761 F 761

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