Deficiencies in Medication Storage and Labeling
Penalty
Summary
Surveyors identified multiple deficiencies related to the storage and labeling of medications and biologicals. In one medication room, two expired containers of Lisinopril labeled for a resident with hypertension were found on a shelf, despite the resident still being present in the facility and having received new medications from the pharmacy. Staff interviews revealed uncertainty about who was responsible for removing expired medications, and the expired drugs had not been properly disposed of as required by facility policy. In another instance, a sealed, unopened box of Semaglutide, which requires refrigeration, was found stored at room temperature in a medication cart for a resident with Type 2 Diabetes Mellitus and diabetic neuropathy. The medication box was clearly labeled to be refrigerated, but staff confirmed it had not been stored correctly and could not determine how long it had been at room temperature. The responsibility for ensuring proper storage upon arrival from the pharmacy was not clearly assigned or followed. Additionally, an opened bottle of saline nasal spray was found in a medication cart, labeled only with a resident's first initial and last name handwritten in marker, lacking other required identifying information. Staff acknowledged that the labeling was insufficient, especially given the commonality of the name, and could not confirm the medication was intended for the correct resident. The facility's policy and staff interviews confirmed that medications should be properly labeled and stored to prevent errors.