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F0761
D

Unsecured Wound Care Cart with Medications and Biologicals Left Unattended

Dallas, Texas Survey Completed on 05-09-2025

Penalty

No penalty information released
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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

A wound care cart was observed parked in a hallway near the rehabilitation department with its lock protruding, indicating it was not secured. The cart and its drawers, which contained wound care supplies such as normal saline, triple antibiotics, and wound cleanser solutions, were easily accessible and could be opened by anyone passing by, including residents and staff. The cart was left unattended and unlocked in an area with frequent resident and staff traffic, and the contents could be easily taken. Interviews with the DON, ADON, and Administrator confirmed that the cart should have been locked when not in use and that the expectation was for staff to secure all medication and wound care carts when unattended. The facility's policy also required all medications and biologicals to be stored in locked compartments when not in use. The DON was unaware of how long the cart had been left unlocked and believed it may have been last used by night nurses.

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