Medication Storage and Dietary Preference Deficiencies
Penalty
Summary
A deficiency was identified when a medication container was found left on a resident's overbed table rather than being stored in the designated medication cart. An LPN confirmed that medications should not be left at the bedside and that the container was removed and discarded after use. The LPN was unable to explain how the medication ended up in the resident's room. Further review of the medication cart confirmed the medication was not present, and the LPN stated the last dose had been administered and the empty container discarded. Facility policy requires medications to be stored in an orderly manner in secure locations, not at the bedside. Another deficiency was observed when a resident's breakfast tray did not match the dietary preferences and orders indicated on the resident's diet slip. The tray was missing items such as a Western omelette and yogurt, and included scrambled eggs and only one cold cereal instead of two. The resident confirmed the discrepancy between the ordered and delivered meal items. The facility is required to provide food that accommodates resident allergies, intolerances, and preferences, as well as appealing options of similar nutritive value.
Plan Of Correction
Label/Store Drugs and Biologicals CFR(s): 483.45(g)(h)(1)(2) 1. Address how corrective action will be accomplished for those residents found to have been affected by the deficient practice: Resident 10 was NJ Ex Order 26.4(b)(1). Resident was interviewed and stated they received their medications accordingly. 2. Address how the facility will identify other residents having the potential to be affected by the same deficient practice: All residents have the potential to be affected by this deficient practice. 3. Address what measures will be put into place or systemic changes made to ensure that the deficient practice will not recur: The Director of Nursing or Designee in-serviced licensed nursing staff on proper medication storage. 4. Indicate how the facility plans to monitor its performance to make sure that solutions are lasting: The Director of Nursing or designee will conduct audits on 5 random residents to ensure that medications are stored properly and not at bedside. Audits will be conducted weekly x 4 weeks, then every other week for 4 weeks, and then monthly x 3 months. The results of the audit will be reported to the facility QAPI committee until compliance is determined to be sustained. F 761 1. Address how corrective action will be accomplished for those residents found to have been affected by the deficient practice: Resident 20 was interviewed by the Food Service Director on whether they were served a diet taking into consideration their preferences and what they received for meals. 2. Address how the facility will identify other residents having the potential to be affected by the same deficient practice: All residents have the potential to be affected by this deficient practice. 3. Address what measures will be put into place or systemic changes made to ensure that the deficient practice will not recur: The Food Service Director or designee in-serviced the dietary department staff on providing meals as ordered that meet resident preferences.