Improper Storage and Disposal of Medications
Penalty
Summary
Surveyors identified multiple deficiencies related to the storage, labeling, and disposal of medications in the facility. Discontinued lorazepam oral solutions, a controlled substance, for two residents were found in the medication room refrigerator, despite physician orders indicating the medications had been discontinued. These medications were not removed or disposed of according to the facility's policies, which require discontinued controlled substances to be documented and destroyed by the DON and consultant pharmacist. Additionally, other medications for one resident, including ondansetron orally disintegrating tablets, hyoscyamine sublingual tablets, acetaminophen suppositories, ipratropium with albuterol inhalation solution, and bisacodyl suppositories, were stored in the refrigerator contrary to manufacturer specifications, which could affect their safety and efficacy. Further observations revealed that two medication carts contained unsealed red biohazard containers filled with discarded tablets and capsules. The containers were left with open lids, making the medications accessible and retrievable. Nursing staff interviewed were unaware of why the containers were left in this state and acknowledged that the medications should have been removed or discarded properly to prevent accidental exposure or misuse. The DON confirmed that the red bins should have been emptied into the incineration bin and that accessible medications posed a risk for misuse and accidental exposure. Facility policies reviewed by surveyors outlined the proper procedures for the disposal of controlled and discontinued medications, as well as requirements for medication storage areas to be clean, well-lit, and free of clutter. Despite these policies, the facility failed to ensure compliance, resulting in discontinued and improperly stored medications remaining accessible in medication storage areas and medication carts.