Medication Storage and Labeling Deficiencies
Penalty
Summary
Surveyors identified multiple failures in the facility's medication management practices across two medication rooms and three medication carts. Expired medications were not removed after their discard or use-by dates, and discontinued medications for two residents remained on the medication carts without active orders. Additionally, some medications, such as eye drops and insulin, were not labeled with the opened date as required, and an insulin vial and flexpen were retained beyond the 28-day discard period. Orally administered medications were stored together with externally used medications, such as suppositories and topical solutions, contrary to facility policy. During inspections, surveyors observed that oral and external medications were stored together in both medication carts and storage rooms. In one instance, a box of bisacodyl suppositories was stored with oral medications, and acetylcysteine solution was stored beside lidocaine patches. A bottle of doxycycline had an illegible expiration date, and a discontinued topical medication was not properly disposed of. The medication storage room was also found to be unsanitary, with visible dust, debris, and discarded items on the floor. Interviews with nursing staff and facility leadership confirmed that the observed deficiencies were contrary to facility policies, which require proper labeling, timely removal of expired and discontinued medications, and separate storage of oral and external medications. Staff acknowledged that the responsibility for medication storage, cleanliness, and removal of discontinued or expired medications rested with the assigned licensed nurse, and that these procedures had not been followed as required.