Deficient Medication Storage, Labeling, and Disposal Practices
Penalty
Summary
Surveyors identified multiple failures in the facility's management of drugs and biologicals, including improper storage, labeling, and disposal of medications. In Medication Room A, a vial of tuberculin solution was found labeled with an open date exceeding the recommended 30-day discard period, and another tuberculin vial lacked an open date entirely. Additionally, ice cream belonging to a resident was stored in the medication refrigerator, and three insulin pens for a resident were missing pharmacy prescription labels. A container of Super Sani Cloth Wipes was also observed with an illegible expiration date. In Medication Room B, the medication refrigerator was found to be operating below the required temperature range, with ice buildup present, and a tuberculin solution stored past its discard date. Further deficiencies were observed in the medication carts. Medication Cart B contained a bottle of nitroglycerin tablets stored with IV supplies, and an expired IV Luer lock cap was found. Medication Cart D contained opened and exposed single-use dressings, skin staple remover, and steri-strips, as well as expired wound dressings. Expired medications and supplies were not removed from Medication Carts B and D. In Medication Cart C, a container was found filled with melted and dried medications, indicating improper disposal of refused or discontinued medications. Staff interviews confirmed a lack of knowledge regarding proper medication disposal procedures. Facility policy reviews indicated that medications should be labeled, stored, and disposed of according to state and federal laws and standards of practice. However, observations and staff interviews revealed that these policies were not consistently followed, resulting in expired, improperly stored, and unlabeled medications and supplies remaining accessible in medication rooms and carts. The Director of Nursing and Administrator acknowledged these findings during interviews.