Medication Storage and Labeling Deficiencies Identified
Penalty
Summary
Surveyors observed multiple deficiencies in the facility's medication storage and labeling practices. During an inspection of the medication storage room, expired medications were found, including a box of Ipratropium and Bromide and Albuterol with an expiration date of 6/2025, and two bottles of Lansoprazole syrup, both past their expiration dates. Additionally, an IV 5% dextrose 1000ml bag was found outside of its manufacturer plastic cover, with a label indicating it should be used by a specific date, as per pharmacy protocol. The Director of Nursing Services (DNS) confirmed that IV supplies sent by the pharmacy are labeled with a 28-day expiration after removal from the manufacturer bag, after which they should be discarded. However, the DNS was unable to specify which nurse or shift is responsible for checking medication expiration or how often this task is performed. Further inspection of a medication cart revealed that an opened Humalog Kwikpen was properly dated, but a Lantus Solostar Insulin pen was found opened without a resident name or date of opening. An LPN stated that the Lantus pen likely belonged to a specific resident, as they were the only one on insulin on that cart, but this was not clearly labeled. Facility policy requires that open-dose vials of insulin be maintained no longer than the manufacturer’s instructions or 28 days, whichever is shorter, and that they be properly labeled with the date opened. These findings indicate a failure to consistently date insulin pens when opened and to ensure all medications are within their expiration dates, as required by facility policy and professional standards.