Medication Security, Labeling, and Disposal Deficiencies
Penalty
Summary
Surveyors observed that medication cart keys, including those for controlled substances, were left unattended in a disposable cup on top of the medication cart near the nurse's station. When questioned, a registered nurse stated that staff had been instructed by management to leave the keys in this location, rather than keeping them on their person as required by facility policy. The nurse confirmed that the narcotic key was included in this set. Additionally, review of the narcotic endorsement log revealed missing signatures for the change of shift count on two occasions, indicating that the required reconciliation and documentation of narcotic counts were not consistently performed. Further inspection of the medication cart revealed a vial of Humulin R insulin that was past its discard date but had not been disposed of, and the medication administration record showed that a resident had received doses from this vial after the discard date. The cart also contained blood glucose testing supplies, including test strips and control solutions, that were not labeled with open or discard dates, contrary to manufacturer instructions and professional standards. Staff were unable to determine when these supplies had been opened or when they should be discarded.