Controlled Substance Not Double-Locked as Required
Penalty
Summary
A deficiency was identified when a medication card containing hydrocodone/acetaminophen, a Schedule II controlled substance, prescribed to a resident for chronic pain management, was found stored in an unlocked cabinet within the locked medication room. The resident had a history of spondylosis, polyosteoarthritis, age-related osteoporosis, and chronic pain, and was cognitively intact according to the most recent assessment. The medication was reportedly awaiting destruction at the time of observation. During the investigation, nursing staff were unable to confirm whether the cabinet where the narcotic was stored could be locked. Attempts to lock the cabinet revealed that the lock was nonfunctional, allowing the door to open even when the key was turned. Facility policy requires that Schedule II-V medications be stored in a permanently affixed, double-locked compartment, separate from other medications, which was not followed in this instance.