Unattended and Unlocked Medication and Treatment Carts
Penalty
Summary
Staff failed to store drugs and biologicals in accordance with state and federal requirements, as evidenced by multiple observations of unlocked and unattended medication and treatment carts. On several occasions, the high side medication cart on the first floor was observed unlocked and unsupervised in the hallway, with staff and residents passing by, and no nurse present at the cart. Facility policy requires all drugs and biologicals to be stored securely, with carts locked when not in use and never left unattended if open or accessible. Additionally, on the second-floor secured unit, which houses residents with wandering behaviors, the treatment cart in the whirlpool/tub room was repeatedly found unlocked and unattended. The surveyor was able to access drawers containing resident-specific treatment supplies, such as creams and ointments, and the cart was accessible to residents. Interviews with nursing staff and the DON confirmed that all medication and treatment carts should be locked when unattended, including the treatment cart in the shower/tub room.