Failure to Securely Store Resident Medications
Penalty
Summary
Surveyors identified that the facility failed to ensure medications and biologicals were labeled and stored in accordance with accepted professional standards for three residents. Specifically, medications such as inhalers and nasal sprays were observed left unsecured on bedside tables or in open areas of residents' rooms, rather than being stored in locked compartments as required. Facility policy allows bedside medication storage only for residents who have been assessed and approved for self-administration, with the stipulation that medications must be inaccessible to other residents. For one resident with COPD and shortness of breath, multiple inhalers and a nasal spray were found on top of the nightstand, despite orders permitting self-administration and bedside storage. However, staff interviews revealed uncertainty about whether these medications needed to be locked, and it was noted that at least one medication (Fluticasone Propionate Nasal Spray) should not have been at the bedside, as the resident was not approved to self-administer it. Another resident with a history of stroke and cognitive impairment had a nasal spray left unsecured in the room, even though the most recent assessment indicated no desire to self-administer medication. The physician's order for self-administration predated the assessment, and the record did not reflect the change in the resident's ability or desire to self-administer. A third resident with COPD was found with an inhaler left unsecured on the overbed table, which the resident stated was left by the night nurse and that they were not supposed to have. Staff interviews confirmed that these residents should not have had medications at the bedside unless proper assessments and secure storage were in place. The DON expressed uncertainty about the storage requirements for non-narcotic medications and indicated a need to review facility policy.