Failure to Remove Expired Medications and Date Opened Medications
Penalty
Summary
Surveyors observed that the facility failed to remove expired medications and failed to date open medications in both a medication storage refrigerator and a medication cart. In the Blue Hall medication storage refrigerator, an open glargine insulin pen was found without an open date, despite manufacturer instructions to discard after 28 days of use. Additionally, an open vial of tuberculin purified protein derivative was found with an open date exceeding the 30-day discard period. Unit Manager #1 confirmed these findings and acknowledged that nurses were responsible for dating and checking medications for expiration, but the expired medication had not been removed as required. On the Red Hall medication cart, several open medications, including insulin pens, inhalation powders, and various ophthalmic solutions, were found without open dates. These medications all had manufacturer recommendations for timely disposal after opening, which were not followed. Medication Aide #2 and Unit Manager #2 confirmed the lack of open dates and indicated there was no specific staff member assigned to check the medication cart for compliance. The DON stated that all nurses were responsible for dating and checking medications, but the required procedures were not consistently followed.