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F0839
D

Unqualified Staff Administered Narcotics and Insulin

Pomeroy, Ohio Survey Completed on 08-12-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

Certified Medication Aide/Tech #3 administered narcotic medication and insulin to two residents without being qualified or trained to do so. One resident, with multiple diagnoses including diabetes, cerebrovascular disease, and cognitive impairment, received hydrocodone-acetaminophen, a class II narcotic, on two occasions as documented in the medication administration record and controlled drug log. Another resident, with a history of diabetes, COPD, hemiplegia, and other conditions, received insulin aspart via Flex pen on two separate occasions, also administered by the same unqualified staff member. Documentation confirmed that the aide/tech had not completed the required training and was not authorized to administer these medications at the time of administration. Interviews with facility staff, including the administrator and a registered nurse, confirmed that the aide/tech was unqualified to administer narcotics and insulin. Review of the personnel file showed no evidence of completed training or qualification for medication administration. Facility policy requires that medications be administered by licensed nurses or staff legally authorized to do so, which was not followed in these instances. The deficiency was identified through review of records, interviews, and policy documents, affecting two residents out of 32 with narcotic and/or insulin orders.

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