Failure to Ensure Accurate Medication Administration and Storage
Penalty
Summary
The facility failed to provide adequate pharmaceutical services for two residents and in one medication room, as evidenced by multiple deficiencies in medication administration and storage. For one male resident with diagnoses including dementia, epilepsy, and osteoporosis, the medication aide (MA) did not check the resident's blood pressure prior to administering Metoprolol, a medication with specific parameters requiring blood pressure and heart rate checks before administration. The MA stated there was no area to document blood pressure in the medication administration record and therefore assumed it was not necessary to check, despite the physician's order specifying parameters. Review of the medication administration record showed no documented blood pressure checks prior to administration for several days. Another deficiency involved a female resident with a history of diverticulitis, mood disorder, anxiety, and hypertension. The facility failed to ensure the availability of her physician-ordered Hydralazine, resulting in a missed dose. The MA was unaware of the reason for the medication's unavailability and stated that medications were typically reordered when a 4-5 day supply remained. The MA reported notifying the charge nurse, but the charge nurse stated she had not been informed and would have checked the emergency kit or contacted the pharmacy if notified. Documentation confirmed the medication was not available at the time of administration. Additionally, during an observation of a medication room, expired medications were found, including bottles of melatonin, folic acid, and acetaminophen suppositories. The LVN interviewed was unsure of the process for checking expiration dates in the medication supply room and stated that medication aides were responsible for keeping the room clean and stocked. The DON confirmed there was no designated person responsible for checking expiration dates and that medication aides and nurses should have checked the medication rooms daily for expired drugs. Facility policy required accurate and timely provision of medications, proper storage, and adherence to physician orders, which was not followed in these instances.