Expired Medications Not Removed from Medication Carts
Penalty
Summary
The facility failed to provide adequate pharmaceutical services by not ensuring the timely removal of expired medications from two medication carts. On Med Cart A, three blister packs of Tramadol 50 mg tablets, totaling 68 tablets and all with the same expiration date, were found. The nurse responsible for the cart acknowledged missing the expired medication during routine checks. The medication administration records showed that the resident had not received Tramadol for several months, and the medication had not been administered during the period in question, despite the presence of a new order. On Med Cart B, a blister pack containing nine tablets of Hyoscyamine Sulfate and another containing one tablet of Haloperidol, both expired, were found. The nurse interviewed stated that nurses and unit managers were supposed to check the carts weekly, but the expired medications remained. The medications were associated with a resident who had not received them in recent months, and one of the medications had been discontinued without a documented end date. The nurse indicated that the medications had come from the resident's hospice and were no longer in use. Interviews with nursing staff and facility leadership confirmed that procedures were in place for checking medication expiration dates, and recent in-services had been conducted on medication management. However, the expired medications were not identified or removed as required by facility policy, which states that expired medications should be reported to the nurse manager. The failure to remove expired medications from the carts was observed directly by surveyors during their review.