Consultant Pharmacist Failed to Provide Comprehensive Onsite Pharmacy Services
Penalty
Summary
The facility failed to ensure that the Consultant Pharmacist (CP) provided comprehensive consultation on all aspects of pharmacy services. During observations, loose pills were found in the medication cart, and multiple bottles of tube feeding formula were stored in a cabinet underneath a hand washing sink. The Registered Nurse (RN) present was unaware of the improper storage of both the loose pills and the formula. The Director of Nursing (DON) confirmed the improper storage and stated that there was a designated container for loose pills, expecting licensed nurses to dispose of medications properly. Additionally, a cabinet in the medication room was found to be full of discontinued narcotic medications, with the last destruction of these drugs by the CP occurring several months prior. The DON stated that the CP had been conducting medication reviews remotely and had not visited the facility to assist with the destruction of discontinued medications. The Administrator reported that the CP had been inconsistent with facility visits, continued remote reviews since the COVID-19 period, and had not attended quarterly Quality Assurance (QA) Committee meetings since 2022. The CP's Director of Clinical Operation was unaware of the lack of physical presence and stated that pharmacy policy required in-person visits for drug destruction and QA attendance.