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F0761
E

Medication Security and Storage Deficiencies Identified

San Antonio, Texas Survey Completed on 06-27-2025

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

A nurse prepared insulin for a resident by drawing up the medication and then entered the resident's room to administer it, leaving the vial of insulin unsecured on top of the medication cart and the cart itself unlocked and unattended in the hallway. This action left the medication accessible to others and out of the nurse's line of sight, contrary to facility policy and accepted professional standards for medication security. The nurse acknowledged during an interview that the insulin and cart should not have been left unsecured and unattended. Additionally, an inspection of the medication refrigerator in the facility's medication room revealed that the temperature was consistently below freezing, with recorded temperatures as low as 29-30 degrees Fahrenheit. Review of the temperature logs for the month showed that on 17 out of 25 days, the temperature was below the recommended range for medication storage. The temperature log did not include the acceptable temperature range, and staff were initially unable to state the correct storage temperature for medications. Multiple types of medications, including insulin, were stored in this refrigerator.

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