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F0658
E

Failure to Follow Professional Standards in Medication and Insulin Administration

Lewistown, Missouri Survey Completed on 11-17-2025

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

Staff at the facility failed to adhere to professional standards of practice during medication administration for multiple residents. Certified Medication Technicians (CMTs) were observed removing medications from their original packaging and placing them into unlabeled medication cups with only the resident's first name written on the side, prior to the scheduled medication pass. This practice was observed for 13 residents, and the cups were stored in the medication cart drawers until administration. The medications in the cups were not labeled to indicate their contents, and the CMT acknowledged that this was done to expedite the medication pass, despite knowing that medications should not be removed from packaging until the time of administration. The Director of Nursing confirmed that this practice was not in accordance with facility policy and could lead to medication errors. Additionally, staff failed to follow the facility's policy and manufacturer instructions for insulin administration for a resident with diabetes. The CMT administering insulin did not keep the insulin pen needle in the resident's skin for the required 6-10 seconds after pressing the plunger, as specified in both the facility's policy and the medication instructions. Instead, the needle was removed immediately after the dose counter reached zero, potentially resulting in incomplete administration of the prescribed insulin dose. The CMT stated they were unaware of the need to keep the needle in place for the specified duration.

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