Medication Storage and Labeling Deficiencies
Penalty
Summary
Surveyors identified multiple failures in medication management within the facility. For one resident with a history of acute respiratory failure, muscle weakness, dysphagia, diabetes, hypertension, and heart disease, an open and used insulin pen was found on the medication cart without a date indicating when it was opened. The Assistant Director of Nursing confirmed the insulin pen was undated, opened, and used. For another resident with hypertension, congestive heart failure, diabetes, and chronic kidney disease, both an Insulin Lispro pen and a Lantus pen were found open, used, and undated on the medication cart, as verified by the ADON. Additionally, a third resident with multiple chronic conditions, including COPD, asthma, diabetes, and heart failure, had several medications and topical treatments at the bedside without any current physician orders for those items. The Director of Nursing confirmed these medications were present without orders and removed them from the room. Further inspection of the medication storage room revealed several expired medications, including children's acetaminophen, aspirin, multivitamins with iron, vitamin E soft gels, and nicotine patches. An opened and undated tuberculin vial was also found in the refrigerator, along with multiple lancets lacking expiration dates. The Director of Nursing verified the presence of these expired and undated items. Facility policy requires that medications be dated when opened and that expired medications be removed from active supply, but these procedures were not followed, resulting in expired and improperly labeled medications being available for use.