Expired and Improperly Stored Medications Identified During Survey
Penalty
Summary
Surveyors observed that expired medications were not removed from the medication refrigerator in the medication storage room at the nursing station. Specifically, a box containing five expired COVID-19 mRNA vaccine injections, an open bottle of cephalexin oral suspension, and an open bottle of vancomycin hydrochloride oral solution were found past their expiration dates. The DON confirmed these findings prior to removal and stated that the Unit Manager was responsible for checking and removing expired medications, but checks were only performed every few weeks. Additionally, on the Hall 100 medication cart, an open inhalation powder medication used for COPD and asthma was found to have exceeded the six-week discard period after opening, which Nurse #1 was unaware of. The DON, who was new to the facility, had not yet implemented a process for regular checks of medication carts for expired medications. Further observations revealed that unopened insulin lispro injector pens, which require refrigeration according to manufacturer recommendations, were stored at room temperature on the Hall 200 medication cart instead of in the refrigerator. Both Nurse #2 and the Pharmacist confirmed that the insulin pens should have been refrigerated until opened, as indicated by clear labeling on the packaging. The DON also acknowledged that the insulin pens should have been placed in the refrigerator upon delivery from the pharmacy.