F0761

E

Failure to Properly Date and Remove Expired Medications From Medication Cart

Abilene, Texas Survey Completed on 01-22-2026

Penalty

No penalty information released

Summary

Surveyors identified a deficiency in the facility’s medication labeling and storage practices on one of three medication carts (Hall 200/300). During an observation, the cart contained a Novolin 70/30 FlexPen for Resident #2 and a Lantus FlexPen for Resident #69 that were not labeled with an open date, despite being multiuse insulin pens. The same cart also contained a bottle of nitroglycerin for Resident #15 with an expiration date of 12/22/2025 and a box of ondansetron with an expiration date of 12/07/2025, both of which remained on the cart past their expiration dates. The facility’s written policy on Medication Access and Storage stated that outdated, contaminated, or deteriorated medications are to be immediately removed from stock, disposed of according to destruction procedures, and reordered from the pharmacy.

In interviews, RN-E stated that all multiuse vials should be dated when opened, that it was the nurse’s responsibility to date medications upon opening and to check dates prior to administration, and that expired medications should be removed from the cart, which should be routinely checked for expired medications. RN-E acknowledged that not putting an open date on multiuse medications could result in residents receiving expired medications. The DON similarly stated that all multiuse vials should be dated when opened by the nurse who first uses them and checked each time they are administered, and that expired medications should be removed from the cart immediately. The DON also confirmed that the pharmacy conducted random cart checks but emphasized that nurses were ultimately responsible for ensuring medications requiring dating were dated, and she acknowledged that the facility did not have a policy specifically addressing the dating of insulin or other multiuse dose medications.