Expired Medications in Storage and Unsecured Bedside Medications
Penalty
Summary
Surveyors found that the facility failed to store and manage medications according to professional standards and facility policy. During an observation of the central medication room, multiple expired medications were identified, including unopened boxes of Alfrin Allergy Sinus nasal spray with an expiration date of January 2025, Bisacodyl stimulant laxative with an expiration date of June 2025, and Vitamin E 180 mg (400 IU) with an expiration date of April 2025. In a separate medication room (Vistas South), twenty boxes of Flucelvax Trival 2024–2025 syringes were found in the medication refrigerator, all expired as of June 17, 2025. These medications remained in storage despite the facility’s written policy requiring that all expired, discontinued, or deteriorated medications be promptly removed from storage and handled per pharmacy instructions. Surveyors also identified a failure to ensure medications were not left at a resident’s bedside without an assessment and authorization for self-administration. One resident with alcohol dependence, major depressive disorder, anxiety disorder, GERD, COPD, type 2 diabetes, and hyperlipidemia had a BIMS score of 12, indicating moderate cognitive impairment, and was documented as alert and oriented times two. During observation, this resident was found sleeping with a small cup of medications (aripiprazole, hydroxyzine, and cholecalciferol) left on the bedside table. The LPN who administered the medications stated she believed the resident had taken them but concluded the resident must have pocketed them and later spit them out after she left. The clinical record contained no evidence that the resident had been assessed and determined able to self-administer medications, despite the facility’s policy that residents may self-administer only if the physician and interdisciplinary team determine they have the decision-making capacity to do so safely.
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