Medications Left at Bedside Without Ensuring Ingestion
Penalty
Summary
The deficiency involves the facility’s failure to ensure that medications were administered in accordance with professional standards and the facility’s own medication guidelines for one resident (R79) out of ninety-one residents screened. The facility’s policy, last updated January 2025, required that residents be observed after administration to ensure that the dose was completely ingested. On 9/2/25 at 9:16 AM, a surveyor entered R79’s room and observed six pills left on top of the bedside table. When asked, R79 stated, “I don't know what these are do you?” The surveyor left the room and immediately returned with E13 (LPN), who confirmed that they had left R79’s medications without ensuring that the medications were ingested, contrary to the facility’s policy and professional standards. On 9/9/25 at 2:00 PM, these findings were reviewed with the Nursing Home Administrator (E1) and the Quality Manager (E3) during the exit conference.
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