Improper Labeling of Insulin, Liquid Protein, and Tuberculin Solution
Penalty
Summary
The deficiency involves the facility’s failure to ensure medications and biologicals were properly labeled in accordance with facility policy and accepted professional standards. The facility’s Medication Labeling and Storage policy, dated February 2023, required that medication labels include, at a minimum, the medication name, prescribed dose, strength, expiration date when applicable, resident’s name, route of administration, and appropriate instructions and precautions. The policy also required that multi-dose vials opened or accessed be dated and discarded within 28 days unless otherwise specified by the manufacturer. Reference materials indicated that Novolog (insulin aspart) should be used or discarded within 28 days of opening, Medline Liquid Active Protein should be used or discarded within three months of opening, and tuberculin skin testing solution (Aplisol) expires 30 days after initial puncture. During observation of the Faith Short medication cart with an LPN, surveyors found an opened Novolog insulin FlexPen with approximately 200 units remaining, no resident name on the pen, and no date indicating when it was opened; the LPN confirmed that about 100 units were missing and that she did not know which resident it belonged to, when it was opened, or when it would expire. On the Love 1 medication cart, an LPN and surveyors observed an open stock bottle of liquid protein without an open date, and the LPN confirmed he would not know when it would expire. In the Faith Wing medication room, surveyors and an LPN observed an opened vial of Aplisol tuberculin testing solution with no open date on the vial, and the LPN confirmed she would not know when it would expire. In an interview, the DON confirmed the expectation that medications be labeled properly. These observations demonstrated noncompliance with the facility’s own policy and applicable state regulations regarding medication labeling and storage.
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