Improper Medication Storage, Security, and Expired Insulin Management
Penalty
Summary
The deficiency involves failure to store and secure medications in accordance with facility policy and accepted professional standards. A surveyor observed an unattended medication cart left outside a resident’s closed room with the lock not engaged, allowing the drawers to be opened. The nurse responsible for the cart confirmed it contained medications for 22 residents and acknowledged that only nurses should have access to the cart and that the keys, which had been left on top of the cart, were for that cart. The nurse then placed the keys in a scrub pocket and re-entered the resident’s room to continue care, again leaving the cart unlocked and unattended in the hallway. In a clean utility room on a locked dementia unit, which was accessible to CNAs and unlicensed staff, the surveyor found an unlocked cabinet above the sink containing individually packaged medications such as Losartan, Metoprolol ER, Potassium Chloride, and Tylenol, as well as a reusable bag with 15 medication bottles labeled for a former resident who had discharged nearly a year earlier. The nurse present did not know why these medications were stored there. An unlocked wound cart in the same room contained multiple prescribed medicated creams and ointments. Review of another medication cart revealed an open vial of Lantus insulin with a discard date that had already passed and a Humalog KwikPen without an open date that should have been refrigerated if unopened, contrary to the facility’s policy requiring all drugs and biologicals to be stored in locked compartments, under proper temperature controls, and routinely inspected for outdated or discontinued medications.
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