Unlabeled and expired medications were found in multiple medication rooms and carts. An LPN, RN, and MNA confirmed open eye drops, an inhaler, and PPD vials without open dates or discard dates, including medications for several residents; one resident's eye drop had been discontinued and another had already stopped receiving an ophthalmic medication. A bottle of eye drops was also found past its manufacturer expiration date.
Unlabeled insulin pens were found on a medication cart during observation with the DON. A resident's Novolog pen and another resident's Novolog and Lantus pens were not labeled with the patient or physician's name, which did not match the facility's insulin pen labeling policy.
Unlocked Medication Cart: The facility failed to keep the Chapel Unit med cart locked when not in use. During observation, the cart was left unlocked for about 3 minutes with no responsible staff nearby, and an MNA confirmed the finding. Facility policy states medication carts and other compartments containing meds and biologicals are to be locked when not in use.
An open bottle of Latanoprost eye drops for a resident was found on a medication cart with no open date or open expiration date on the box or bottle. An RN confirmed the missing labeling, and the pharmacy refill date was visible on the package. Manufacturer instructions stated the bottle may be stored at room temperature for 6 weeks once opened.
An LPN was observed with a Lispro insulin KwikPen for a resident that had already passed its discard date, yet the MAR showed the insulin was still administered after that date. The facility policy required insulin pens to be discarded after 28 days or per the manufacturer, and the manufacturer’s instructions stated the pen should not be used past the expiration date or more than 28 days after first use.
Medication storage and labeling were deficient when a med room refrigerator was found out of range with unopened meds such as insulin and Retacrit stored inside, and a resident’s open inhalers on a med cart lacked open dates or open expiration dates. Staff confirmed the refrigerator temperature was above the required range and the inhalers were not labeled as required by the manufacturer and facility policy.
A facility failed to keep meds properly labeled, remove expired meds, and secure meds on carts. An LPN found a resident’s open insulin pens without proper open/use-by dating, including one pen past its discard date, and an RN left another resident’s scheduled meds unattended on top of a med cart while residents, LNAs, and visitors were nearby. Facility policy required meds to be locked, labeled, dated, and expired meds removed.
Unauthorized Access to Medication Rooms: The facility failed to restrict access to 2 medication rooms to authorized personnel only. The Maintenance Director kept keys to the 2nd- and 3rd-floor med rooms because oxygen tanks were stored there and entered both rooms to work on HVAC systems. During observation, the Maintenance Director used those keys to access rooms containing oxygen tanks, medication cards, OTC meds, IV meds, and unlocked med refrigerators, with no nurse or medication aide present.
Expired eye drops were found on 2 medication carts, including Timolol for one resident and Latanoprost for another, with staff confirming one should have been discarded. In addition, a medication cart was observed unlocked and unattended, despite facility policy requiring carts to be locked when not in use.
A resident’s self-administered inhalers and nasal spray were repeatedly observed unsecured on the bedside table and dresser instead of being kept in a locked storage area, despite care plan and physician orders allowing bedside storage. An LPN confirmed the meds were not locked, and another LPN noted there was a resident on the unit with a history of wandering into other residents’ rooms.
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