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.
Expired insulin was found on a medication cart for a resident. An LPN confirmed the opened Humalog pen had passed its use date, and the manufacturer instructions stated the insulin can only be used for 28 days at room temperature. The facility policy also required outdated drugs to be returned to the pharmacy or destroyed.
Medication storage and labeling were not maintained properly on a medication cart. An LPN found an opened ophthalmic drop, an opened insulin pen, and another opened ophthalmic drop that had a date-opened label, but two of the items lacked required opening dates or expiration dating. Manufacturer directions and facility policy both required date-opened labeling and shortened dating for certain opened products such as insulin pens and ophthalmic drops.
Medication Labeling and Expired Drug Storage Deficiencies: An LPN and other staff were observed with multiple medication storage issues, including an opened lidocaine multi-dose vial with no resident identifier or opening/expiration dates, expired Depakote on a cart, and opened fluphenazine decanoate vials lacking required dating. A Medication Nursing Assistant also showed an opened fluphenazine vial in a med room with only an opening date. The DON confirmed the findings, and facility policy and CDC guidance required dating multi-dose vials and removing outdated medications.
Opened medications and biologicals were found without open or expiration dates on multiple med carts and in a med room. An RN, LPN, and another RN confirmed that a resident’s Latanoprost eye drops, insulin pens/vials, and an opened Aplisol vial were not labeled as required, including items being actively used for residents. Manufacturer directions and facility policy specified discard timeframes after opening, but the observed items were not dated.
Medications for a resident were found on the counter at the nurses' station, including several tablets and capsules with remaining doses. The station entrance was open to the common area with no staff present, and an LPN confirmed that medications should be kept locked in a medication cart or medication room.
Medication labeling and storage were not maintained according to accepted professional principles in the med room and on the East med cart. An open PPD vial was kept beyond the documented open period, and several resident medications, including eye drops and inhalers, had no open date or beyond-use date recorded. An LPN and an RN confirmed the findings, and the facility policy required open dates and expiration/beyond-use dates to be recorded and checked before administration.
Surveyors found an expired Glucagon on one med cart and observed an opened insulin pen for a resident that was not labeled with a date opened or open expiration date; an LPN confirmed the findings and administered the resident’s scheduled Degludec dose from that pen. Surveyors also found an opened inhaler for another resident on a second med cart without a date opened or open expiration date. Facility policy required opened meds to be dated and expired items removed from active supply.
Medication labeling, access, and storage were not properly maintained. An unauthorized corporate RN was observed handling medications in a med cart without being assigned to it, two used inhalers for a resident lacked opening or open-expiration dates, and med refrigerator logs on two units had multiple missing daily temperature entries despite policy requiring daily monitoring and proper refrigerated ranges.
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