cms_NE: 75
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 75 | HOMESTEAD REHABILITATION CENTER | 285049 | 4735 SOUTH 54TH STREET | LINCOLN | NE | 68516 | 2019-09-30 | 761 | E | 1 | 1 | UZYC11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on observation, interview and record review the facility failed to ensure insulin (a medication used to treat diabetes mellitus) was dated when opened This had the potential to affect 2 residents (Resident 34, and 277). The facility failed to provide safe storage of drugs and biologicals as medications were left unlocked and unattended, and medications were left on top of the medication carts. This had the potential to affect all the residents on the 100, 200, 300, 400, and 500 halls. The facility failed to ensure a vial of insulin was labeled updated with the current administration information for 1 resident (Resident 62 and 79). The facility census was 123. Findings are: [NAME] An observation 9 at 07:10 AM Medication administration RN V prepared medications for administration for Resident 79. 1. Acidophilus 500 Million per 2 caps per day (from a stock medication bottle)-take 2 capsules per gastric tube 2. Vitamin B -1 tablet 100mg daily gastric tube 3. Vitamin C 1000mg daily 4. Folic Acid 1 mg daily every afternoon (on the card) - in the EMAR (Electronic Medical Record) the order reflected that the medication was to be given at 0700AM. 5. Modafnil 100mg 1 tab in am. 6. Ocean Nasal Spray 0.65% amount 2 sprays per nasal - The nasal spray was given 2 sprays per nostril. Record review of an order dated 06/13/18 revealed; a standing order that read, (MONTH) change the time of daily medications for compliance with taking medications, to avoid interaction with other medications unless contraindicated by manufacturer or specific time ordered by physician. Order dated 6/13/18 revealed that the medication Folic Acid 1mg was to be given in the afternoon. An interview with the DON on 09/25/19 confirmed that the labels were not the same, there was a standing order to change the times of the medication administration times. B. An observation on 09/2/519 at 12:50 PM of medication administration for Resident 227 revealed; the Humalog Pen was opened and used and not dated with an opened date. An interview on 09/2/519 at 12:52 PM with RN W confirmed; that the Humalog insulin pen was not dated and was opened. C. An observation on 09/30/19 at 09:30AM of 3 cups of liquid with spoons in it on the top of the cart, also on the top of the cart were Medication of Azelastine HCL nasal spray and Breo Ellipta inhaler that were Resident 120's. No staff was present medications were unsecured. An interview with MA (Medication Aide X) on 09/30/19 at 09:40 AM confirmed; that the medications in the cup were [MEDICATION NAME] that were premixed prior to administration and the medications belonged to Resident 69, 120, and 324. The MA revealed that medication on the cart were not secured. C) Observation on 9/25/19 at 2:26 PM of 200 hall treatment cart revealed there were 2 boxes containing multi-dose vials of [MEDICATION NAME] 70/30 bound together with a rubber band. One box contained an unopened vial and one box was opened and contained a partially used vial. The open and partially used vial was labeled by the facility pharmacy with instructions to administer 11 units before breakfast. The unopened vial was labeled with instructions to administer 13 units before breakfast. Interview on 9/25/19 at 2:36 PM with the DON (Director of Nursing) confirmed the label on the partially used vial did not match the current order. Review of Resident 62's Physician order [REDACTED]. Review of Storage of Medications policy revise (MONTH) 2007 revealed drug containers that have missing, incomplete, improper, or incorrect labels shall be returned to the pharmacy for proper labeling before storing. D) Observation on 9/25/19 at 4:50 PM of the 100 hall medication cart revealed Resident 34's [MEDICATION NAME] inhaler (a medication to keep the airway relaxed and open) did not have an open date documented on the inhaler or on the box. Interview on 9/25/19 at 4:50 PM with the DON confirmed the inhaler did not have an open date documented. E) Observation on 9/25/19 at 4:20 PM of 600 hall medication cart revealed Resident 373's Toujeo insulin (a long acting insulin (a medication to lower the blood sugar level)) did not have an open date documented on the pen. Interview on 9/25/19 at 4:20 PM with the DON confirmed the insulin pen did not have an open date documented. Review of Storage of Medications policy revised (MONTH) 2007 revealed the facility shall not use discontinued, outdated, or deteriorated drugs or biologicals. F) Observation on 9/26/19 at 7:13 AM of the 200 hall medication cart revealed the cart was unattended and unlocked. Interview on 9/26/19 at 7:15 AM with LPN-B confirmed the medication cart was left unlocked while unattended. LPN-B revealed the expectation was for the medication cart to be locked when unattended. Interview on 9/26/19 at 11:17 AM with CSC (Clinical Services Coordinator) revealed the expectation for securing the medication cart was for the medication cart to be locked when unattended. Review of Storage of Medications policy revised (MONTH) 2007 revealed compartments containing drugs and biologicals shall be locked when not in use, and carts used to transport such items shall not be left unattended if open or other potentially available to others. | 2020-09-01 |