| 90 |
RIO RANCHO CENTER |
325033 |
4210 SABANA GRANDE SE |
RIO RANCHO |
NM |
87124 |
2018-02-12 |
761 |
F |
0 |
1 |
M2BO11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to ensure that medications were stored safely, which had the potential to affect any of the facility's 113 residents listed on the facility census provided by the Administrator on 02/05/18. Expired medications were stored with current medications, a lock box for controlled medications was not secured, food was present in a medication storage room, and medications were left unsecured at an unattended medication cart. These deficient practices have the potential to result in resident injury, through dosing with expired medications, absence of needed controlled medications, contamination of medications, or overdose by a confused resident. The findings are: [NAME] On 02/07/18 at 3:37 pm, during observation in the north unit's medication room, two medication refrigerators were inspected. Observed inside were: 1. An open bottle of a medicinal yeast product with a marked expiration date of (MONTH) (YEAR). 2. 2 bags of injectable [MEDICATION NAME] Sodium (an antibiotic) for use by former resident #308 showing an expiration date of 01/19/18. 3. A opened vial of influenza vaccine, in a water-damaged box, dated 12/04/17. 4. A locked clear medication storage box, containing 5 cards of controlled medications, which was not permanently affixed to the refrigerator and was able to be easily removed. B. On 02/07/18 at 3:49 pm, during interview with Licensed Practical Nurse (LPN) #1, he confirmed that the medications were expired. He indicated that the date on the influenza vaccine was the date that it had been opened, but stated that it's only good for 30 days after opening. He advised that the expired medications would be destroyed. C. On 02/07/18 at 3:53 pm, during interview with LPN #2, she was asked to open the south unit medication room for inspection. She responded Don't eat my chicken! Upon observation of the medication room, a plate containing LPN #2's dinner was noted on the counter. She stated You don't see that, and I have to put it in here, or they'll eat it. If you'll just turn your back for a minute, it'll be gone. Upon inspection of the medication refrigerator, a banana was found inside. LPN #1 stated That's for a patient. D. On 02/08/18 at 9:00 am, during observations in the north unit hallway, an unattended medication cart was present. On top of the medication cart was a bottle of [MEDICATION NAME] (a steroid medication) solution 5 mg/5 mL (5 milligrams per 5 milliliters) labeled for use by resident #164. Over the next 5 minutes, multiple residents and staff walked or wheeled past the cart. The staff (including the Administrator and LPN #1) did not take any action to secure the medication. After 5 minutes, RN #1 returned to the cart and stated that he had left the [MEDICATION NAME] on top of the cart because he had had to go to the medication storage room to retrieve another of R #164's medications. He acknowledged that it was not appropriate to leave the medication unattended on top of the cart. E. On 02/08/18 at 10:26 am, during interview with the Director of Nursing (DON) she confirmed: 1. that expired medications should be identified, collected and logged, and that pharmacy should be called right away for pickup. 2. that the influenza vaccine vial was expired 30 days after opening. 3. that the other medications found, which she had inspected, were also expired. 4. that there should never be any food in the medication rooms. 5. that the controlled medication lock box should be permanently affixed to the refrigerator. 6. that medications should be consistently secured to prevent unauthorized access. F. On 02/08/18 at 12:34 pm, during observations in the north unit hallway, RN #1's medication cart was noted to be unlocked and unattended, with the drawers opening easily when pulled. After 2 minutes, RN #1 returned to the cart, and stated that he had left the cart unlocked because he had been called away during medication preparation. [NAME] Record review of a document titled Storage and Expiration Dating of Drugs, Biological's, Syringes, and Needles, dated 08/01/02 and last revised 05/16/11, found statements indicating: 1. Policy: Drugs, biological's, syringes, and needles are stored under proper conditions with regard to sanitization, temperature, light, moisture, ventilation, segregation, security, and expiration date as directed by state and federal regulations and manufacturer/supplier guidelines. 2. All drugs and biological's, including treatment items, are securely stored in a locked cabinet/cart or locked medication room, inaccessible by patients and visitors. 3. Food is not stored in the refrigerator, freezer, or general storage areas where drugs and biological's are stored. 4. Drugs and biological's that have an expired date on the label or are after manufacturer/supplier guidelines/recommendations, or if contaminated or deteriorated, are stored separately, away from use, until destroyed or returned to the provider. 5. All discontinued drugs and biological's for expired or discharged patients are stored separately, away from use, until destroyed or returned to the provider. 6. The Center destroys or returns all discontinued, outdated/expired, or deteriorated drugs or biological's, per pharmacy return/destruction guidelines. |
2020-09-01 |