| 81 |
HATLEY HEALTH CARE INC |
15023 |
300 MEDICAL CENTER DRIVE |
CLANTON |
AL |
35045 |
2019-05-09 |
761 |
D |
0 |
1 |
HQGM11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on a review of a facility policies titled, STORAGE OF MEDICATIONS AND BIOLOGICALS and CONTROLLED MEDICATION STORAGE, observations and interviews, the facility failed to ensure: 1. the A Wing medication storage room / cabinet did not contain expired medications, including five unopened bags of normal saline intravenous fluids, along with eight other medication including creams, ointments, gel, liquid and tablets and 2. the Medication Cart for the 600 hall did not include a medication (narcotic) labeled with an unreadable expiration (discard) date. This affected one of two medication rooms observed and one of four medication carts observed. Findings include 1. A review of the facility's policy titled, 3.1: STORAGE OF MEDICATIONS AND BIOLOGICALS, with a date of 3/11, revealed: . Procedure . 11. Outdated, contaminated, or deteriorated medications and . are removed from stock, disposed of according to procedures for medication disposal, . The Surveyor reviewed another facility policy titled, 4.3: Disposal of Medication Non-Controlled Medication Destruction, with a date of 3/11, . Policy . expired medications, .are destroyed or disposed of per federal/state regulations. On 05/08/19 at 04:29 pm, the Surveyor observed, with Employee Identifier (EI) # 5, the A Wing Medication Storage Room. Observations were made of the following items: One of the lower cabinets contained a paper bag with expired intravenous fluids (see the expiration dates below). The Surveyor observed with EI# 5, a total of five unopened bags of normal saline 0.9 Sodium Chloride injection, labeled for a resident,t one bag with an expiration of [DATE] (YEAR), one bag with an expiration date of (MONTH) (YEAR) and three bags with an expiration date of (MONTH) (YEAR). The Surveyor also observed, with EI# 5, an upper cabinet containing the following: 1. one opened bottle of Icy Hot Arthritis pain relief lotion 5.5 ounces with a handwritten first name on it, expired 6/14; 2. one opened tube of Preparation H ointment 2 ounces with Resident Identifier # 32 hand written name on it, expired 6/2017; 3. one opened tube of Capzasin HP Arthritis Pain relief topical [MEDICATION NAME] cream 1.5 ounces, expired 7/17; 4. one opened tube of Risamine Ointment with a label for a resident, expired 3/18; 5. one opened [MEDICATION NAME] 1 percent Iodoquinol 1 percent cream with label for a resident, expired 7/17; 6. one opened bottle of Allergy Tablets [MEDICATION NAME] 4 mg tablets 1000 tablets with a resident's name hand written on it expires 3/18; 7. one opened bottle of Pepto Bismol Max [MEDICATION NAME] 4 ounce bottle, expired 2/16 and 8. one tube of [MEDICATION NAME] maximum tooth ache get unopened instant pain relief .42 ounces, expired (YEAR), with a resident's name handwritten on the box. On 05/08/19 at 05:37 pm, the Surveyor interviewed EI #5. EI #5 was asked if she observed expired intravenous fluids with the surveyor in the Medication Storage Room cabinet. EI # 5 replied, yes ma'am. She was asked, how many bags of expired fluids were in the cabinet. EI# 5 replied, to be honest it was four or five. EI #5 was asked, did she observe eight medications including, tubes of ointments,creams, lotion, liquid medication and tablets that had expired, with the surveyor in the medication storage room cabinet. EI#5 replied, yes ma'am. She was asked, what was the facility policy regarding expired medication in the medication storage room/cabinet. EI# 5 replied, expired medications are supposed to be turned in to the Director Of Nursing (DON) to be destroyed. EI #5 was asked, according to the policy what was the correct time frame expired medication should be turned in to the DON. EI# 5 replied, she could not tell the exact time frame, but in a timely manner. EI #5 was asked, what was the potential harm for having expired medications including, intravenous fluids, creams, liquids and tablets in the medication storage room cabinets. EI# 5 replied, the potential harm was it could be used on another resident. 2. A review for the facility policy titled, 3.2 CONTROLLED MEDICATION STORAGE revealed: . 10. Controlled medication expiration dates and storage dates are periodically monitored by the consultant staff. On 05/08/19 at 08:38 am, the Surveyor observed with EI# 6, the Medication Cart for the 600 hall and found: 1. Label -Resident # 92 [MEDICATION NAME] 0.5 mg total 27 verified, 3/8/19 date on top right corner of the label. Part of the label was cut off bottom of card, was unreadable. The Surveyor and EI #6 were unable to read the Discard after date. The Surveyor asked EI #6 how did she know what the expiration date was for that medication. EI# 6 replied, you don't positively know. On 05/09/19 at 08:10 am, the Surveyor interviewed EI# 6. EI #6 was asked, on (MONTH) 8th 2019 did she observe an [MEDICATION NAME] card of medication that had an unreadable discard date, on the medication cart in the locked narcotic box. EI# 6 replied, yes she did and she did correct that. EI #6 was asked was medication signed out off on the card that had an unreadable expiration date. EI# 6 replied, yes there were three or four of them. EI #6 was asked what was the potential harm with a medication on the cart with an unreadable expiration date. EI# 6 replied, it could have been expired, the medication strength may not have been as potent. And EI# 6 continued, they should not be giving out dated medications. |
2020-09-01 |