| 93 |
ST JOHN'S LUTHERAN HOME |
275024 |
3940 RIMROCK RD |
BILLINGS |
MT |
59102 |
2019-08-22 |
761 |
E |
1 |
1 |
P5VQ11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on observation, interview, and record review, the facility failed to dispose of expired pain, antiemetic, and over-the-counter (OTC) medications for 7 (#s 4, 18, 67, 83, 105, 116, and 117) of 38 sampled and supplemental residents. The facility failed to dispose of an expired floor stock medication and medical supplies; this deficient practice had the potential to affect all residents who utilized the facility's floor stock medication and supplies in the storage area. Findings include: 1. During an observation on 8/21/19 at 10:38 a.m., of the Garden Court (Wing 7) medication cart, the following occured: -one syringe of [MEDICATION NAME] 100 mg/5ml had an expiration date label attached to the syringe barrel which showed 4/19. The Ziplock bag, which the syringe was located in, with the resident label attached, showed an expiration date of 11/19. The syringe was labeled with the name of resident #67. -one syringe of [MEDICATION NAME] HCL 1mg/ml showed no expiration date. The syringe was labeled with the name of resident #83. -one syringe of [MEDICATION NAME] 100 mg/5ml showed no expiration date. The syringe was labeled with the name of resident #18. -one bottle of sodium chloride nasal spray showed an expiration date of 7/19. The bottle was labeled with the name of resident #4. -one box of [MEDICATION NAME] 4mg tablets showed an expiration date of 4/19. The box was labeled with the name of resident #116. -one bottle of Geri-Lanta showed an expiration date of 6/19. The bottle was labeled with Wing 7 stock. During an interview on 8/21/19 at 10:54 a.m., staff member G stated she checked the expiration dates, and looked at them when she pulled tickets for re-order, on Mondays and Thursdays. Staff member G stated, I try to glance at things. I guess that is when I do it. Staff member G did not state how the lack of expiration dates or expired medications were missed during her checks. During an interview on 8/21/19 at 10:56 a.m., staff member H stated, The night nurse does the checking for expiration dates and the resource nurse checks the carts when she comes through. Last time she checked the dates was 8/19/19. During an interview on 8/21/19 at 12:48 p.m., staff member I stated the procedure was to have the expiration date on both the Ziplock bag that holds the syringe, and the barrel of the syringe. Staff member I stated, The usual pharmacy tech that works was on vacation. Staff member I stated if expiration dates were missing, her expectation, was to be notified. During an interview on 8/21/19 at 1:30 p.m., staff member I stated the medications with a missing expiration date label, had been fixed, and no residents had received expired medications. 2. During an observation on 8/21/19 at 2:05 p.m., in the Transitional Care Cottage, one bottle of Metaxalone 800 mg showed no expiration date. The bottle was labeled with the name of resident #117. During an interview on 8/21/19 at 1:48 p.m., staff member J stated, We look for expired meds one time a month. 3. During an observation on 8/21/19 at 2:25 p.m., in the Hansen Cottage, the following occurred: -four syringes, in one Ziplock bag, of [MEDICATION NAME] 20 mg/ml, filled to 1 ml, showed no expiration date on the syringes or the pharmacy label attached to the Ziplock bag. The Ziplock bag was labeled with the name of resident #105. -15 syringes, in one Ziplock bag, of [MEDICATION NAME] 20 mg/ml, filled to 1 ml, showed no expiration date on the syringes or the pharmacy label attached to the Ziplock bag. The Ziplock bag was labeled with the name of resident #105. -five 21 guage x one inch needles showed an expiration date of 3/18. -three 21 guage x one inch needles showed an expiration date of 1/19. -four 23 guage x one inch needles showed an expiration date of 9/18. -one female catheter showed an expiration date of 3/31/19. -one Ultrasite injection site supply showed an expiration date of 1/18. -five IV Ultra pac showed an expiration date of 1/18. -one IV universal showed an expiration date of 9/18. During an interview on 8/21/19 at 2:47 p.m., staff member K stated the resource nurse was in the cottage last night, 8/21/19, checking expiration dates. |
2020-09-01 |