Penalty

No penalty information released

The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to implement an efficient process to accurately document and secure emergency medications (E-Kit) for its residents. During an inspection of the medication storage room, it was observed that the E-Kit containing insulin was stored in the medication refrigerator with a red tag, indicating it had been opened. The E-Kit logs showed that vials of Humalog and Lantus insulin were removed on two separate dates, and the E-Kit had not been replaced for six days after the last removal. A licensed nurse confirmed the delay in replacement and stated that it takes longer for refrigerated E-Kits to be replaced. The Director of Nursing confirmed that the E-Kit had not been replaced in a timely manner and acknowledged that staff should have followed up to ensure prompt replacement. Review of the facility's policy indicated that open E-Kits should be replaced with sealed kits within 72 hours of opening. The failure to replace the E-Kit within the required timeframe was directly observed and confirmed by staff interviews and record review.