Health inspection·January 20, 2023

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. 2. On 1/17/23 at 10:45 a.m., during a tour of the facility, observation of one bottle of Refresh Relieva Ophthalmic Solution 0.5-0.9% eye drops sitting on Resident #21's bedside table. The medication did not have a pharmacy label with the resident's name, the name of the medication with directions for use, and/or any other pertinent information. On 1/17/23 at 10:46 a.m., Resident #21 said, she was admitted to the facility in September 2021. She said she uses the Refresh eye drop to moisturize her left eye. She is unable to put the eye drops in her eyes so when she needs the eye drops, she would call the nurse and they would put the eye drops into her eyes. She said the Refresh eye drops are kept in her room on her over the bed table even when she is not in her room. She said she did not remember the nursing staff explaining to her the directions for the use of the eye medication and how to safely keep the medication in her room. On 1/17/23 at 3:15 p.m., a bottle of Refresh Relieva Ophthalmic Solution 0.5-0.9% eye drops was observed sitting on Resident #21's bedside table. Resident #21 was not in her room during the observation. On 1/17/23 at 3:30 p.m., Registered Nurse (RN), Staff E said Resident #21 was out of the facility for an appointment. She confirmed a bottle of Refresh Relieva Ophthalmic Solution 0.5-0.9% eye drops was sitting on Resident #21's bedside table, and the medication did not have a pharmacy label with the resident's name, the name of the medication with directions for use, and/or any other pertinent information. Staff E said residents were allowed to self-administer and keep the medication in their room after a self-administration assessment was completed and the interdisciplinary team (IDT) determined it was safe for the resident to administer the medication. Then it would be safe for the resident to keep the medication in their room. Staff E said she had seen the Refresh eye drops on Resident #21's bedside table for the past couple of months but did not know how long she's had them. On 1/19/23 at 10:53 a.m., the DON confirmed Resident #21's Refresh eye drops were kept on Resident #21's bedside table, not in a secure area, and the medications did not have a pharmacy label with the resident's name, the name of the medication with directions for use, and/or any other pertinent information. 3. On 1/17/23 at 12:40 p.m., an unlabeled box of individual use Retaine eye drops was observed stored on Resident #19's bedside table. Resident #19 was in a recliner, watching television. Page 1 of 2 105472 105472 01/20/2023 Village on the Isle 910 Tamiami Trail South Venice, FL 34285

F 0761 Level of Harm - Minimal harm or potential for actual harm Resident #19 said her significant other brought the box of eye drops for her in case she needed them. She said she nurses administer the eye drops. On 1/18/23 at 11:00 a.m., Resident #19 was in her room watching television. The Retaine eye drops remained unsecured on the bedside table. Residents Affected - Few On 1/19/2023 at 3:22 p.m., Licensed Practical Nurse (LPN) Staff H verified Resident #19 had an unsecured box of Retaine eye drops stored at the bedside. On 1/20/2023 at 11:00 a.m., in a joint interview the Director of Nursing (DON) and the facility Administrator said no medication should be stored unsecured at the bedside. Based on observation, review of facility's policy and procedure, staff and resident interviews, the facility failed to label, and safely store medications for 3 (Resident #19, #21, #16) of 4 residents observed with unsecured medications at the bedside. The findings included: The facility policy titled Resident Self-Administration of Medications dated June 13, 2018 Specified, If medications are stored at the resident's bedside, a lockbox or locked drawer must be used to store the medication(s). 1. On 1/17/23 at 11:02 a.m., and on 1/18/23 at 12:45 p.m., an over the counter bottle of Tylenol and Tylenol PM were observed stored unsecured at Resident #16's bedside. On 1/18/23 at 3:06 p.m., Licensed Practical Nurse (LPN) Staff G said if a resident self-administers medications, they are stored in a locked cabinet in the bathroom. On 1/18/23 at 3:09 p.m., Resident #16 said he's had the two bottles of over the counter medications at his bedside for six months. 105472 Page 2 of 2