Health inspection·July 30, 2024

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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to ensure medications were not left unattended in resident rooms. This affected one of three residents (Resident #43) reviewed for medication storage. The census was 101. Findings Include: Review of the medical record for Resident #43 revealed an admission date of 09/21/23. Diagnoses included congestive heart failure, hypertension, chronic obstructive pulmonary disease, and acute kidney disease. Review of the quarterly Minimum Data Set assessment dated [DATE] revealed Resident #43 had impaired cognition. Review of Resident #43's physician orders for July 2024 revealed orders for aspirin 81 milligrams (mg) daily, Farxiga (antidiabetic) 10 mg tablet, isosorbide mononitrate (for chest pains) tablet extended release, every 24 hours, 30 mg tablet, Lisinopril-Hydrochlorothiazide (for blood pressure) 20-25 mg tablet daily and Symbicort HFA aerosol inhaler (for pulmonary disease) 160-4.5 microgram (mcg)/actuation, two puffs twice a day. Review of Resident #43's Medication Administration Record for July 2024 revealed medications were documented as being administered. Review of the self-administration of medications document dated 07/10/24 revealed Resident #43 did not want to self-administer medications. Observation of Resident #43's room on 07/29/24 at 9:43 A.M. revealed there were five pills, two were on the bedside table and three pills were on the floor. At the time of the observation, STNA #320 verified the five pills and placed them in a medication cup. There was also an inhaler noted on the bedside table. Observation on 07/29/24 at 9:48 A.M. with Licensed Practical Nurse (LPN) #386 confirmed the medications in Resident #43's room. The medications were identified as Farxiga 10 mg, aspirin 81 mg, isosorbide mononitrate extended release 30 mg, Lisinopril-Hydrochlorothiazide 25 mg/20 mg and Symbicort HFA inhaler. LPN #386 verified Resident #43 was ordered the five medications. LPN #386 verified Resident #43 was not to self-administer medication and the nurses were to watch Resident #43 take his Page 1 of 2 365432 365432 07/30/2024 Diplomat Healthcare 9001 W 130th St North Royalton, OH 44133

F 0761 medication; medications should not be left in Resident #43's room. Level of Harm - Minimal harm or potential for actual harm Interview on 07/29/24 at 10:00 A.M. with the Director of Nursing (DON) revealed nurses were to watch residents take their medications and inhalers should not be left in resident's room unless they had an order in place and a self-administration assessment completed. Residents Affected - Few Review of the facility policy Drug Storage Regulations by State, dated May 2024 revealed all drugs were to be maintained under locked security except when under direct supervision of the nurse. 365432 Page 2 of 2