Health inspection·September 23, 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. Based on observation, interview and record review the facility failed to ensure, in accordance with State and Federal laws, all drugs and biologicals were stored in locked compartments under proper temperature controls and permitted only authorized personnel to have access to the keys for 1 of 5 medication/treatment carts (Medication Cart #1) reviewed for medication storage. The facility failed to ensure Medication Cart #1 was not left unattended and unlocked. This failure could place residents at risk to having access to unauthorized medication and/or lead to possible harm or drug diversion. Findings include: Observation on 9/23/2023 at 1:12 PM revealed medication cart # 1 at the entrance to hall 200 unsupervised and unlocked. At 1:13 PM two residents walked by the unlocked cart without attempting to open it. At 1:15 PM the RN supervisor walked by, when asked if she knew who's cart it was, she noticed it was unlocked. The RN Sup opened the drawers to the medication cart and revealed, vials of insulin, insulin and other syringes, insulin pens, several bottles of over-the-counter medications and a drawer of prescription medications and locked compartment. 1:20 pm the Medication cart was then locked by RN Sup . Interview on 9/23/23 at 1:20 PM with the RN sup revealed the medication cart should be locked when not in use. She stated she had not noticed how long the cart was unlocked. She stated that the nurses are responsible to lock the cart when not in use. She stated an unlocked medication cart could be a potential harm to a resident if they were able to take any of the medications that are on the cart . Interview on 9/23/23 at 1:25 PM with LVN A, she stated she was unaware the cart was unlocked and she shared the cart with the other nurse. She stated she was unsure if she locked the cart the last time she used it. She reported she was aware of the facility policy that medication carts were to remain locked when not in use. She stated there was a potential risk to the residents if they were to get access to the medications, they are not theirs. Interview on 09/23/23 at 1:35 PM with LVN B, she stated she was unaware the medication cart was unlocked and she was not sure which of the nurses used the cart last. She stated the facility policy stated the medication cart should be locked when not in use . She stated a resident getting any of the medications on the cart could be a potential harmful situation. Page 1 of 2 455960 455960 09/23/2023 Hays Nursing and Rehabilitation Center 1900 Medical Pkwy San Marcos, TX 78666

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Interview on 9/23/23 at 3:30 PM with the ADM, he stated his expectations was the medication carts be locked when not in use. He stated the staff were in serviced on this earlier in the week. He stated he felt there was a high probability for harm had a resident opened the drawers and decided to take some of the medications inside. Record review of the, undated, policy titled controlled medications- storage and reconciliation reflected Proper storage of controlled medications should be secured in the nurses cart when unattended . There was no policy on OTC or regular prescription drugs provided, 455960 Page 2 of 2