Health inspection·February 22, 2019

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 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 store medications under proper temperature controls when: one of two medication refrigerators stored refrigerated medications in temperatures which exceeded 46 degrees Fahrenheit (F) (temperature scale). This practice had the potential for residents to receive medication exposed to increase temperatures and not receive the therapeutic (healing) effects of the medications administered. Findings: On 2/21/19 at 2:57 p.m., during a medication storage observation in station 300 and concurrent interview, licensed vocational nurse (LVN) opened the refrigerator and stated the following sealed medications were stored inside the refrigerator. Two Insulin Basaglar (medication used to control high blood sugar), one Humalog insulin (a rapid acting medication used to control high blood sugar), one Humulin Regular (a short acting medication used to control high blood sugar), one PPD solution (purified protein derivative[solution used to test for tuberculosis[an infectious disease that affects the lungs]), one Humalog kwik injection (a rapid acting medication used to control high blood sugar with the use of a medication pen), two Pneumovax injections (a vaccine used to help prevent infections caused by certain types of bacteria called pneumococcus), two Ertapenem injections (a medication used to treat and prevent infections after colon or rectal surgery), three boxes of Tylenol suppositories (rectal medication used to treat fever) and one box of Bisacodyl suppositories (rectal medication used to treat constipation). The LVN stated the refrigerator temperature was 58 degrees F. On 2/21/19 at 2:59 p.m., during an interview and concurrent record review, the LVN stated the temperature log in the medication storage room indicated temperatures were required to be maintained in temperatures of 36 to 46 degrees F. On 2/21/19 at 3:20 p.m., during an interview, the director of nursing (DON) stated the medication refrigerator temperature should have been between 36 degrees F to 46 degrees F. The DON stated if the medication refrigerator was not at the appropriate temperature the medications could lose their efficacy (effectiveness) and not be good anymore. The DON stated the temperature of 58 degrees F was not an appropriate temperature of the medication refrigerator. On 2/21/19 at 3:24 p.m., during a concurrent observation and interview in the medication storage room on nurse's station 300, the physical plant director (PPD) inserted an electrical thermometer. The thermometer's final reading was 52 degrees F. The PPD stated it was not the appropriate temperature (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 4 Event ID: 555901 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 555901 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/22/2019 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Anberry Transitional Care 1000 West Yosemite Avenue Merced, CA 95341 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)