San Nicolas II

Based on observation, documentation review, and interview, the manager failed to ensure policies and procedures were implemented for discarding medication. The deficient practice posed a risk if medications were not properly disposed of and if the standards expected of employees were not followed. Findings include: 1. During a tour of the facility the Compliance Officer observed a small refrigerator underneath a dining room counter. The refrigerator was not secured and the Compliance Officer was able to open it with little effort. Inside the refrigerator, the Compliance Officer observed a prescription medication blister pack affixed with a label which read "Acetaminophen 650 MG SUPPOS." 2. A review of facility policy and procedures, dated November 30, 2023, revealed a policy titled, "Medication Services Policy and Procedure." The policy included a section outlining "Medication Disposal:" which stated "Expired mediation and medication which have been discontinued will be returned to the responsible party..." The policy also stated, "The manager or manager designee will dispose of this medication within 60 days of expiration or discontinuation." 3. In an interview, E1 reported the medication had been prescribed to a resident who had not lived at the facility for months. E1 acknowledged the medication had not been discarded according to the facility's policy.

Based on observation and interview, the manager failed to ensure that poisonous or toxic materials were stored in a locked area and inaccessible to residents. The deficient practice posed a risk to the physical health and safety of a resident. Findings include: 1. During a tour of the facility, the Compliance Officer observed a cabinet in a laundry room accessible to residents, which had a sign affixed to the cabinet reading, "PLEASE LOCK ME." The cabinet was equipped with a magnetic lock system and a mechanical locking mechanism requiring a key. The magnet was was left attached over the locking mechanism, the location of which was marked with a sticker. The mechanical locking mechanism was not engaged and the Compliance Officer was able to open the cabinet with little effort. Inside the cabinet the Compliance Officer observed numerous containers of detergents and cleaners to include a bottle of "Lysol Toilet Bowl Cleaner," affixed with a label which read "Hazards to Humans and Domestic Animals," and "CORROSIVE. Causes irreversible eye damage and skin burns." Also inside the cabinet was a can of "Resolve High Traffic Foam" carpet cleaner affixed with a label which read, "KEEP OUT OF REACH OF CHILDREN AND PETS," and "CAN CAUSE EYE IRRITATION." 2. In an interview, E1 acknowledged the toxic chemicals were not kept in a locked area, inaccessible to residents. This is a repeat deficiency from a compliance inspection conducted on November 10, 2022.