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Based on observation, interview and policy review, the facility failed to provide appropriate medications in one (1) of three (3) emergency carts.

Findings were:

Upon a tour of the radiology department with employee #1 on 3/16/16 at 12:20 p.m., the contents of the emergency cart in the computerized axial tomography (CT a specialized x-ray device) trailer were inspected. The following outdated medications were found :-

· Epinephrine (a heart stimulant)- two pre-drawn syringes had expiration dates of 3/1/16;
· Dexamethasone (a steroid often used for allergic reactions)- two vials had expiration dates of 2/2016;
· Dopamine (a medication for intravenous use to raise blood pressure)- one bag had an expiration date of 1/2016.

During an interview with employee #1 in the CT scan trailer on 3/16/16 at 12:20 p.m., he/she stated that it was the responsibility of the pharmacist to monitor and replace the medications in the emergency cart.

A review of a Pharmacy policy dated 9/08 entitled Emergency Medication Lists indicated that there were 24 different medication containers on the CT Emergency cart. Therefore, five (5) of twenty-four (24) medications were out of date on this one cart. A review of a Pharmacy policy dated 9/08 entitled Emergency Crash Carts indicated that the contents of the locked emergency cart would be listed with expiration dates and placed on the outside of the cart. This list could not be located.

Based on observation during tours and interviews, the facility failed to provide for the safety of patients who need handrails in the hallways of the facility.

Findings were:

Upon a tour of the facility on 3/14/16 at 1:00 p.m. with the engineer (employee #16), the facility had two main hallways with handrails, the inpatient hall, and the outpatient hall. The handrails were of plastic and metal composition. Several of the handrails were loose with a gap between two sections of handrails which had exposed metal.

In an interview with the engineer in one of the patient care hallways on 3/14/16 at 1:00 p.m. he/she admitted that the rails needed repair.