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Based on staff interviews and observations the facility failed to maintain an acceptable level of safety and quality of supplies and equipment when the hospital had multiple expired supplies in the Emergency Department available for patient use.

Findings were:

Emergency Room Trauma Room 1: expired supplies
" 6-Epinephrine Injection 0.1 mg/ml (expiration date extension given on this medication due to emergency shortages based on stability data provided by Pfizer and reviewed by FDA)
" 5-22 gauge, 1-inch intra-venous catheter, exp. 4/2018
" 3-24 gauge, 5/8-inch intra-venous catheter, exp. 5/2018
" 1-IV Start Kit with Tegaderm, exp. 11/2018
" 3-Vacuette vacutainer, red top, 5 ml, exp. 9/5/2018
" 5-Vacuette vacutainer, green top, 4 ml, exp. 4/18/2018
" 4- Vacuette vacutainer, blue top, 2 ml, exp. 12/9/2017
" 4- Vacuette vacutainer, purple top, 3 ml, exp. 2/28/2018
" 2- Vacuette vacutainer, red top, 5 ml, exp. 5/9/2018
" 1- Vacuette vacutainer, gray top, 2 ml, exp. 4/4/2018
" 4-20 gauge, 1 1/4-inch intra-venous catheter, exp. 5/201
" 1-Normal Saline IV flush, 12 ml, exp. 2/2018
Emergency Room Trauma Room 2: expired supplies
" 2-24 gauge, 5/8-inch intra-venous catheter, exp. 4/2019
" 2-Vacuette vacutainer, gray top, 2 ml, exp. 2/28/2019
" 2-Vacuette vacutainer, blue top, 2.7 ml, exp. 1/31/2019
" 1-Vacuette vacutainer, purple top, 1 ml, exp. 5/32/2019

The Emergency Room Director confirmed the above findings.

Based on record review and staff interview the facility failed to complete a comprehensive assessment on 4 out of 5 patient and failed to provide an ongoing program to support residents in their choice of activities on 5 out of 5 patient records reviewed.

Findings were:

In review of Swing-bed patient records there was no documentation in 5 of 5 chart of ongoing activities being provided to patients by the facility and their was no documentation of a comprehensive assessment being completed on 4 out of 5 patient charts being reviewed.

The above findings were confirmed with the facility Chief Nursing Officer on the evening of June 12, 2019.