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Based on observation, staff interview, and review of facility policy and procedure, the hospital failed to ensure expired medications were discarded and opened medications were labeled with the date opened in 1 of 3 storage areas. The findings were:

According to the policy and procedure entitled "Multi-Dose Vials," approved 8/5/10, medication vials should be labeled with the date opened and the date of expiration (28 days after opening), and all vials should be discarded at the expiration date. On 7/1/14 at 2:20 PM the following expired multi-dose medications were observed in the medication room cabinet: Naproxin Sodium (mild to moderate pain reliever) which expired September 2013, KCL 10% liquid (potassium chloride replacement) with an expiration date of September 2013, and Valporic acid oral suspension (anticonvulsant) which expired April 2014. Interview with the interim director of nursing (DON) at the time of the observation verified these medications were expired but were still available for administration to patients. In addition, the KCL bottle was opened, but was not labeled as to when it was opened as was the Valporic acid oral suspension. Finally, a 473 milliliter bottle of Sodium Polystyrene Sulfonate Suspension (used to treat a high level of potassium) was opened but not labeled as to when. Interview with the interim DON at the time of the observation verified these medications were opened but not dated as to when they were opened.