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Based on observation, review of documentation and interviews with facility staff, the facility failed to properly store medications and medical supplies as expired medications and medical supplies were found in patient care areas available for use in patient care. This was not consistent with facility policy and potentially could have resulted in patients receiving ineffective or unsafe medications or medical supplies.
The findings were:
The facility policy entitled "Handling and disposition of expired Pharmaceutical Products" dated 4/04 reflected in part "Hospital shall not use any Pharmaceutical product that has expired and will check stock on a monthly basis to prevent usage of such products."
During a tour of the facility on the morning of 8/4/15 the following expired medications and medical supplies were found in patient care areas available for use in patient care.
1. Found in a cabinet in the Radiology department: 70% isopropyl alcohol, 16 oz. bottle, expired 12/11; Betadine solution, 4 oz. bottle expired 5/15; Hydrogen peroxide, 16 oz. bottle, expired 5/14; KY Jelly, 4 oz. tube, expired 2/04. In an interview with the administrator, staff #1 during the tour on the morning of 8/4/15, staff #1 agreed that the above listed medications were expired.
2. Found in central supply: BD blunt plastic cannula, 2 boxes of 100 expired 1/14 and 12/14. In an interview with staff #1 during the tour on the morning of 8/4/15, staff #1 agreed that these medical supplies were expired.
3. Found in the CT scan room: BD vacutainer blood collection set, 21 gauge x ¾", 5 expired 10/14; Coiled IV connector, 60", 85 expired 2/15. In the CT emergency drug box, 0.9% sodium chloride, 10 ml vial, expired 1/15; Solumedrol 125 mg vial, expired 4/15; Epinephrine 1 mg/ml, 1 ml vial expired 8/1/15; 0.9% sodium chloride, 250 ml bag, expired 5/15. In an interview with the radiology manager, staff #13 during the tour on the morning of 8/4/15, staff #13 agreed that the above listed items were expired.
4. Found in ER room #1: Ethilon 3-0 suture, 1 box, expired 1/14; Prolene 3-0 suture expired 1/14; Chromic gut 5-0 suture, expired 1/13; Ethilon 4-0 suture, expired 1/15; Urinary drainage bag expired 11/14. In an interview with the Nursing Director, staff #19 during the tour on the morning of 8/4/15, staff #19 agreed the above listed items were expired.

Base on review of documentation and interviews with the facility staff, the facility fell to follow the physician orders. Daily weights were order for patient # 1 whose length of stay was 7 days. The patient was only weigh three times.
Findings were:
Review of nursing notes revealed daily weights were order 7/3/15 for patient #1. Patient was discharge on 7/9/15. Review of the medical record indicated patient #1 was weighed on 7/3/15, 7/6/15, and 7/7/15.
In an interview with staff #19 director of nursing on 8/4/15 at the facility; the findings were confirmed by staff # 19 the patient was weigh 3 times and not daily as the physician ordered.

Based on review of medical records the facility fell to ensure that the physician participated in discharge preparation for swing bed patients. 4 of 4 swing bed discharge progress plans records were not signed by the physician.
Findings were.
4 of 4 medical records did not reveal the physician had participated in discharge planing preparation. The discharge planning plan did not contain documentation of the physician participation.
Review of Coordinated discharge planning policy stated " planning goals will be established with the patient, family, health care team and primary contributors. "
In an interview with staff # 19 director of nursing, at the facility on 8/4/15 at 3:40 pm staff 19 agreed the physicians had not signed the discharge planning plan, and does not attends the meetings on Wednesday.