The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

PERIMETER BEHAVIORAL CENTER OF JACKSON 49 OLD HICKORY BLVD JACKSON, TN 38305 April 9, 2021
VIOLATION: DELIVERY OF DRUGS Tag No: A0500
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on policy review, medical record review, observations and interviews, the hospital failed to ensure timely disposal of unused medications for 4 of 7 (Patient #6, 7, 8 and 9) discharged patients reviewed.

The findings included:

1. Review of the facility policy "Pharmacy Services" revealed, "All medications will be stored in a manner consistent with State and Federal law, Joint Commission standards and the highest standards of professional practice ...Once a patient has been discharged and his/her medications have not been picked up within 7 days, this medication will be discarded in a manner that is safe and in accordance with DEA [Drug Enforcement Agency] requirements and State Board of Pharmacy, where applicable ..."

2. Medical record review for Patient #6 revealed an admission date of [DATE] with diagnoses of developmental disability delay, autism and poor coping skills. Patient #6 was discharged from the facility on 3/24/2021.

Observations on 4/6/2021 at 9:15 AM revealed Ondansetron 4 milligram (mg) tablets prescribed to Patient #6 in the medication cart, 13 days after Patient #6 was discharged .

3. Medical record review for Patient #7 revealed an admission date of [DATE] with diagnoses of intermittent explosive disorder. Patient #7 was discharged from the facility on 3/15/2021.

Observations on 4/6/2021 at 9:15 AM revealed Nicotine 21 mg 24 hour patches prescribed to Patient #7 in the medication cart, 22 days after Patient #7 was discharged .

4. Medical record review for Patient #8 revealed an admission date of [DATE] with diagnoses of suicidal ideations. Patient #8 was discharged from the facility on 3/3/2021.

Observations on 4/6/2021 at 9:15 AM revealed Hydroxyzine pamoate 25 mg capsules prescribed to Patient #8 in the medication cart, 34 days after Patient #8 was discharged .

5. Medical record review for Patient #9 revealed an admission date of [DATE] with diagnoses psychosis. Patient #9 was discharged from the facility on 3/4/2021. Observations on 4/6/2021 at 9:15 AM revealed Benztropine Mesylate 1mg tablets prescribed to Patient #9 in the medication cart, 33 days after Patient #9 was discharged .

6. In an interview with LPN #2 on 4/6/2021 at 9:20 AM, LPN #2 stated she was not aware the medications for the discharged patients were in the medication cart.

In an interview on 4/6/2021 at 9:50 AM, the Director of Nursing (DON) stated it was unacceptable for the medications to be in the medication cart. The DON stated at times the pharmacy did not pick up discontinued medications and the medications are left in the cart.