Based on observations and staff interviews, the facility failed to store medications at the refrigeration temperature specified by the manufacturer in 1 of 3 Medication Rooms observed (Unit 2 Med Room). The findings included: On 6/6/23 at 10:42 AM, an observation was made of the facility's 100 Hall Medication (Med) Room. At that time, the Med Room's refrigerator temperature was observed to be 46 degrees Fahrenheit (o F) and within the recommended range (36o - 46o F) for refrigerated medications. However, a food-related refrigerator temperature log was observed to be taped onto the Med Room refrigerator. This temperature log indicated the Med Room refrigerator temperature should be less than 41o F. Accompanied by the facility's Director of Nursing (DON), an interview was conducted on 6/6/23 at 10:45 AM with the facility's consultant pharmacist. During the interview, use of the food-related refrigerator temperature log posted on the Med Room refrigerator was discussed. The consultant pharmacist confirmed the standard temperature range for refrigerated medications was 36o - 46o F. Accompanied by Nurse #1, an observation was made of the Unit 2 Medication Room (Med Room) on 6/6/23 at 10:48 AM. A thermometer placed inside of the Med Room's compact refrigerator indicated the refrigerator's temperature was 34o F (not within the recommended range for pharmaceuticals). Nurse #1 confirmed the temperature reading of the thermometer. A food-related temperature log was also observed to be taped onto the top of the Med Room's medication refrigerator at the time of the observation. This temperature log read as follows: Refridgerator [Refrigerator] Temperatures Log 1. Acceptable refrigerator temperature is at 41 F or below. 2. If temperature is not in range adjust the thermostat and retake temp in about 30 minutes. 3. If temperature is still not in range, move items to an appropriate refrigerator and notify Maintenance. The temperature log recorded the following temperatures taken in June 2023 to date: 6/1/23 at 2:00 AM = 32o F; 6/2/23 at 7:15 AM = 34o F; 6/3/23 at 7:00 AM = 36o F; 6/4/23 at 10:00 PM = 34o F; 6/5/23 at 12:00 AM = 38o F; 6/6/23 at 12:00 AM = 34o F. Four (4) out of the 6 recorded temperatures were outside of the recommended temperature range of 36o - 46o F for refrigerated medications. The contents of the Med Room refrigerator at the time of the observation included: --One unopened box of 1.5 mg / 0.5 milliliters Trulicity (an injectable antidiabetic medication) containing 4 single-dose pens; --4 unopened Lantus insulin pens; --1 unopened vial of Lantus insulin; --1 unopened vial of Levemir insulin; --3 unopened bottles of latanoprost ophthalmic eye drops (used for the treatment of glaucoma); A review of the manufacturers' product information for the individual medications stored in the Unit 2 Med Room refrigerator included the following storage requirements: -- Unopened Lantus insulin pens may be stored in a refrigerator (36o - 46o F); Do not freeze. -- Unopened vials of Lantus insulin may be stored in a refrigerator (36o - 46o F); Do not freeze. -- Unopened vials of Levemir insulin may be stored in a refrigerator (36o - 46o F); Do not freeze. -- Unopened (intact) bottles should be stored in a refrigerator (36o - 46o F). The facility's Director of Nursing (DON) joined Nurse #1 in the Unit 2 Med Room on 6/6/23 at 11:00 AM. At that time, concern related to the current temperature of the Med Room refrigerator and the previously recorded June temperatures recorded on the log were discussed. Upon review of the temperature log, the DON stated a nurse recording the temperatures should have called Maintenance to check on the refrigerator and to ensure it was within the appropriate temperature range. The DON also reported she would need to develop a new Med Room temperature log which included the correct temperature range of 36o F - 46o F for refrigerated medications. The DON stated she would call the Maintenance Director to request that he check on the refrigerator. On 6/6/23 at 11:10 AM, the Maintenance Director came to the Med Room with a new thermometer. The Maintenance Director was observed as he placed a new thermometer in the Unit 2 Med Room refrigerator (along with the old thermometer) to check both the temperature of the refrigerator and the accuracy of the old thermometer. Additionally, the Maintenance Director checked the thermostat setting of the refrigerator and reported it was set too cold. He stated the thermostat was turned up past 6 but should have been set at 5. The Maintenance Director was observed as he adjusted the refrigerator's thermostat. Accompanied by the Maintenance Director and Nurse #1, a second observation of the Unit 2 Med Room refrigerator was made on 6/6/23 at 12:10 PM. At that time, both the old and the new thermometers read the temperature of the refrigerator as 40o F (within the recommended range of 36o F - 46o F for refrigerated medications). The Maintenance Director reported the agreement of the two thermometers confirmed the accuracy of the original thermometer placed in the refrigerator.