Five Counties Nursing Home: Medication Storage Failures - SD
That detail, documented by federal inspectors at Five Counties Nursing Home during a March 12 visit, was one piece of a broader medication storage problem the inspection turned up. Across the facility, inspectors found medications that had been opened without anyone recording when, and multi-use items that carried no label identifying which resident they belonged to.
The Director of Nursing, identified in the report only as DON B, confirmed both problems during an interview that afternoon. Resident 29 should not have had the Vicks VapoRub at her bedside, she said. It was her expectation, she added, that medications be dated when opened, labeled with the resident's name, and stored securely.
What inspectors found did not match that expectation.
The facility's own policies spelled out exactly what was supposed to happen. When opening any multi-dose container, staff were to record the open date immediately. Labels on multi-use vials had to include the date the vial was first opened or needle-punctured. Any opened vial was to be discarded within 28 days unless the manufacturer directed otherwise. Inhalers, eye drops, and other medications designed for multiple administrations had to be labeled with the specific resident for whom they were prescribed.
None of the policies were dated. Neither, apparently, were a number of the medications.
The gap between written policy and actual practice is the kind of thing that can seem administrative on paper, a labeling technicality, a storage oversight. In a nursing home, it carries different weight. Multi-dose medications that go undated can stay in circulation past the point they should have been thrown out. An unlabeled inhaler or set of eye drops sitting on a medication cart can end up administered to the wrong person. For residents with severe cognitive impairment, who cannot advocate for themselves or flag when something seems wrong, the margin for error is smaller.
Resident 29 had severe cognitive impairment. The report does not say how long the Vicks VapoRub had been at her bedside, or whether anyone had applied it.
The inspection covered multiple residents. The report notes the medication storage problems affected some residents, without specifying how many were directly involved beyond the one named case. CMS rated the level of harm as minimal harm or potential for actual harm, the lower end of the violation scale, though inspectors documented the finding as a deficiency requiring correction.
Five Counties Nursing Home sits at 405 6th Avenue West in Lemmon, a town of roughly 1,200 people in the northwestern corner of South Dakota. For many residents, it is the closest long-term care option available. The facility serves a population that, by the nature of nursing home admission, often cannot monitor their own medications, read their own labels, or know whether the inhaler being handed to them was opened three weeks ago or three months ago.
The DON said what the right practice was. The policies said what the right practice was. On the day inspectors walked through, a woman with severe cognitive impairment had an unprescribed product within reach, and the medication storage system inspectors reviewed did not reflect the standards the facility had written down for itself.
The report does not say whether anyone at the facility noticed the Vicks VapoRub before inspectors did.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Five Counties Nursing Home from 2025-03-12 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Corrections: We strive for accuracy in everything we publish. If you believe any fact in this article is incorrect, please contact us with details, and we will review and correct it promptly.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: November 8, 2026 · Our methodology
Five Counties Nursing Home in LEMMON, SD was cited for violations during a health inspection on March 12, 2025.
The Director of Nursing, identified in the report only as DON B, confirmed both problems during an interview that afternoon.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.