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F0761
D

Unattended and Unlocked Medication and Treatment Carts

Boston, Massachusetts Survey Completed on 05-09-2025

Penalty

Fine: $26,685
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

Facility staff failed to store drugs and biologicals in accordance with State and Federal requirements, as well as the facility's own policy. Multiple observations were made on the fourth floor where medication and treatment carts were left unlocked and unattended. Specifically, a medication cart was found unlocked in the hallway without a nurse present, and the surveyor was able to access its drawers for four minutes without staff intervention. During this time, other staff members, including a certified nurse's aide and another staff member, passed by without addressing the unsecured cart. Additionally, several treatment carts were observed unlocked and unattended near the nurse's station and in the hallway. The surveyor was able to access these carts without interference, and staff, including the Admissions Director, walked by the unlocked carts multiple times without securing them. Interviews with nursing staff and the Director of Nursing confirmed that only authorized personnel should have access to these carts and that they are required to be locked at all times when not in use.

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