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F0883
D

Failure to Administer Pneumococcal Vaccine After Consent

Millbury, Massachusetts Survey Completed on 04-25-2025

Penalty

Fine: $72,173
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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

The facility failed to administer a Pneumococcal Conjugate Vaccine (PCV) to a resident after obtaining proper consent from the resident's activated Health Care Proxy (HCP). The resident, who had a history of Delusional Disorder and a cerebrovascular accident, was determined to lack capacity, and the HCP's consent for the PCV was documented. Despite this, there was no evidence in the medical record that the vaccine was administered following the consent. Facility policy required that pneumococcal vaccines be administered in accordance with current CDC recommendations, which, for adults over 50 who previously received PPSV23, includes administration of a PCV after one year. The resident had received PPSV23 in the past, and the HCP consented to the PCV, but the vaccine was not given. The Clinical Services Coordinator confirmed that the vaccine should have been administered within a few days of consent, but this did not occur.

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