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F0883
E

Deficient Consent and Documentation for Flu and Pneumococcal Vaccinations

Newport, Vermont Survey Completed on 07-17-2025

Penalty

Fine: $121,650
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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 obtain required consents and maintain accurate records for influenza and pneumococcal vaccinations for three residents. For one resident, the representative declined the influenza vaccine and signed the informed consent form, but the resident later received the vaccine without an updated consent form in the electronic health record. Another resident's pneumococcal vaccine form was not signed by the resident, nor was there documentation indicating the resident's wishes regarding the vaccination, although the provider signed and dated the form. For a third resident, the pneumococcal vaccine form was not signed by the resident; instead, a nurse signed in the resident's place and also signed again in the section designated for a licensed nurse. The Director of Nursing confirmed that the consent forms and documentation for these vaccinations were incomplete or incorrectly filled out.

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