F0755

E

Failure to Obtain and Administer Ordered Hizentra Therapy

Howell, Michigan Survey Completed on 03-23-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to obtain and administer a physician-ordered immune globulin medication, Hizentra, for a resident with common variable immunodeficiencies and Crohn’s disease. The resident, who was cognitively intact and had diagnoses including respiratory failure and common variable immunodeficiencies, had an order dated 2/28/25 for Hizentra 10 g/50 mL to be given subcutaneously once weekly. Although this order was discontinued on 10/22/25, a similar weekly Hizentra order was started on 10/27/25 and continued, with a later change to a Wednesday schedule beginning 3/11/26. Review of the Medication Administration Records from October 2025 through March 2026 showed multiple weeks where the medication was documented as “not available” or “not given,” with only sporadic administrations noted by nursing staff.

The resident reported on 3/23/26 that they had not received Hizentra in months despite being supposed to receive it weekly and stated they had an immune-compromised disease. The DON stated the medication was supplied by a specialty pharmacy and provided a letter from the infusion pharmacy dated 3/13/26 indicating the pharmacy had been unable to reach the resident and would close the case pending a return call. In a phone interview, a pharmacy employee reported that the last monthly supply of Hizentra (four doses) was shipped to the facility on 9/2/25 for delivery on 9/3/25 and that the pharmacy had not received any calls from the facility after that shipment. The facility’s own medication administration policy required medications to be administered by licensed staff as ordered by the physician and in accordance with professional standards of practice, but the facility did not ensure ongoing availability and administration of the ordered Hizentra for this resident.