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F0883
D

Failure to Administer Vaccines After Consent

Weyauwega, Wisconsin Survey Completed on 04-17-2025

Penalty

5 days payment denial
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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 ensure that two residents received influenza or pneumococcal vaccines as indicated by their consent and eligibility. One resident, who had moderate cognitive impairment and an activated Power of Attorney for Healthcare (POAHC), was admitted with a diagnosis of Parkinson's disease. The POAHC provided verbal consent for the resident to receive the influenza vaccine, as documented on the Vaccine Administration Record-Immunization Consent Form. However, the medical record did not show that the influenza vaccine was administered to this resident. Another resident, who was cognitively intact and responsible for their own healthcare decisions, was admitted with a diagnosis of congestive heart failure. This resident signed an Authorization and Release form consenting to receive a pneumococcal vaccine. Despite this, the medical record did not indicate that the pneumococcal vaccine was administered. In both cases, the Infection Preventionist confirmed during interviews that the residents should have received the respective vaccines but did not.

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