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F0883
E

Failure to Administer and Document Flu and Pneumonia Vaccines

Holton, Kansas Survey Completed on 08-26-2025

Penalty

No penalty information released
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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 the Pneumococcal Conjugate Vaccine (PCV20) and Influenza vaccine to a resident who had provided signed consent and was within the required vaccination date range. The resident's electronic medical record and consent form confirmed eligibility and consent for both vaccines, as well as receipt of educational information. However, there was no evidence in the clinical record that either vaccine had been administered, and the facility was unable to provide documentation of administration upon request. Additionally, the facility did not offer the PCV20 and Influenza vaccines to two other residents, and there was no documentation or evidence that these vaccines were offered or declined. Administrative staff and nursing staff were unable to locate records of vaccine administration or signed declinations, citing staff changes as a possible reason for the missing information. The facility's own policy required that all residents be offered these immunizations, but this was not followed for the residents in question.

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