Missing COVID-19 Vaccine Consent Form for Resident
Penalty
Fine: $121,650
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 a COVID-19 vaccine consent form for one resident. Record review showed that the resident's immunization records did not include the required consent form for the COVID-19 vaccine. During an interview, the DON confirmed that the consent form had not been completed and acknowledged that it was needed. This deficiency was identified through both record review and staff interview, with direct confirmation from facility leadership regarding the missing documentation.