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F0887
D

Failure to Administer COVID-19 Vaccine After Resident Consent

Costa Mesa, California Survey Completed on 08-29-2025

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

Facility staff failed to administer the COVID-19 vaccine to one of five sampled residents, despite the resident having the capacity to make healthcare decisions and providing verbal consent for the vaccine. Medical record review showed that the resident was approached by staff and consented to receive the influenza, pneumococcal, and COVID-19 vaccines. There was no documented evidence that the resident refused the COVID-19 vaccine. Further review and interviews with the Infection Preventionist (IP) and Director of Nursing (DON) confirmed that the COVID-19 vaccine was not given to the resident. The facility's policy required offering and documenting COVID-19 vaccination for all residents unless medically contraindicated or refused, but this process was not followed for the resident in question.

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