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F0887
E

Failure to Document COVID-19 Vaccine Offer and Refusal

Salt Lake City, Utah Survey Completed on 11-20-2025

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 ensure that residents were offered the COVID-19 vaccine and that their acceptance or refusal was properly documented. During interviews and record reviews, it was found that for three out of five sampled residents, there was no documentation indicating whether the COVID-19 vaccine was offered or refused for the year 2024. The residents involved had significant medical conditions, including quadriplegia, protein-calorie malnutrition, anxiety disorder, type 2 diabetes mellitus, morbid obesity, schizoaffective disorder, major depressive disorder, dementia, and adult failure to thrive. The Director of Nursing confirmed that there was no documentation available to show that these residents were offered or refused the vaccine, and stated that a refusal form should be completed if a resident declines vaccination.

See complete original report
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