Based on record review and interview, the facility failed to obtain a declination form for the COVID-19 Vaccine with Education for 1 (Resident #30) of 3 sampled residents. The findings are: a. On 01/29/2024 at 11:30 AM, The Administrator provided the admission packet, the Consent for Vaccinations documented, .Consent for Vaccinations . I have read, or had explained to me, the vaccine information statements and understand that there is a risk of having an allergic reaction to the vaccine/s . b. Resident #30's medical record stated the resident refused the COVID-19 vaccine. c. On 1/30/2024 at 2:30 PM, the Surveyor asked the Assistant Director of Nursing (ADON) to show the consent to the Surveyor. …
F887 citations in Arkansas
COVID-19 vaccination · Infection Control Deficiencies
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2024
Arkansas cites F887 less often than its own record predicts
0.21 times the national share — cited less often here than elsewhere.
Of every deficiency written in Arkansas in 2024, this is the portion that was F887.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Arkansas surveyors wrote
F887 findings written in Arkansas, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on record review and interview, the facility failed to ensure the resident's medical record included documentation indicating the resident or resident representative was provided education regarding the benefits and potential risks associated with COVID-19 vaccine and for 2 (Residents #53 and #17) of 5 (Residents #53, #17, #38, #72 and #67) sampled residents reviewed for COVID Vaccine administration. The findings are: 1. Resident #53 had diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . The Admission Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 5/10/21 documented the resident scored 14 (13-15 indicates cognitively intact) per a Brief Interview of Mental Status (BIMS). a. …
The short window
Recent years
| Year | Share of Arkansas citations | vs expected |
|---|---|---|
| 2023 | 0.39% | 1.48× |
| 2024 | 0.06% | 0.21× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Arkansas surveyors cite →
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