Failure to Provide Recommended Pneumococcal Immunizations
Penalty
Summary
The facility failed to provide recommended pneumococcal immunizations for three residents, as evidenced by a review of clinical records and facility policies. Resident 21, admitted in June 2021, had previously received a pneumococcal vaccine (Prevnar 13) in 2016, but there was no documentation indicating that the facility offered her the necessary follow-up PPSV23 vaccine as per CDC guidelines. Resident 53, admitted in October 2022, had no documented evidence in his clinical record showing that the facility assessed his eligibility for the pneumococcal vaccine or offered it within 30 days of admission. Similarly, Resident 85, admitted in August 2024, had received a PPSV23 vaccine prior to her admission in 2008, but there was no documentation indicating that the facility offered her the required follow-up PCV15 or PCV20 vaccine. An interview with the infection control preventionist confirmed these findings, indicating a failure in the facility's immunization procedures for these residents.
Plan Of Correction
The facility offered Pneumococcal vaccinations to residents 85, 21, and 53. The facility will offer the Pneumococcal vaccinations to all eligible current residents and document acceptance and refusals. The facilities infection preventionist will receive education on the facilities "Pneumococcal vaccine" policy. The DON or designee will audit newly admitted residents to ensure a pneumococcal vaccine is offered to eligible residents within 30 days of admission. The results of the audits will be reviewed at the facilities QAPI meeting for recommendations.