Failure to Offer and Document Pneumococcal Vaccination per Policy
Penalty
Summary
The facility failed to ensure that pneumococcal (PNA) vaccines were offered and/or administered to two of five sampled residents in accordance with facility policy. For both residents, who were cognitively intact and required varying levels of assistance with activities of daily living, there was no documented evidence that a consent or declination form for the PNA vaccine was obtained at the time of admission. Instead, the consents were obtained at a later date, well after their respective admissions. The facility's process, as described by the Infection Prevention (IP) Nurse, involves screening residents upon admission for vaccination status using resident or representative interviews and checking immunization registries, followed by obtaining consent or declination forms based on current vaccination status. Record reviews confirmed that for both residents, the required documentation regarding the offer or administration of the PNA vaccine was missing at admission, contrary to the facility's policy and CDC recommendations. The facility policy, reviewed previously, specified that pneumococcal immunization should be offered according to CDC guidelines, but this was not followed for the two residents identified in the report.