Failure to Offer and Document Pneumococcal Vaccination per CDC Guidance
Penalty
Summary
The facility failed to offer, obtain informed declination, or secure physician-documented contraindication for the pneumococcal PCV20 vaccination for several residents, as required by the latest CDC guidance. Record reviews for five residents revealed that none had documentation of being offered the PCV20 vaccine, nor was there evidence of signed consent, informed declination, or physician contraindication in their clinical records. These residents had been admitted to the facility, but their electronic health records did not show that the pneumococcal PCV20 vaccine had been offered or administered since admission. Interviews with administrative nursing staff confirmed that the facility did not have a definitive system in place to determine resident eligibility for the PCV20 vaccine, nor a process to track whether residents had been offered or declined the vaccination. Staff acknowledged that not all residents had been reviewed for vaccine eligibility and that the facility lacked a system to identify which residents were eligible for which pneumococcal vaccination. The facility's own policy required assessment and offering of pneumococcal vaccines upon admission, but this was not consistently implemented.