Failure to Obtain Guardian Consent for Immunizations
Penalty
Summary
The facility failed to ensure that a resident's co-guardians were permitted to exercise their authority to consent or decline influenza and COVID-19 immunizations. The resident, who had diagnoses including ataxic cerebral palsy, epilepsy, nutritional anemia, schizophrenia, and obsessive-compulsive disorder, was admitted with co-guardians appointed for personal decisions. The medical record listed the co-guardians as primary contacts, and official court documents confirmed their status as co-guardians of the person. Despite this, the care plan did not specifically reference the guardians, instead using the term 'resident representative.' Consent forms for both COVID-19 and influenza vaccinations were signed by the resident, who was assessed as cognitively intact, rather than by the co-guardians. The Director of Nursing (DON) acknowledged uncertainty regarding the consent process and had the resident sign the forms, although she stated she contacted the guardian by phone, which was not documented in the record. This resulted in the co-guardians not being given the opportunity to exercise their legal authority to consent or decline immunizations for the resident.