Failure to Administer Influenza and Pneumococcal Vaccines After Consent
Penalty
Summary
The facility failed to ensure that influenza and pneumococcal vaccinations were administered in accordance with its own policy for one resident. The facility’s undated Influenza and Pneumococcal Vaccine policy stated that residents should be vaccinated against pneumococcal disease and influenza unless medically contraindicated or refused by the resident or legal representative. Resident #60’s Minimum Data Set, with an Assessment Reference Date of 01/07/2026, showed the resident was admitted on 07/02/2025 and had a Brief Interview for Mental Status score of 10, indicating moderately impaired cognition. Review of the clinical record on 01/20/2026 revealed no documented evidence that the resident had received either the influenza or pneumococcal vaccines. Further record review showed that on 07/02/2025, the resident’s responsible party had signed consent forms for both the pneumococcal and influenza vaccines. In an interview, the resident stated he wanted the influenza and pneumococcal vaccines but had not received them, and the responsible party confirmed she had consented for the vaccines and was unsure if they had been given. The Assistant DON/Infection Preventionist reported that the facility had no evidence the resident received either vaccine since admission. The DON and the Administrator both acknowledged in interviews that the resident had not received the influenza or pneumococcal vaccinations prior to 01/21/2026 and that the resident should have received them.
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