F0883

D

Failure to Administer Authorized Influenza and Pneumonia Vaccines on Admission

Hamlet, North Carolina Survey Completed on 12-18-2025

Penalty

No penalty information released

Summary

The facility failed to administer influenza and pneumonia vaccines on admission to a resident who had authorized these immunizations. The resident was admitted with diagnoses including heart failure and hypertension and was assessed on the admission MDS as severely cognitively impaired. On the admission consent form, the resident’s representative checked “yes” to authorize both the flu vaccine, to be given annually unless medically contraindicated, and the pneumonia vaccine, to be given on admission unless medically contraindicated. The spaces to document the dates of the last flu and pneumonia vaccines were left blank. The admission MDS documented that influenza and pneumonia immunizations were not given because they were not offered.

Record review showed no documentation that the resident received either the flu or pneumonia vaccine after admission and no documentation that consent for immunizations had been withdrawn or that the vaccines had been given in the recent year. In a phone interview, the resident’s representative stated that the resident had not received flu or pneumonia vaccines on admission, that she had signed the consents, and that no one from the facility had communicated that the vaccines were administered. The former IC nurse confirmed she had not provided flu or pneumonia vaccines to this resident, despite being aware from daily morning meetings that the resident had requested them, and reported no reason for not administering them. The Administrator stated that new admissions and requested immunizations were discussed in daily morning meetings and that the representative was unsure if the resident had received vaccines prior to admission and was going to obtain that information, but the expectation was that residents would receive vaccines when requested.