cms_GA: 8004
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 8004 | QUIET OAKS HEALTH CARE CENTER | 115396 | 125 QUIET OAKS DRIVE | CRAWFORD | GA | 30630 | 2012-05-17 | 334 | E | 0 | 1 | R15H11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, the facility failed to administer the pneumonia vaccine to seven (7) residents (#21, 39, 37, 46, 20, 52, 12), of fifteen (15) sampled resident immunization records reviewed. Findings include: Review of Resident Immunization Informed Consent Authorization forms dated 12/21/10 and 8/10/11 revealed that the responsible parties for residents #21 and #39 wanted the residents to receive the pneumococcal immunization. However, there was no documentation on the Vaccine Administration records that the vaccine was ever given. On 5/16/12 at 4:00 p.m., the Administrator stated that per pharmacy invoice records, the pneumonia vaccine had not been ordered since 2009. The facility's Procedure for Vaccine Administration noted that each resident will have the option of receiving the [MEDICATION NAME] vaccine on a one-time basis. Review of the resident's immunization informed consent authorization form dated 01/19/11 for resident #52 documented that the responsible party signed the consent indicating they wanted resident #52 to receive the pneumococcal immunization. This form had a hand written statement that the resident had never taken the pneumococcal vaccine. There was no evidence that the pneumococcal vaccine had been given to the resident. Interview with the Director of Nursing on 5/16/12 at 11:35 a.m. revealed that she was unaware that the resident's family had wanted the resident to have the pneumococcal vaccine as the family had not mentioned it to her. She was unaware if the facility would provide pneumococcal vaccines to residents. Observation of the medication room on 5/16/12 at 10:42 a.m. revealed there were no pneumococcal vaccine medications located in the medication room refrigerator. Further interview with the DON on 5/16/12 at 1:35 p.m. revealed that the Social Worker gets consents for vaccines from the responsible party or the resident on admission to the facility. Interview with the Social Worker on 5/16/12 at 2:32 p.m. revealed that when he admits a resident he gets the Immunization consent forms signed and puts them on the chart and that nursing was responsible providing the vaccines to residents. Review of the consent form for the pneumococcal immunization for resident #12 dated 6/20/11 documented the family signed that the resident wanted to have the pneumococcal vaccine. There was no evidence that the resident had received the vaccine. Record review for resident #46 revealed a consent form that included a request to receive the pneumococcal vaccine was signed by the resident's responsible party on 01/13/10 with no evidence the vaccine was ever given to the resident. Record review for resident #37 revealed a consent form and request for receiving the pneumococcal vaccine, signed by the resident's responsible party on 7/19/11, with no evidence the vaccine was given to the resident. Record review for resident #20 revealed a consent and request to receive the pneumococcal vaccine, signed by the resident's responsible party on 3/03/11, with no evidence the vaccine was given to the resident. An interview with the Director of Nursing on 3/16/12 at 11:00 a.m. confirms she could find no evidence that resident #46, #37, and #20 had received the pneumococcal vaccine as requested. | 2016-07-01 |