09/04/2025

Survey Tip of the Week: Influenza Vaccine Orders

With influenza season approaching, facilities should ensure the Medical Director is actively involved in developing and approving immunization policies. According to the State Operations Manual Appendix PP, F883 (§483.80(d)), influenza and pneumococcal vaccines may be administered pursuant to physician-approved facility policy after an individualized assessment for medical contraindications. The facility and Medical Director should review and update policies to reflect current standards of practice and confirm alignment with §483.21(b)(3)(i) (professional standards of quality—F658) and F880 (infection prevention and control).

An effective immunization program involves collaborating with the medical director to develop resident care policies for immunization(s) that reflect current standards of practice and that include:

• Physician approved policies for orders of influenza and pneumococcal vaccines (administration must be based on an assessment of each resident for possible medical contraindications – see 483.30(b)(3), F711, for physician orders for vaccinations);
• Review of the resident’s record of vaccination and immunization status, including assessment for potential medical contraindications;
• How pertinent information and education will be provided to residents or their representatives. The facility may wish to use educational resources such as those provided by the U. S. Centers for Disease Control and Prevention (CDC)120F1; and
• The vaccination schedule including mechanisms for recording and monitoring for administration of both influenza and pneumococcal vaccines in accordance with national recommendations.

Facilities should also routinely monitor compliance using the surveyor guidance outlined in the State Operations Manual Appendix PP.