Change In Requirement for Signed Physician's Order For Influenza and Pneumonia Vaccine A new regulation that will remove the federal barrier requiring nursing home providers, home health agencies and hospitals to have individually signed physician's order for influenza and pneumococcal vaccines has been issued, effective immediately, by the Department of Health and Human Services.

 

The Survey Procedures and Interpretive Guidelines for Long Term Care Facilities, Home Health Agencies and Hospitals has required physicians to signed and date all orders. This new regulation allows nursing home providers, home health agencies and hospitals to adopt strategies to increase influenza and pneumonia vaccination rates such as institution or physician-approved protocols i.e., standing orders, that do not require individually signed physician orders.

Accordingly, surveyors should not be citing providers that adopted standing orders for influenza and pneumococcal vaccinations for the failure to have individually signed physician orders.

 

As a result of this issuance, effective immediately CMS is altering the guidance to states and regions. For long term care facilities, physicians must sign and date all orders with the exception of influenza and pneumococcal polysaccharide vaccines, which may be administered per physician-approved facility policy after an assessment for contraindications. For home health agencies, drugs and treatments are administered by agency staff only as ordered by the physician with the exception of influenza and pneumococcal polysaccharide vaccines, which may be administered per agency policy developed in consultation with a physician and after an assessment for contraindications. For hospitals , all orders for drugs and biologicals must be in writing and signed by the practitioner or practitioners responsible for the care of the patient as specified under §482.12© with the exception of influenza and pneumococcal polysaccharide vaccines, which may be administered per physician approved hospital policy after an assessment for contraindications.

Influenza

• Vaccination Assessment

• Consent Form

• Standing Order

Pneumonia

• Vaccination Assessment

• Consent Form

• Standing Order