R432.  Health, Family Health and Preparedness, Licensing.
R432-40.  Long-Term Care Facility Immunizations.
R432-40-1.  Legal Authority.
	This rule is adopted pursuant to Title 26, Chapter 21.

R432-40-2.  Purpose.
	Influenza and pneumococcal immunizations are recommended for persons aged 65 years and older and for persons of any age who have medical conditions that place them at high risk for complications of influenza.  The purpose of this rule is to require long term care facilities to have policies and procedures in place to protect vulnerable patients and residents from vaccine preventable illnesses.

R432-40-3.  Definitions.
	As used in this rule:
	"Long-term care facility" means a nursing care facility, small health care facility, assisted living type I and type II, intermediate care facility for the mentally retarded, and swing bed unit of a general acute care hospital
	"Pneumococcal immunization" means an immunization using the 23-valent pneumococcal polysaccharide vaccine (PPV23).

R432-40-4.  Policy and Procedures.
	Each long-term health care facility shall implement written policies and procedures that include:
	(1)  a comprehensive assessment and immunization program for residents and employees;
	(2)  how and when to provide the influenza and pneumococcal immunizations;
	(3)  standing orders from a qualified health care practioner to ensure residents obtain influenza and pneumococcal immunizations;
	(4)  collection and recording of resident-specific immunization history information for each resident admitted to the facility;

R432-40-5.  Immunization Offer and Exemptions.
	(1)  Each long-term health care facility shall make available to all employees an influenza immunization during the recommended vaccine season.  The facility shall be deemed to have made influenza immunization available if the facility documents that each employee on staff had the opportunity to receive an influenza immunization under their existing health plan coverage.  If the employee does not have health plan coverage for influenza immunization, then the facility shall be deemed to have made influenza immunization available if the facility documents that each employee on staff had the opportunity to receive an influenza immunization at a cost to the employee that is at or below that charged by their local health department.
	(2)  Each long-term health care facility shall document circumstances beyond its control that prevent it from providing immunizations, such as non-availability of vaccine.  If the facility is unable to obtain the necessary vaccines, it shall provide documentation and request an alternative plan from the local health department or Utah Department of Health.
	(3)  The following are exempt from influenza and pneumococcal immunizations:
	(a)  a resident, or the resident's responsible person if the resident is unable to act for himself, who has refused the immunization(s) after having been given the opportunity to be immunized and;
	(b)  an employee who has refused the immunization(s) after having been given the opportunity to be immunized;
	(c)  a resident or employee who has a condition contraindicated for immunization according to the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practice (ACIP) recommendations for influenza vaccine or for pneumococcal vaccine.
	(2)  For each resident and employees who is not immunized, the facility shall document in the resident's or employee's respective files the reason for not becoming immunized.  The long-term care facility shall annually make influenza and pneumococcal immunizations available to all residents and employees who have claimed an exemption.  The long-term care facility shall document each refusal to receive and medical contraindication to influenza and pneumococcal immunizations.

R432-40-6.  Reporting of Data.
	By January 31 of each year, each long-term care facility shall report to the Utah Department of Health the number of residents who have received influenza and pneumococcal immunizations from May 1 to December 31 of the prior year, even if the resident is no longer in the facility.

R432-40-7.  Civil Money Penalty.
	The Department may assess up to a $500 civil money penalty for failure to maintain and report annual immunization data to the Utah Department of Health, Immunization Program, by January of each year.  The Department may assess up to a $100 civil money penalty per resident or employee who, for reasons under the control of the facility, does not obtain an appropriate immunization(s) or if the facility does not have documentation of a refusal or medical contraindication.

KEY:  health care facilities, vaccinations
Date of Enactment or Last Substantive Amendment:  December 19, 2002
Notice of Continuation:  February 13, 2017
Authorizing, and Implemented or Interpreted Law:  26-21