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We have already learned safety best practices to optimize LTC facilities’ workflows against COVID-19. This time we are stepping up to ensure providers follow optimal vaccination practices. Neal Cox shares some workflow solutions related to COVID-19 vaccination. We will go over the reporting requirements, whether the vaccinations are administered in-house by facility staff or by outsourced entities such as pharmacies, and resources at the state level and CDC.

Importance of Optimizing Vaccination Workflows

The COVID-19 pandemic requires specific health and safety considerations. This increased workload threatens long-term care facilities with possible disruptions in their vaccination workflows. Physical distancing requirements, community reluctance, or the lack of staff amplify the list of concerns facilities must consider when designing vaccination programs. 

Whether in-house or outsourcing, the CDC addresses the process Skilled Nursing Facilities across the country will encounter when organizing their residents and staff immunization.  

Learn more about CDC COVID-19 Vaccination FAQ’s

LTC Facilities’ Options for Their COVID-19 Vaccine Delivery

The CDC partnered with pharmacy providers across the country to expand long-term care facilities’ options when organizing their vaccination programs. Skilled Nursing Facilities can choose between planning their staff and residents’ vaccination in-house or outsourcing for pharmacy partners to account for the COVID-19 vaccination process’s logistics. This decision will mainly depend on their organizational capabilities, situation, and staff preparedness.

In-House COVID-19 Vaccination

Facilities that choose to participate in the CDC COVID-19 Vaccination Program must be prepared to adhere to all agreed-upon requirements while monitoring and complying with any updates. These can be found in the CDC toolkit and on the CDC website, along with a mailing list that will provide email updates. With these requirements, there are a few things to consider.  

Storage Quality & Capacity

Vaccines must be stored and handled properly to protect their potency and effectiveness. This ensures that each vaccine’s expiration date is monitored, and each recipient is safely protected from preventable diseases or infections. Facilities must ensure the following is provided. Storage

  • Cold chain storage according to vaccine manufacturer and CDC’s Vaccine Storage and Handling Toolkit.
  • Preservation of all records related to COVID-19 vaccine management for a minimum of three years or longer as required by the jurisdiction’s agreement or law.
  • Safe disposal options.

Staffing Reporting Requirements 

There are rigorous reporting requirements facilities must follow to comply with state and federal demands. 

Find more information about the state and federal reporting obligations.

Guidance for Personnel

CDC provides interim guidance for healthcare personnel to get accustomed to the workflow changes brought on by the COVID-19 pandemic. COVID-19 vaccination providers are required to implement this guidance when providing the COVID-19 vaccine.

Outsourcing with CDC Pharmacy Partnership

CDC’s Pharmacy Partnership helps reduce the burden on facilities’ clinical leadership, administrators, and health departments. The partnership involves 21 national pharmacy partners and independent pharmacy networks offering free of cost, on-site COVID-19 vaccination services.

Find in the list below the retail pharmacies participating in your state.

Alabama Walmart, Inc
Alaska Walmart, Inc
Arkansas Walmart, Inc
Arizona Albertsons Companies, Inc
The Kroger Co
Walgreens
California CVS Pharmacy, Inc
Rite Aid Corp
Chicago, IL Walgreens
Colorado The Kroger Co
Walmart, Inc
Connecticut CVS Pharmacy, Inc
Walgreens
Washington DC Retail Business Services, LLC
Delaware Walgreens
Florida Publix Super Markets, Inc
Southeastern Grocers
Walmart, Inc
Georgia Walmart, Inc
The Kroger Co
Hawaii CVS Pharmacy, Inc
Iowa Hy-Vee, Inc
CPESN USA, LLC
Idaho Albertsons Companies, Inc
Walmart, Inc
Illinois (excluding Chicago) Walgreens
Indiana Walmart, Inc
The Kroger Co
Kansas Walmart, Inc
The Kroger Co
Good Neighbor Pharmacy
Cardinal Health’s PSAOs
CPESN USA, LLC
GeriMed
Health Mart Pharmacies
Kentucky Walgreens
Good Neighbor Pharmacy
Louisiana Walmart, Inc
Massachusetts CVS Pharmacy, Inc
Maryland CVS Pharmacy, Inc
Walgreens
Maine Walmart, Inc
Michigan Rite Aid Corp
Cardinal Health’s PSAOs
Meijer Inc
Minnesota Walmart, Inc.
Managed Health Care Associates
Mississippi Walmart, Inc
Cardinal Health’s PSAOs
Missouri Walmart, Inc
Health Mart Pharmacies
Montana Albertsons Companies, Inc
Cardinal Health’s PSAOs
Topco Associates, LLC
North Carolina Walgreens
Nebraska Walmart, Inc
Good Neighbor Pharmacy
Cardinal Health’s PSAOs
New Hampshire Walgreens
New Jersey CVS Pharmacy, Inc
Rite Aid Corp
New Mexico Walgreens
Nevada Walmart, Inc
New York (excluding NYC) CVS Pharmacy, Inc
Walgreens
Retail Business Services, LLC
New York City Walgreens
Rite Aid Corp
Costco Wholesale Corp
Ohio The Kroger Co
Rite Aid Corp
Oklahoma Walmart, Inc
CPESN USA, LLC
Oregon Albertsons Companies, Inc
Costco Wholesale Corp
Health Mart Pharmacies
Pennsylvania (excluding Philadelphia) Rite Aid Corp
Topco Associates, LLC
Philadelphia, PA Rite Aid Corp
Topco Associates, LLC
Puerto Rico Walgreens
Rhode Island CVS Pharmacy, Inc
South Carolina CVS Pharmacy, Inc
South Dakota Walmart, Inc
Hy-Vee, Inc
Cardinal Health’s PSAOs
GeriMed
Tennessee Walmart, Inc
Texas CVS Pharmacy, Inc
H-E-B, LP
Good Neighbor Pharmacy
Walmart, Inc
Utah Walmart, Inc
The Kroger Co
Virginia CVS Pharmacy, Inc
Vermont Walgreens
Washington Albertsons Companies, Inc
Costco Wholesale Corp
Health Mart Pharmacies
Wisconsin Walgreens
West Virginia Walgreens
Wyoming Walmart, Inc
United States Virgin Islands Walgreens
Cardinal Health’s PSAOs

Long-term care facilities deciding to outsource their vaccination program must still prepare all of the information ahead of time for the outsourced provider and keep record copies. It’s also suggested to schedule or hire extra staff to ensure full preparedness for the process.

Preparation for Vaccination Day

COVID-19 vaccine providers must follow specific preparation guidelines to ensure the vaccine administration succeeds. According to official requirements, certain mandatory forms must be filled and closely followed to arrange the vaccine administration process.vaccine

Whether organizing the vaccine administration in-house or outsourcing, it’s mandatory to have a plan in place prior to the Day of Vaccination. Providers must prepare extra staff and documentation ahead of time to track the day’s progress and ensure the process’s safety. For example, the location’s organization needs to guarantee social distancing in every step of the process.

To organize this tracking documentation, Skilled Nursing Facilities may develop their own checklists or use the following CDC’s official pre-vaccination screening form:

https://www.cdc.gov/vaccines/covid-19/downloads/pre-vaccination-screening-form.pdf

An EHR solution is the most complete preparation a long-term care facility can engage to ensure easier, safer, and more organized vaccination process management. An Electronic Health Record software complies with CDC’s reporting and administration requirements and helps facilities avoid legal issues. 

Discover how NetSolutions streamlines your vaccination management

COVID-19 Vaccine Providers’ Communication

Maintaining streamlined communication with staff and residents is key for COVID-19 vaccine providers. The team needs to be fully aligned with the facility’s plan and the vaccination program’s regulatory requirements.

On the other hand, the vaccine provider needs to entail communication with their residents to enhance confidence and understanding around the vaccination process. Below are the primary communication topics to go through with long-term care residents.

Before

  • Learn about COVID-19 vaccines.
  • Find if the COVID-19 vaccination is recommended for you.

 During

  • Read your COVID-19 vaccine fact sheet.
  • Communicate medical conditions.
  • Receive a vaccination record card.
  • On-site monitorization after vaccination.

After

  • Receive the second shot.
  • Expect some side effects.
  • Enroll in v-safe.
  • Continue using all the measures to protect yourself (mask, social distance, handwashing)

CDC provides LTC administrators and clinical leadership with all the information and resources necessary to build vaccine confidence among staff and residents. 

Learn useful tips to enhance confidence among residents.

Vaccination Reporting Requirements

The reporting requirement is among the most important vaccine providers must follow to avoid legal issues with CDC. Long-term care facilities participating in the COVID-19 Vaccination Program are required to report specific vaccine information-related information in a timely manner.

  • Administered at location/facility name/ID
  • Administered at location type
  • Administration address (including Company)*
  • Recipient name and ID*
  • Recipient date of birth*
  • Recipient sex*
  • Recipient race
  • Recipient ethnicity
  • Recipient address*
  • Administration date*
  • CVX (product)*
  • NDC (national drug code)
  • Dose number*
  • Lot number (Unit of Use [UoU] or Unit of Sale [UoS])*
  • MVX (manufacturer)*
  • Sending organization (name of the Agency submitting the report)
  • Vaccine administering provider’s name and suffix*
  • Administering provider’s address, if different than the administration address*
  • Vaccine administration site (on the body)*
  • Vaccine expiration date*
  • Vaccine route of administration*
  • Vaccine series

The vaccine administration must be documented in the medical record system within 24 hours of administration and use their best efforts to report administration data to the relevant system for the jurisdiction (i.e., immunization information system) as soon as practicable and no later than 72 hours after administration.

Keeping a close vaccination track is part of the crucial task of documenting the COVID-19 vaccine administration. The program is tracked via the vaccine cards, documentation from the pharmacy, and in your EHR.

You can also use the CDC’s resources to track the progress of the vaccine. 

Who is Neal Cox?

Neal

Neal Cox is a licensed practical nurse (LPN) He trained in the army as a nurse and then an active nurse in the north and the army for 12 years. Today, he’s a volunteer regularly at long-term care facilities, has five kids, four grandchildren, and add Experienced Care. He’s worked in almost every area possible, implementation support, and today joins us as a senior clinical product manager.

Transcript

Peter

Hi there. My name is Peter Lewis. I’m the Director of Marketing at Experience Care, and today I have the pleasure of inviting Neal Cox to join us on the show to talk about workflow solutions specifically related to COVID vaccinations. We’ll go over reporting requirements, whether or not the vaccinations are administered in-house or by the facility staff or outsourced by pharmacies, and such. I expect we’ll explore other subtopics related to vaccination reports and reporting responsibilities that you and your facility might have, but also resources at the state level and from the CDC. Neal Cox is an LPN. He trained in the army as a nurse and then an active nurse in the north and the army for 12 years. Today, he’s a volunteer regularly at long-term care facilities, has five kids, four grandchildren, and add Experienced Care. He’s worked in almost every area possible, implementation support, and today joins us as a senior clinical product manager. Neal, why is the topic of workflows and code vaccinations important?

Neal

Right now in the era of COVID, and in the pandemic, the vaccines, a lot of people feel like that’s the solution that we’ve been waiting for. And it’s not quite as easy as all of that. Because it is such a big deal. It spans across the globe, there’s a lot of regulation involved. There are a lot of requirements, a lot of misinformation happened. And so basically, with the vaccine, now, it brings us to a point where nurses can actually start to function somewhat like they already know how to do with current and a little more regulation. So developing that workflow to make things go smoother. It’s a one, any nurse will tell you that the smoother my day can go, the better.

Peter

That’s a good introduction to explaining why the topic at hand is important. Now, I know you and your team and the support team at NetSolutions prepared some amazing videos, to help clients of NetSolutions prepare that workflow, and I’ll put those in the notes. But today, we’re gonna go a little bit broader. And we want to address the topic. So that could be helpful for anybody with any EHR, and even helpful for those that are still working manually and putting everything on paper. So let’s dive right in. And to get started, I’d like to ask you what are facilities currently doing in the US to provide COVID vaccinations to residents and staff.

Neal

Right now, here, there are really two options. You can have it outsourced through the pharmacies, or you can do it in-house. And even that comes with some regulations. The CDC set up a program apart, pharmacy partnership with CVS, Walgreens, and a group of pharmacies that are a bit on the east coast and a bit in the Midwest. They partnered with them and set up a program for them to come to facilities and go ahead and give the vaccine report. And then, you have the option of doing it in-house. That also comes with some strings. Some states don’t want that to happen. They’re regulating that, how they fit other states. For instance, California. They have set it up so facilities have to be certified with a specific reporting module in order to do it. And even further in California, it has to be done through EHR, through what we call an HL7 message. There are also reporting requirements that have to do with certain Excel type files, if you use Excel called a CSV. So yeah, it’s in short, the answer is it’s either going to be done by the pharmacies outsource or it can be done in-house. And across America, the majority so far right now, are being done by pharmacists.

Peter

Is that true in the case of the facilities where you volunteer as well, the majority by a pharmacy?

Neal

That’s correct. 

Peter

Okay. 

Neal

Mostly, we’ve been working with pharmacies, Walgreens…

Peter

What are some of the considerations that facilities should take into account when handling them in-house and utilizing their own staff?

Neal

Well, in-house first. You got to realize you’re still going to be working with a pharmacy so that collaboration isn’t a lot different. There’s got to be some pretty good communication there. If you’re going to do it yourself. The big thing is to remember that you’re going to bear the responsibility of all of it. The receipt storage of the vaccines, all the supplies, you’re going to have to use the staffing reporting requirements, you have to report both state and federally within 72 hours. There are certain certifications you may have to get. So, those are some things to think about. You may also want to think about using some of the toolkits when you’re setting up your process and stuff. CDC has toolkits on their website. States have toolkits that you can download and look at, we have a specific link that that goes through and links you to your state. So you can find that kind of information. And then, once you do, you’ve got to remember that you’ve got to report the vaccine. And you may have to do it two ways, both federally and by states. And we have been doing flu vaccine for quite a while reporting to states or federally, so that’s not a big thing, there are a few more requirements or certifications that may be needed. But the short version of that I guess is you really just have to take a look at your state and know the procedures for storing the vaccine, getting the supplies giving the vaccine, how you’ve got to set everything up. So there’s quite a lot to it.

Peter

And if you’re not doing it in-house, rather you’re doing it, you’re outsourcing it with the pharmacy, what other considerations should a facility take into account?

Neal

Well, with the pharmacy if they’re going to do it. We already know coordination of everything is key. And you’ll hear me say communication a lot. You want to communicate with the pharmacy, you’re going to want to get book a binder checklists kind of thing, set up an SOP process to work with that pharmacy to make sure that they have everything they need. Remember that they’re going to be recording the vaccine. So that communication is going to be key. Also, you have to make sure that you have communicated with the families, the patients themselves. And also remember that either way you’re going to give it your staff can get the vaccination as well. And you’ve got to be able to accommodate that no matter who’s giving it. But you know, with the pharmacy coming in, takes away some of the other stuff like storage and supplies and things like that, that you may have to deal with. And along with that, with the pharmacy, you also have to kind of worry about what we call hybrid records. That’s a cross between paper and electronic, certain information can’t be sent across to the pharmacy. So you’ve got to have that kind of paper trail going on.

Peter

You mentioned SOPs. I’m guessing that this process of vaccination is new. The process was brought on quickly and a lot of it is new. So what have facilities been learning about the process about themselves and those that have been doing it well? What’s the secret to doing it well?

Neal

Well, the good side is that only part of it is new. We’ve been doing flu vaccines for a long time. And there’s a bit of a buildup on that now, with this being a global pandemic. Some of the things that we’ve learned that the facilities that I volunteered with, and the ones that I work with on a day-to-day, here are things like make sure you have adequate staffing, but also extra staffing. You have to consider that, you know, you need social distancing, after a person gets a vaccine, you’re going to need to do the monitoring. After that, you need staff for that for a certain timeframe. When you’re setting that up and you’re doing it in-house, you can kind of get away with the staffing by leapfrogging the nursing staff through the patient’s rooms as the pharmacist goes room to room and gives those vaccinations. Make sure also, communication is a really big thing. I mentioned that quite frequently. But family members, other staff, make sure that everybody knows what’s going on that you have all the proper certifications that you need and all the proper consents and things that you need. And a big one is a reminder. The day before the vaccine, please remind your staff and the residents that we’ll be getting the vaccine, that is going to happen. And that, you know, they need to maintain social distancing and why. And don’t forget the family members or the pls as well. And the last point on that is you got to think a little bit out of the box. Sometimes things come up. And that’s just that just happens in medicine no matter what. In nursing, it happens very frequently. And we’re used to thinking outside of the box, but one good example of that is that we had a patient too, who doesn’t like injections of any kind. We found through some of the programs that were out there, we were able to get some money for mobile devices. One of the patients we had had her family members, couldn’t have come in on the day of the vaccines. We had family members on the screen. There was a nurse standing there with a family member, you know? Kind of helping calm them down and talk to them nicely. They got the injection, went really well. So you know, it’s just one example of thinking outside of the box, you may have to do that a little bit.

Peter

When a pharmacy or an outside source shows up at the facility, what are they hoping to find in the book or the binder on day one?

Neal

Well, you want to do this ahead of time and communicate with that pharmacy about what they need. Initially, we had thought that because there were only really the three pharmacy groups in the pharmacy program that CDC set up, that we would have just some kind of really easy checklist to go through. And we would be able to get that for all the residents get it ready for him to go. What we found is that even from state to state, like for instance, Walgreens, and I don’t mean to call them out by name, they have kind of a standard list. But we found different ones that we contacted that they have a little bit more or a little bit different checklists. So you’ve got to communicate with the pharmacy to find out exactly what it is that they need you to have ready for that.

Peter

So what you’re saying is you think that this might be standardized, but there are intricacies for each pharmacy. And so that communication should probably start two or three weeks before day one to make sure you’re prepared.

Neal

A little bit. Yeah, there is some kind of consistencies, but we’ll go through them.

Peter

Is a doctor’s requirement for vaccinations in our EHR, and especially if you’re not giving the injections in-house?

Neal

No, you don’t necessarily have to have the order. If you’re not giving the injection, the pharmacy is going to be taken care of any event that they need, what you may actually need in the system and on paper or in your EHR that I would suggest is to have the orders for monitoring. Because you’re going to be monitoring them for several days afterward. What they found is that like, kind of like the flu, if you’re going to have a side effect, it’s going to happen usually the day after the vaccine. But it can happen anytime within 72 hours and then if something does happen, and it’s manageable, not life-threatening, usually, it’ll go away within two days. But you do want to have some kind of orders for monitoring in there. And part of that goes along with the idea that you’re going to have to give a second injection or the pharmacy is going to have to, which means you’re going to do this again. And you need to know when it’s going to happen. And you need to be able to communicate that throughout the facility, to the residents to the staff, to make sure that everything works.

Peter

Specifically in the facility, what are you seeing as solutions or even problems related to the physical spacing? How are pharmacies and facilities working together to handle the schedules, but also make sure, you know? Social distancing is there and the spacing is set up correctly.

Neal

I’m actually glad you brought up the social distancing. So facilities across the country are set up differently, you have private rooms, semi-private rooms, etc. What we’ve done and some of our customers have done I’ve talked to several about that is, first of all, if you can try to try to get it all done as much as you can in one or two days, and then includes doing your staff as well, on the same day. So you want to make sure that you not only have the right amount of staff to be there, you’ve got to have the staff to monitor the staff they’re getting the injections can actually be part of the monitoring crew. And once they’re done, they can do some of that leapfrog throughout the residence rooms. As far as physical spacing, social distancing is really important. Make sure that when you’re doing the vaccinations that the people receiving them are six feet apart, and if you’ve got them lined up, keep that social distancing. Go on and keep the PPE therapy on. If you can, the residents preferably do those in their rooms. Usually, if you have a couple of beds, there’s enough space in between them that you can do that and do that leapfrogging. So, you really want to maintain that social distancing while you’re getting those injections, and also for the staff in the room that are monitoring during that time.

Peter

You know in the case that a facility is outsourcing these vaccinations, who’s responsible for the vaccine report?

Neal

Or responsibility for reporting lands on the pharmacy or they’re getting giving the injections they’re going to report it, but that doesn’t really let you off the hook. As far as the documentation goes. You do need to make sure that you maintain a copy of that, that documentation, and long-term care, the resident needs a copy, the facility definitely needs a copy. Hopefully, you’ve got a book for that, or you’re scanning it into your EHR, or whatever the case is. But the pharmacy is going to be reporting it, you may still have to report side effects going through. So that’s something to keep in mind. You’ll want to know what the process is for that.

Peter

If I see if I hear you correctly, it sounds like the pharmacy is responsible, but you better back it up. And whether it be on an EHR document or if even if you’re doing it on paper. Twice is your recommendation.

Neal

Old nursing adage, if it wasn’t written down, it wasn’t done. 

Peter

Okay. Where can we get more information regarding the requirements in each specific state in each specific region?

Neal

So we actually have a link to this. The neatest one I found is a website called immunized.org. But you can also put in immunized.org backslash states, and that will actually have a list of all 50 states. If you click on that state, it will take you to your COVID support section, where they have toolkits and things like that for you to use.

Peter

Lastly, what should facilities be asking of their EHR to help them with this process, and what is Experienced Care to help doing to help with this process?

Neal

Let’s take a look at regulations outside of ours. First, you have to communicate with them. And I would recommend that you do so. Most EHR sell by modules. And a lot of times you don’t realize what you don’t have that happens in nursing as well. They may have a vaccination module that you’re not using or a scanning type of module or some kind of a triggering alert triggering the type of module, that would help out. Also, I mentioned California, I’m on the west coast. So that’s one that I’ve been researching that impacts me a lot. They have their care vaccination program set up. And your EHR may be able to work with that other agency to electronically handle those records for you like the reporting for you, you still have to do your due diligence in documenting that stuff. But the interface could be set up through your EHR for the reporting. And as a matter of fact, and care to my understanding if that’s a requirement. In a lot of other states, you can do what’s called a CSV document, or it’s a type of Microsoft Excel document that you can create with information, you can upload that into a state website. And I believe if I understand correctly, that care actually requires it to go electronically, so you can’t just upload the CSV. So talk to your EHR about those kinds of things. You know, alert triggering is great, when you’ve got to keep track of that next dose, this can be due, there’s going to be that second inoculation that’s going to happen. So those kinds of things are what I would talk to your EHR provider about. As far as Experience Care, we did create the COVID Vaccine videos. One of the things as a product manager that I was tasked to work on is getting things to talk together. As far as vaccination goes, we designed our products so that you can put in an order for the vaccination that will automatically flow to the immunization section, you can go to our charting module where you’re passing medicine document, and you can document that vaccination, and then your documentation will automatically flow into the immunizations module. So you don’t have to do a lot of dual documentation or triple documentation going from module to module, to module. You can get that all done. And we are working on the HL7 interfaces and things with various states and those CSV documents to be able to upload those things as states require. We do have modules that are set for triggering to let you know when certain things need to be done. Could be anything from a pure medication. But in this case, it can also alert you for things like when that second dose needs to be done. So those are some of the things that we’ve done, we’ve got training videos. Another thing you might want to do and we do this I hope other EHRs do is we create kind of a quick card that you can actually print out and put at your workstation that would, you know? Kind of give you a step-by-step of how to use specific modules or how to put certain data in. We also created something called quick bite videos which are really quick couple of minute videos that walk you through procedures within your facility with COVID. Nurses have always not had a lot of time in their day, barely enough to get things done. A lot of times you’re working extra. But in COVID, that’s just throwing a whole lot more on the pile. So, use your EHR, if possible to take as much of that burden off of you as possible. So communicate with them and communicate with us about how we can possibly make it easier and better for your day.

Peter

That I’m glad you brought that up. And I’ll put those again, in the notes and in the time that I’ve been in Experience Care, the most amount of feedback that we’ve gotten from our clients are specifically from that workflow, those videos. Quick bite videos and those reference cards. So I’m sure that they’ll be helpful. And even if your EHR doesn’t have it, you pick it ours, it’ll inspire you to think about how you could come up with a reference card for yourself based on the EHR that you’re using. So, Neal, I’ve asked you a lot of questions, we’ve gone through a lot of reporting requirements. Are there any questions I didn’t ask you, that we want to put into this conversation?

Neal

I think we went through pretty much everything. The only thing I would like to add on a little bit is back where we were talking about those books, the binders, or checklists for the pharmacies. It’s really important to get as much information as possible. And I’m recommending actually, and a lot of facilities have two books, because like I said, it would be great if you could do the residents and the staff on the same day. So have two separate books. And you’re going to need some information in there both. For your residence, you may need a face sheet diagnosis list, some kind of consent forms insurance cards diagnosis list, you’re going to have to have the form that the CDC put out that you’re going to give to the resident after the vaccination is done. But don’t forget that you also need the same kind of information for your staff, you’re going to need insurance information from them, some kind of IDs, demographic information, stuff like that. So the less people you have handling that, the better. So get that kind of checklist from the pharmacy. But the other part of that is that even though it’s in paper, remember to also, and I know this is not something that we all want to do, do that piece of dual documentation, get that in the EHR as well. One of the reasons for that is that, if you have a couple of physical binders, one of which the pharmacy is going to take with them and hopefully you have a copy for yourself. So in essence, you almost would have four binders. Two, which is staff and resident for the pharmacy, two, which is staff and resident for your facility, right. So you’re going to have a lot of that information. But if you have them in physical books, and that information can only be stored in so many places. That means maybe everybody that needs access to that stuff doesn’t really have it, that dual documentation that we all really don’t want to do once you put it in your EHR, if possible. It centralizes that information in a way that everybody can get to it that really, really needs it. So I know that all of us nurses hate that. But in this case, it’s really important to make sure that you’re getting that information into the EHR as well for the best possible communication with both the staff, families, residents, everybody.

Peter

Well, Neal, really appreciate your time today as we went through the vaccination report. Whether you’re doing it in-house or outsourcing that to a pharmacy. Thank you for your help. And we look forward to having you back for another interview. Have a great day now.

Neal

Thank you.