Nursing homes and other healthcare facilities must provide or obtain laboratory services, including transfusion services, to meet the needs of their residents. The facility is responsible for the quality and timeliness of the services, and must use processes for transfusion that include positive confirmation of the correct blood or blood components into the intended recipient. Only authorized personnel in accordance with State law, including scope of practice laws, shall verify the correct identification of transfusion recipients and administer blood or blood components, and must have the competencies and training to perform these services and identify and manage adverse events appropriately. Recipients of transfusion services must be closely monitored during and after the transfusion, and all transfusion-related activities must be documented in the resident’s medical record. If the facility provides transfusion services, they must have policies, procedures, and protocols for transfusion processes, investigating transfusion reactions, and reporting transfusion reactions to the appropriate officials and agencies. They must also ensure their process includes the positive identification of the blood or blood components to be transfused into the intended recipient. Nursing homes must also hold an appropriate CLIA certificate and must meet all of the requirements of §493.1103 for transfusion services. If any of these requirements are not met, the facility should be cited under Quality of Care at F684.

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