CVS and Walgreens have created paper and digital consent forms that nursing homes can use. Consent must be given in advance; the pharmacies need to know how many doses of the vaccine, which must be kept very cold, to bring with them.

There’s significant confusion among nursing homes about getting consent, especially when it involves representatives who aren’t physically at the nursing home and can’t come because of concerns about spreading the virus. Will an email suffice? What about consent over the phone? Or will consent forms have to be signed, either in hard copy or electronically?

Mr. Cox, the CVS executive, said the company this week has provided nursing homes with additional guidance on how to get consent. He said he expects most facilities to simply have an employee get consent over the phone from a resident’s medical proxy and then enter it in the person’s medical record. A nursing home employee can then sign the consent form on the resident’s behalf, he said.

Even getting over-the-phone or electronic consent in a matter of days could prove time-consuming.

Employees at SavaSeniorCare, one of the country’s largest nursing-home chains, don’t think they can start getting consent from residents and staff until they get the forms from CVS. As of Monday, they hadn’t received them, said Annaliese Impink, a SavaSeniorCare executive who is coordinating the vaccine rollout. (T.J. Crawford, a CVS spokesman, said the last batches of paperwork should arrive at nursing homes by Wednesday.)

In the meantime, Ms. Impink said, nursing home staff have been calling family members of residents who can’t make their own consent decisions to confirm contact information to quickly get in touch for approval of the vaccination.

Cissy Sanders, whose 71-year-old mother has a neurodegenerative disease and lives in a nursing home in Austin, said she has felt pressure to make a quick decision about vaccinating her mother.

The administrator of her mother’s nursing home sent her an email on Monday, she said, informing her that the vaccine process was moving swiftly and doses were likely to run out.



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