The invitation to affluent Floridians arrived in writing and by telephone.

“He asked me if I wanted to have a vaccine,” said Ryna Greenbaum, 89, recounting the phone message she got last week. “I’m one of the people who has given him some money.”

The call, she said, had come from Keith Myers, chief executive of MorseLife Health System, a high-end nursing home and assisted-living facility in West Palm Beach, Fla., to members of the board and major donors.

MorseLife has made scarce coronavirus vaccines — provided through a federal program intended for residents and staff of long-term-care facilities — available not just to its residents but to board members and those who made generous donations to the facility, including members of the Palm Beach Country Club, according to multiple people who were offered access, some of whom accepted it. The precise number of invitations, and how many may have also gone to non-donors, could not be learned.

But the arrangement, in appearing to rely on a program run by chain pharmacies for nursing home residents and staff, may have violated national immunization guidelines, as well as state protocols, even though state officials, speaking on the condition of anonymity to address sensitive matters, acknowledged that the rules have not been spelled out clearly enough by Gov. Ron DeSantis (R). Vaccine doses are allocated to the state by the Trump administration but reserved for people living in long-term care facilities, who are at the highest risk of dying from covid-19.

The MorseLife episode highlights how the country’s patchwork approach to immunization against the coronavirus — leaving decisions about eligibility to state and local authorities as well as to individual providers — is creating opportunities for facilities to provide access to well-connected people while thousands of others wait in line. In Florida, some elderly residents have camped out overnight in hopes of receiving a shot.

Top health personnel in Palm Beach County did not authorize the vaccinations of nonresidents at MorseLife, according to a health official who spoke on the condition of anonymity because they were not cleared to discuss the issue. The official was shocked to learn that members of the public, even those of advanced age, were given priority access to immunization at the facility, while others wait in line for appointments at sites set up by the county.

Myers did not respond to multiple requests for comment. An assistant who answered the phone at MorseLife on Tuesday afternoon said, “He has your message.”

UC Davis Health received its first shipment of the Pfizer-BioNTech vaccine on December 15, with emergency department employees receiving the first doses. (The Washington Post)

The recipients of his largesse appear to include long-standing donors to the facility, a top-line senior center offering everything from independent-living arrangements to hospice care and promising “luxury, comfort and outstanding personal service.”

The foundation associated with the Palm Beach Country Club, some of whose members were immunized at MorseLife, has contributed $75,000 to MorseLife affiliates since 2016, tax filings show. And foundation chairman David S. Mack, a New Jersey-based real estate developer, is also a board member at multiple MorseLife affiliates. MorseLife Health System’s street address is named after him. Another street address on the campus is named for Greenbaum, who is also a board member of multiple affiliates, according to tax filings.

In a statement, a spokesman for Mack and his brother Bill, also a real estate mogul, said they had “assisted” MorseLife with its vaccination campaign. The spokesman, George Shea, said vaccinations were “conducted in full accordance” with an executive order issued by DeSantis, which says that shots may be given at this stage only to medical workers, residents and staff of long-term-care facilities, and adults 65 and older.

Shea did not respond to follow-up questions about how the Macks assisted the effort, or whether they had received shots there.

State Rep. Omari Hardy (D), who represents the section of West Palm Beach that includes MorseLife, said the facility appeared to be “selling access to this vaccine.” He said it was unimportant that recipients may have fallen within the age group eligible to be immunized because they were taking advantage of a process “unavailable to the rest of us,” including one of his elderly constituents “who doesn’t know many powerful people, who doesn’t have a lot of money, and she’s asking me how she can get access.”

“And I don’t know what to tell her,” Hardy said. “So if MorseLife is giving this vaccine away to the well-connected, they need to be held accountable for that.”

Florida’s Agency For Health Care Administration, which licenses nursing homes and other health-care facilities in the state, directed questions from The Washington Post to the state health department and the division of emergency management. The state health department directed questions to the county, where officials did not immediately respond.

David Grabowski, a Harvard Medical School professor and nursing home researcher, called the vaccination of donors and facility board members “irregular.”

“That certainly sounds inconsistent with what CDC and other administration officials had in mind for prioritizing residents and caregivers of nursing homes,” he said. “There’s a reason nursing home residents were prioritized” over the general population of seniors, “based on their physical and cognitive impairments,” he said.

Robert Fromer, the former managing partner of a New York City law firm whose family foundation has donated $45,000 to MorseLife since 2015, said he and his wife received shots at MorseLife last week.

He estimated that about 12 vaccinators from Walgreens were on site, and he praised the event as well-run. “All I heard from the people who were there was that it was remarkably appreciated,” he said in a brief phone interview on Monday.

Fromer is a member of the Palm Beach Country Club, as well as a director of its philanthropic arm that donates to various causes. He said only a small number of the country club’s approximately 300 members were among those receiving vaccinations. When asked if members of the country club, which used to include disgraced financier Bernie Madoff, were given preference over others, he said: “Nothing could be farther from the truth.”

He said he and his wife, both in their 80s, “applied” to get immunized and were accepted, but he declined to elaborate on the process. He insisted the shots administered by MorseLife were not strictly for the long-term-care facility’s residents, but for any older residents of West Palm Beach. The health official in Palm Beach County, however, said members of the general public were not able to sign up at MorseLife.

Suzanne Levine, 80, a board member of three MorseLife-affiliated entities, said her invitation had come in writing — also from Myers. She had heard complaints from donors that powerful people unaffiliated with MorseLife had received vaccines, she said.

“I heard some people say, ‘My goodness, people who never gave a dime to MorseLife got invited,’” she said. When asked how those people got invited, Levine said: “Friends.”

The U.S. Department of Health and Human Services, in outlining the program for long-term care facilities, was explicit that chain pharmacies would be responsible only for “residents and staff” at these centers. The initiative was not set up for the chain pharmacies to carry out additional immunization at the sites, according to a federal health official, who spoke on the condition of anonymity to address sensitive matters.

Physicians and health officials said the arrangement at MorseLife appeared to be at odds with those protocols.

“The allocation comes with the caveat of following the guidelines,” said Larry Bush, an infectious-disease doctor and president of the Palm Beach County Medical Society.

In Florida, as in most places, a portion of the state’s weekly allocation is set aside for CVS and Walgreens to carry out vaccinations at long-term-care facilities. The state sends the remainder of its allotment to hospitals and county health departments, with additional vaccination sites soon to be identified.

Hospitals have primarily been inoculating their own staff, under the governor’s phased guidelines that provided first for medical workers and residents of nursing homes. When the state moved at the end of December into the second phase, which includes adults 65 and older, county health departments began administering the vaccine to the general public.

In Palm Beach County and elsewhere, that process has been highly chaotic. The county’s phone-based request system was so overwhelmed that it “absolutely died on us,” Alina Alonso, the health director in Palm Beach County, said at a news conference on New Year’s Eve, causing officials to move to an email system.

Anyone aged 65 or older is now asked to send in a name, phone number and date of birth — with no guarantee that an appointment will be forthcoming, but rather dependent on the county’s supply.

“We were told to tell our constituents that the process is in place, and that they need to be patient,” said state Sen. Bobby Powell (D), who represents the area.

Representatives of the chain pharmacies, meanwhile, said enrolling people to receive vaccines is the responsibility of individual facilities.

“We request that all long-term-care facilities register all residents and staff through our registration portal before clinics,” said Rebekah Pajak, a Walgreens spokeswoman.

She declined to confirm that Walgreens had performed vaccinations at MorseLife, citing “security and privacy reasons,” though two people who received shots there said Walgreens had been on site.

Michael DeAngelis, a spokesman for CVS, said the pharmacy receives a list of names from each facility, at which point it begins scheduling the first of three visits — the first for the initial shot of the two-dose regimens, the second for the booster shot and the third to complete immunization for anyone who received an initial shot during the second visit.

“We get a count of how many people are signed up to be vaccinated so we can bring enough vaccine,” he said. “We don’t capture the personal information of patients beforehand.”