The Centers for Medicare & Medicaid Services says the state database should give you a fatal record error (404) when the following occurs: The bottom line: When the target date of the assessment (A3a or R4 for discharge summaries) falls within the flu season there's no way the resident isn't in the facility during that time (W2b = 1), says Nathan Lake, RN, an MDS software developer in Seattle.
• W2a (Did the resident receive the influenza vaccine in this facility for this year's influenza season?) is marked as 'No' AND
• W2b is marked as "1" (Not in facility during this year's flu season) AND
• The A3a (assessment reference date) or R4 (discharge) date is between 10/1 and 3/31.