MDS Alert

Here's what you need to know now.

MDS section "W" will be asking a couple of the "W" questions - that is, whether residents have received flu and pneumonia vaccinations - and if not, why. So get your vaccination program in gear now to make sure you don't have too much explaining to do when the new section goes into effect on Oct. 1.

Why Section W?  The Centers for Medicare & Medicaid Services plans to implement the new section to help the U.S. Centers for Disease Control & Prevention with data collection about the rate of elderly immunized in nursing homes. The new section also paves the way for a new publicly reported immunization quality measure, according to CMS' Mary Pratt, speaking at the March 31, 2005 SNF Open Door Forum.

"The National Quality Forum recommended an immunization quality measure for nursing facilities some time ago, but the MDS didn't support such a QM at that time," observes Rena Shephard, MHA, RN, FACDONA, president of RRS Healthcare Consulting in San Diego. Implementation of Section W removes that barrier, Shephard tells Eli.

The influenza vaccine question will determine whether the resident received the influenza vaccine during the flu season and also collect information as to why a resident did not receive an immunization, if that's the case. The pneumococcal vaccine question asks about the resident's PPV status and also determines why the resident has not received the vaccine.

"Section W will be a new supplemental page for all assessment forms and all discharge tracking forms," according to CMS' Robert Connolly, in a presentation at the March 2005 American Association of Nurse Assessment Coordinators conference in Chicago.

CMS has released version 3.0 of the MDS 2.0 Data Specifications to software vendors with the October 2005 implementation date in mind.

How smoothly will implementation likely go? Unless CMS listens to feedback from the software developers,  Section W may be confusing for facilities, predicts Peter Arbuthnot, regulatory industry analyst with American HealthTech Inc. in Jackson, MS. "That's because the assessment reference date for coding the flu shot (during the flu season) - and the resident's age for the pneumonia shot - rather than the MDS form type will determine whether the questions appear on a particular assessment," he says.

Tip: If your state law allows, the facility's nursing staff can provide vaccinations under a facility-approved standing order protocol.

Information about the Medicare influenza/pneumococcal prevention campaign is available at www.cms.hhs.gov/preventiveservices/2.asp.