MDS Alert

Cover these bases to ensure residents receive flu vaccination.

To code W2 correctly and boost your facility's flu immunization rates during the flu season, use a standardized approach to find out if residents received their annual flu shot outside the facility.

If the resident didn't receive a flu shot elsewhere for the current flu season--or you can't figure out if the resident did--immunize him, if he agrees. Then code a "1" for yes at W2a to get credit for the vaccination.

Breathe easy: If the resident received the flu immunization somewhere else, the facility will also get credit for him being immunized, said the Centers for Medicare & Medicaid Services' Mary Pratt, RN, MSN, during a CMS-sponsored Webcast on flu and pneumoccocal vaccinations and Section W.

Follow The RAI Manual Steps

To determine if the resident received the flu vaccine outside the facility for that year's defined flu season, follow these steps outlined by the August 2005 RAI user's manual update:
 
Step 1. Review the resident's medical record to see if it contains the information. If the medical record doesn't  indicate one way or another, proceed to the next step. 
Step 2. Ask the resident if she received the influenza vaccine outside of the facility.

Step 3. If the resident is unable to answer, then ask the resident's responsible party/legal guardian.

Step 4. If you can't determine the resident's vaccination status, go ahead and give him or her the flu shot according to standards of clinical practice.

Real-world practice: St. Joseph's Place captures information for Section W from the resident's admission assessment sheet which asks for the date of the person's last flu shot, pneumococcal polysaccharide vaccination and PPD, says J. Landman, RN, MDS coordinator for the Port Jenis, NY, nursing facility. The nursing home staff call the resident's regular doctor if the resident' isn't able to tell them when he received his last flu shot or if the family doesn't know, Landman tells Eli.  While the August 2005 RAI manual update instructions don't require facilities to contact the physician to determine a resident's vaccination status, doing so represents good clinical practice, says Bet Ellis, RN, a consultant with LarsonAllen in Charlotte, NC. Don't forget to document in the resident's medical record that you contacted the resident's physician and the results of that contact, she adds.