AGING AND DISABILITY SERVICES ADMINISTRATION
2005 NH "Dear Administrator" Letters
December 12, 2005
ADSA: NH #2005-035
Influenza and Pneumococcal VACCINATIONS
Dear Nursing Facility/Home Administrator:
Although it is late in the year to remind you that it is time for residents and staff to receive influenza and pneumococcal vaccinations, we have been hearing public concern that long term care facilities have not been providing the opportunity for residents to be vaccinated. We encourage you to plan early each year for how you can protect your residents and staff.
Influenza and pneumonia combined represent the fifth leading cause of death in the elderly. Therefore, immunizations can have a positive impact on the elderly population with a significant decrease in the rate of hospitalization, pneumonia and related mortalities as well as quality of life.
There are new federal regulations regarding influenza and pneumococcal vaccinations.
- As of October 7, 2005, the Centers for Medicare and Medicaid Services (CMS) adopted new federal regulations regarding immunizations. These new regulations can be found at
http://www.cms.hhs.gov/providerupdate/regs/cms3198F.pdf - Surveyors and providers will receive further guidance in the interpretive guidelines on implementation and severity guidance for this new regulation late in spring of 2006 as outlined in Survey and Certification Letter (S&C) #06-03. The CMS website is the best source for accessing the most current information available. View the S&C letter at:
http://www.cms.hhs.gov/medicaid/survey-cert/letters.asp
Washington State Regulation:
- Revised Code of Washington (RCW) 74.42.285 requires nursing facilities to provide access on-site or make available elsewhere for all residents to obtain the influenza virus immunization on an annual basis.
Some facilities currently have standing orders from physicians for immunizing residents; however, facilities should always remember that:
- Residents have the right to refuse immunization; and
- The resident’s current medical status should be assessed prior to administering the immunizations.
How else can I help prevent/control influenza or pneumococcal outbreaks?
Remind and monitor staff to assure the consistent use of good infection control techniques, including proper hand washing.
The following websites provide more sources of information:
- www.doh.wa.gov/cfh/immunize - Immunization Program, Department of Health
- www.cdc/gov - Centers for Disease Control Home Page
- ftp://ftp.cdc.gov/pub/Publications/mmwr/rr/rr4903.pdf - Prevention and Control of Influenza
- ftp://ftp.cdc.gov/pub/Publications/mmwr/rr/rr4608.pdf - Prevention of Pneumococcal Disease
What documentation is important for influenza and pneumococcal vaccinations?
In addition the recoding of the administration on the medication administration record CMS expects facilities to document the provision of education, contraindications, and/or refusal for the immunizations in the resident’s record.
Who should be notified if multiple staff and/or residents come down with the flu?
Notify your local health department. The local health department generally will call the department’s complaint hotline at 1-800-562-6078.
Who should I call if I have questions?
If your questions are about immunizations, call your local health department. If your questions are regarding the regulations for influenza or pneumococcal vaccinations, or infection control please contact your RCS Field Manager.
Thank you for your continued commitment to the nursing home residents in the state of Washington.
Sincerely,
Joyce Pashley Stockwell, Director
Residential Care Services
