CMS Revised Guidance: F334-Influenza and Pneumococcal Immunizations

1. CMS Revised Guidance: F334-Influenza and Pneumococcal Immunizations

Subject: CMS Revised Guidance: F334-Influenza and Pneumococcal Immunizations
Importance: High

We've received (from AAHSA) the final copy of the CMS surveyor guidance for LTC facilities for F334-Influenza and Pneumococcal Immunizations (Appendix PP), and the corresponding changes made to Survey Tasks 2-Entrance Conference, and 5-Information Gathering (Sub-task 5C-Resident Review) (Appendix P).

This guidance implements the October 7, 2005 final rule that requires participating nursing facilities to provide eligible residents the opportunity for immunization.
The surveyor guidance for flu and pneumococcal immunization and the accompanying changes to Task 5 are effective October 1, 2006.

Attached are the Survey and Certification Letter announcing the new guidance and effective date; the CMS Transmittal implementing the guidance; advance copy of the guidance; and training materials including an instructor guide and a PowerPoint Training presentation.

Appendix P changes include the addition of item #4 at Task 2 - Entrance Conference for surveys conducted outside of the flu season (10/1 to 3/31). Surveyors are instructed to obtain the name of staff responsible for coordinating and implementing the facility's immunization program and request a list of residents in the facility for the previous flu season.
Task 5, Sub-task 5C - Resident Review is revised to include instructions for a review of implementation of the facility's immunization policies and procedures.
The Guidance includes Intent; Definitions; Overview detailing the importance of immunization to LTC residents and the elements of an effective immunization program; and a section on Provision of Immunizations addressing requirements related to education and documentation related to administration and/or the determination not to administer.
The Investigative Protocol instructs surveyors on sampling during the flu season, i.e., residents selected for comprehensive reviews at Task 5C, and outside of the flu season, i.e., 5 residents from the list provided by the facility of current residents who were also residents during the previous flu season.
Investigative Procedures address both influenza and pneumococcal vaccine related to education, documentation, administration, and facility policies and procedures.
Consistent with the format for other recently revised guidance, V. Deficiency Categorization includes examples of noncompliance at the respective severity levels [Severity Level 4 through 1].

Attachment 1 of 5 - SC-06 Immunizations Guidance Letter

Attachment 2 of 5 - Immunizations Guidance - Transmittal Sheet

Attachment 3 of 5 - Advance Copy of Immunizations Guidance 7252006

Attachment 4 of 5 - Immunizations Guidance - Trainer Packet

Attachment 5 of 5 - Immunizations Guidance Traning Presentation