Vaccinations

Section 245.55  Vaccinations a)         Influenza 1) A home health agency and home nursing agency shall annually administer or arrange for administration of a vaccination against influenza to each client /patient , in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention that are most recent to the time of vaccination , unless the vaccination is medically contraindicated or the client /patient has refused the vaccine. (Section 6.5 of the Act) 2)         The following activities by home health or home nursing agencies shall be considered to be "arranging for" a client/patient to receive an influenza vaccination: A)        Referring a client/patient to the health care professional who is supervising the client's/patient's home care, or to his/her primary health care professional; or B)        Referring a client/patient to the hospital affiliated with the home health agency; or C)        Referring a client/patient to the local health department or other community location (e.g., local pharmacy, influenza vaccine clinic, hospital) where influenza vaccinations are available; or D)        Arranging for the local health department or other private or community health organization to provide the vaccination in the client's/patient's home. 3)         When a referral or arrangement is made, home health or home nursing agency staff shall assist the client/patient in developing a plan for implementing the referral or arrangement and shall assess implementation of the plan and document the outcome. 4) Influenza vaccination for all clients /patients age 65 or over shall be completed by November 30 of each year or as soon as practicable if vaccine supplies are not available before November 1.  Home health or home nursing clients /patients whose services start after November 30, during the flu season, and until February 1, shall, as medically appropriate, receive an influenza vaccination prior to or upon service initiation or as soon as practicable if vaccine supplies are not available at the time of the service initiation, unless the vaccine is medically contraindicated or the client /patient has refused the vaccine. (Section 6.5(a) of the Act) 5)         For all clients/patients who are provided services between November 1 and February 28, the home health or home nursing agency shall document in the client's/patient's medical record that an annual vaccination against influenza was administered, arranged, refused, or medically contraindicated or that the client/patient is not a member of a vaccination priority population . (Section 6.5(a) of the Act) 6)         The following shall be considered to be documentation approaches that meet the requirements of Section 6.5 of the Act: A)        Individual client/patient record entries identifying the assessment for the need of vaccination; date of offer or referral; client/patient response; administration, contraindication, or refusal; and any follow-up activities. B)        Standardized check-off form recording client/patient specific information, including the assessment for the need of vaccination; date of offer or referral; client/patient response; administration, contraindication, or refusal; and any follow-up activities. b)         Pneumococcal pneumonia 1) A home health or home nursing agency shall administer or arrange for administration of a pneumococcal vaccination, in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention that are most recent to the time of vaccination , to each client/ patient who is age 65 or over and who has not received this immunization prior to or upon service initiation, unless the client/ patient refuses the offer for vaccination or the vaccination is medically contraindicated. (Section 6.5(b) of the Act) 2)         The following activities by home health or home nursing agencies shall be considered to be "arranging for" a home health client/patient to receive a pneumonia vaccination: A)        Referring a client/patient to the health care professional who is supervising his/her home care, or to his/her primary health care professional; or B)        Referring a client/patient to the hospital affiliated with the home health agency; or C)        Referring a client/patient to the local health department or other community location (e.g., local pharmacy, clinic, hospital) where pneumonia vaccinations are available; or D)        Arranging for the local health department or other private or community health organization to provide the vaccination in the client's/patient's home. 3)         When a referral or arrangement is made, home health or home nursing agency staff shall assist the client/patient in developing a plan for implementing the referral or arrangement and shall assess implementation of the plan and document the outcome. 4) A home health or home nursing agency shall document in each client's/ patient's medical record that a vaccination against pneumococcal pneumonia was offered and was administered, arranged, refused, or medically contraindicated or that the client/patient is not a member of a vaccination priority population . (Section 6.5(b) of the Act) 5)         The following shall be considered to be documentation approaches that meet the requirements of Section 6.5 of the Act: A)        Individual client/patient record entries identifying the assessment for the need of vaccination; date of offer or referral; client/patient response; administration, contraindication, or refusal; and any follow-up activities. B)        Standardized check-off form recording client/patient specific information, including the assessment for the need of vaccination; date of offer or referral; client/patient response; administration, contraindication, or refusal; and any follow-up activities.