Home Health & Hospice

OASIS-C and Vaccinations

Homecare Insider, October 11, 2009

Influenza and pneumonia have been identified as the fifth leading causes of death in the United States.  Vaccination is the best way to prevent the diseases.  Although homecare agencies are not required to offer these vaccinations, the Centers for Medicare and Medicaid Services (CMS) has encouraged the practice for several years.  In addition to the death rate, estimates for the cost of influenza are at least $71–$167 billion each year, with more than 200,000 Americans hospitalized every year.  Influenza vaccinations can reduce hospitalization of the elderly by up to 57 percent.  For a homecare agency, influenza and pneumococcal diseases can directly affect scores for functional outcomes, as well as the utilization outcome related to acute care hospitalization.  One additional challenge with vaccinations is to ascertain whether the patient received a vaccination at any time during the homecare stay.

OASIS-C contains four vaccination-related items, M1040, M1045, M1050, and M1055, within the patient history section.  M1040 and M1045 address influenza.  M1040 asks whether the patient received the vaccine from the agency for the current year’s influenza season, and, if not, M1045 asks why the vaccine was not received.  M1050 and M1055 ask for similar information related to the pneumococcal vaccine.  These questions apply at discharge or transfer to an inpatient facility, which CMS notes gives the agency sufficient time to obtain the information.

Whether an agency already has an immunization program or is developing one, an effective program will provide the data needed for OASIS-C.  Consider these tips as your agency prepares to address the OASIS-C questions.
• Establish policies that streamline the immunization program.
• Designate a spot in the clinical record to document vaccine information.
• Facilitate completion of data elements at transfer of care.
• Access the CMS Web site for the latest information regarding Part B billing.
• Update processes and train the billing staff.

The audio conference on October 15, “Analysis of Redesigned OASIS-C Data Elements,” will provide guidance on evidence-based practices for vaccinations, heart failure, and pressure ulcers.  Click here to find more information.