QIO HHQI Weekly Update :: October 15, 2007   

TIP OF THE WEEK

Immunization Resources for Home Health Agencies

The Centers for Medicare & Medicaid Services (CMS) is implementing a comprehensive effort across all settings of care to improve the immunization rates of Medicare beneficiaries. Ohio KePRO is working with home health agencies (HHAs) in Ohio to include an assessment of flu and pneumococcal immunization status in their comprehensive patient assessments, to offer these vaccinations (or refer patients to other sources), and to provide follow-up. These efforts are in alignment with two national goals: the Healthy People 2010 goal of 90 percent immunization rates for patients and the Association for Professionals in Infection Control and Epidemiology (APIC) goal of 90 percent flu immunization among healthcare staff.

All HHAs should strive for a 90-percent immunization rate among their eligible patients for both influenza and pneumonia. Patients at high risk for complications from influenza are also at high risk for pneumococcal disease. Autumn is the optimal time to institute guidelines for the administration of both influenza and pneumococcal vaccines.

(More information: www.healthypeople.gov and www.apic.org)

WHO SHOULD RECEIVE THE FLU VACCINE?

• People at high risk for complications from the flu, including:
  • Children aged 6 months until their 5th birthday
  • Pregnant women
  • People 50 years of age and older
  • People of any age with certain chronic medical conditions
  • People who live in nursing homes and other long term care facilities
• People who live with or care for those at high risk for complications from flu, including:
  • Household contacts of persons at high risk for complications from the flu (see above)
  • Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)
  • Healthcare workers

Visit http://www.cdc.gov/flu/about/qa/flushot.htm for more information about these priority groups for vaccination against the flu.

WHO SHOULD RECEIVE THE PNEUMOCOCCAL VACCINE?

1. All adults aged 65 and over should receive the pneumococcal vaccine unless the vaccine has been administered within the last five years (and there is documentation for such), or the vaccine is contraindicated for that patient. (See www.cdc.gov/nip/recs/contraindications.htm)
2. Anyone (of any age) who has long-term health problems such as heart disease, sickle cell disease, diabetes, lung disease, cirrhosis, leaks of cerebrospinal fluid or alcoholism should receive the pneumococcal vaccine.
3. Anyone (of any age) who has a disease or condition that lowers the body's resistance to infection such as Hodgkin's disease, leukemia, lymphoma, multiple myeloma, HIV/AIDS, nephrotic syndrome, damaged spleen/no spleen or any organ or bone marrow transplant should receive the pneumococcal vaccine.
4. Anyone (of any age) who is taking a drug or treatment that lowers the body's resistance to infection – such as long-term steroids, radiation therapy or certain cancer drugs – should receive the pneumococcal vaccine.

Visit http://www.cdc.gov/vaccines/vpd-vac/pneumo/default.htm for more information about these priority groups for vaccination against pneumonia.

MEDQIC IMMUNIZATION TOOLKIT AND RESOURCES

CMS developed a comprehensive online resource, Medicare Quality Improvement Community (MedQIC), to share quality improvement resources and to support HHAs with new information on flu and pneumococcal vaccinations. The immunization toolkit 2007-2008 provides information regarding: flu and pneumonia with requirements for immunization; additional information related to avian vaccine and pandemic influenza; and contains valuable sample policies, sample standing orders, forms, checklists, educational materials, posters and references. The toolkit and Resource Package may be accessed on MedQIC.

HOME HEALTH BEST PRACTICE

The Home Health Quality Improvement National Campaign 2007 provides a Best Practice Intervention Package (BPIP) on Immunization that focuses on both flu and pneumococcal immunizations as they relate to the home care setting. The BPIP is for HHAs to use, create or improve upon a structured and effective immunization program. This package correlates with the MedQIC Immunization Toolkit 2007-2008. The BPIP on Immunization may be accessed at www.homehealthquality.org/hh/hha/interventionpackages/immunization.aspx.

THE MEDICARE LEARNING NETWORK

The Medicare Learning Network (MLN) resources give Medicare healthcare professionals information on coverage, coding, billing, reimbursement and claim filing procedures for Adult Immunizations.

MEDICARE BILLING

• Billing information for HHAs: www.cms.hhs.gov/AdultImmunizations/Downloads/0506qanda033006.pdf
• Medicare Claims Processing Manual, Chapter 18 – Preventive and Screening Services, 10.2.3 Bills Submitted to Regional Home Health Intermediaries. www.cms.hhs.gov/manuals/downloads/clm104c18.pdf

CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND NATIONAL IMMUNIZATION PROGRAM (NIP) CONTACT INFORMATION

• Telephone Immunization Hotline 1-800-232-4636 (1-800-CDC-INFO) for general public 1-877-554-4625 for clinicians 1-999-232-6348 TTY Talk with a representative, in either English or Spanish, concerning questions about immunizations or vaccine-preventable diseases, the location of immunization clinics near you, or to order single copies of immunization materials from NIP.
• E-mail: nipinfo@cdc.gov. Healthcare providers can use this e-mail address to submit questions regarding immunizations and vaccine-preventable diseases directly to National Immunization Program experts, or to request printed materials, such as The Advisory Committee on Immunization Practices (ACIP) statements.
• Internet NIP Web site: www.cdc.gov/nip. This Web site provides a calendar of upcoming events, online access to publications such as ACIP Statements and Vaccine Information Statements, online publications ordering, vaccine safety information, the latest pediatric and adult immunization schedules, downloadable Clinic Assessment Software Application (CASA), frequently asked questions, PowerPoint slide presentations from the Pink Book and from NIP satellite broadcasts, and links to additional immunization sites.

 

 

IN THE NEWS

CAN POOR VISION OR HEARING AFFECT YOUR MIND?

October 3, 2007 -- Newswise -- Loss of acuity in hearing and vision is a common accompaniment to aging. While only an estimated one in every 1,000 people under the age of 45 has visual impairment, one in every 13 people over the age of 65 does, according to the American Foundation for the Blind. Hearing suffers a similar decline: among people aged 65 to 74, 23 percent have trouble hearing; after age 75, the figure climbs to nearly 40 percent.

In addition to weakening important connections to the environment, this often-gradual onset of sensory deprivation can have other important effects on the brain. It is associated with the development of mood disorders, and with declines in key aspects of mental functioning. Finding ways to prevent sensory change, and to adjust to impairments if they develop, is important to maintaining mental health as we age, according to Massachusetts General Hospital's Mind, Mood & Memory. Read more >>

CENSUS BUREAU NURSING HOME DATA 'MISLEADING,' LETTER SAYS

October 9, 2007 -- Kaiser Network -- Recent data from the Census Bureau that indicated a decrease in the percentage of elderly U.S. residents who live in nursing homes provide a "highly misleading picture of nursing home care in America today," Alan Rosenbloom, president of the Alliance for Quality Nursing Home Care, writes in a USA Today letter to the editor (Rosenbloom, USA Today, 10/5).

According to the data, 7.4 percent of residents ages 75 and older lived in nursing homes in 2006, compared with 8.1 percent in 2000 and 10.2 percent in 1990. However, the "only accurate assessment" of nursing home care would "evaluate the total number of people served annually -- not the number of people served at a specific point in time," according to Rosenbloom.
Read more >>

MEDICARE AGENCY MOVES UP NATIONAL PROVIDER IDENTIFIER DEADLINE

October 9, 2007 -- iHealthBeat -- The Centers for Medicare & Medicaid Services (CMS) on Oct. 1 moved up the deadline for all hospital and health care organizations to transition to the National Provider Identifier on Medicare claims from May 23, 2008, to Jan. 1, 2008, Healthcare IT News reports. Read more >>

ELDERLY DON'T KNOW STROKE SIGNS: STUDY

October 9, 2007 -- Reuters Health -- Despite increased efforts in recent years to educate the public about stroke symptoms, the people most likely to suffer stroke -- the elderly -- still often do not realize they are having a stroke, a new study shows. Read more >>

 

COMING ATTRACTIONS

Improving AMI Care
IHI Teleconference -- October 18, 2007, 1:00 to 2:00 p.m.
Dial: 1-800-860-2442. No PIN code is required. Ask the operator to connect you to the Campaign Office.

OCHC Home Health Reform PPS Workshop * New session added
A full day in-depth program is scheduled for October 24, 2007 to provide detailed instruction on how to implement the changes at your agency. Download flyer >>

OHCO: Connecting OASIS and Clinical Decisions in the post-PPS Reform Environment

October 30, 2007
Contact Karen Lowe at (614)763-0036, Ext. 206 for more information.

The Many Facets of Pain Management: An Integrated Approach

November 7, 2007, 8:00 a.m. to 4:30 p.m.
MetroHealth Medical Center, Cleveland.
Call (216) 778-7707 for more information.