0
No
yes_no
DiraChart MDS item reference
O0250ASection Ov1.20.1Manual page O-11
Was influenza vaccine received
This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.
Quick coding
Answer Codes
Use the item-specific response choices below when structured codes apply.
Response format: Coded response
1
Yes
yes_no
Item-specific instructions
Coding Guidance
Review what the item asks, how to choose the response, and what should be verified before submission.
Steps for Assessment
1. Review the resident’s medical record to determine whether an influenza vaccine was received
in the facility for this year’s influenza vaccination season. If vaccination status is unknown,
proceed to the next step.
2. Ask the resident if they received an influenza vaccine outside of the facility for this year’s
influenza vaccination season. If vaccination status is still unknown, proceed to the next step.
3. If the resident is unable to answer, then ask the same question of the responsible party/legal
guardian and/or primary care physician. If influenza vaccination status is still unknown,
proceed to the next step.
4. If influenza vaccination status cannot be determined, administer the influenza vaccine to the
resident according to standards of clinical practice.
Coding Instructions
for O0250A, Did the resident receive the influenza
vaccine in this facility for this year’s influenza vaccination
season?
•
Code 0, no: if the resident did NOT receive the influenza vaccine in this
facility during this year’s influenza vaccination season. Proceed to If influenza vaccine
not received, state reason (O0250C).
•
Code 1, yes: if the resident did receive the influenza vaccine in this facility
during this year’s influenza season. Continue to Date influenza vaccine received
(O0250B).
O0250: Influenza Vaccine (cont.)
Coding Instructions for O0250B, Date influenza vaccine received
•
Enter the date that the influenza vaccine was received. Do not leave any boxes blank.
— If the month contains only a single digit, fill in the first box of the month with a “0”.
For example, January 17, 2014 should be entered as 01-17-2014.
— If the day only contains a single digit, then fill the first box of the day with the “0”.
For example, October 6, 2013 should be entered as 10-06-2013. A full 8 character
date is required.
— A full 8 character date is required. If the date is unknown or the information is not
available, only a single dash needs to be entered in the first box.
Coding Instructions for O0250C, If influenza vaccine not received,
state reason
If the resident has not received the influenza vaccine for this year’s influenza vaccination season
(i.e., O0250A=0), code the reason from the following list:
•
Code 1, Resident not in this facility during this year's influenza
vaccination season: resident was not in this facility during this year’s influenza
vaccination season.
•
Code 2, Received outside of this facility: includes influenza vaccinations
administered in any other setting (e.g., physician office, health fair, grocery store,
hospital, fire station) during this year’s influenza vaccination season.
•
Code 3, Not eligible—medical contraindication: if influenza vaccine not
received due to medical contraindications. Influenza vaccine is contraindicated for a
resident with severe reaction (e.g., respiratory distress) to a previous dose of influenza
vaccine or to a vaccine component. Precautions for influenza vaccine include moderate to
severe acute illness with or without fever (influenza vaccine can be administered after the
acute illness) and history of Guillain-Barré Syndrome within six weeks after previous
influenza vaccination.
•
Code 4, Offered and declined: resident or responsible party/legal guardian has
been informed of the risks and benefits of receiving the influenza vaccine and chooses
not to accept vaccination.
•
Code 5, Not offered: resident or responsible party/legal guardian not offered the
influenza vaccine.
•
Code 6, Inability to obtain influenza vaccine due to a declared
shortage: vaccine is unavailable at this facility due to a declared influenza vaccine
shortage.
•
Code 9, None of the above: if none of the listed reasons describe why the influenza
vaccine was not administered. This code is also used if the answer is unknown.
O0250: Influenza Vaccine (cont.)
Coding Tips
and Special Populations
•
Once the influenza vaccination has been administered to a resident for the current
influenza season, this value is carried forward until the new influenza season begins.
•
Influenza can occur at any time, but most influenza occurs from October through May.
However, residents should be immunized as soon as the vaccine becomes available. More
information about when facilities must offer residents the influenza vaccine is available
in 42 CFR 483.80(d), Influenza and pneumococcal immunizations, which can be found in
Appendix PP of the State Operations Manual: https://www.cms.gov/Regulations-and-
Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf#page=708.
•
Information about the current influenza season can be obtained by accessing the CDC
Seasonal Influenza (Flu) website. This website provides information on influenza activity
and has an interactive map that shows geographic spread of influenza:
https://www.cdc.gov/flu/about/season.html,
https://www.cdc.gov/fluview/surveillance/usmap.html.
•
Facilities can also contact their local health department website for local influenza
surveillance information.
•
The annual supply of inactivated influenza vaccine and the timing of its distribution
cannot be guaranteed in any year. Therefore, in the event that a declared influenza
vaccine shortage occurs in your geographical area, residents should still be vaccinated
once the facility receives the influenza vaccine.
•
A “high dose” inactivated influenza vaccine is available for people 65 years of age and
older. Consult with the resident’s primary care physician (or nurse practitioner) to
determine if this high dose is appropriate for the resident.
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