Providers balk at CMS' proposed flu vaccination rule

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Nursing home operators are saying "Not so fast!" to federal health officials over the government's rush to mandate flu and pneumonia vaccinations for all nursing home residents.

"The rules just add a documentation burden. Nursing homes already do, for the most part, give vaccinations unless there's some (medical) contraindication," Janice Zalen, senior director of special programs for the American Health Care Association, told McKnight's LTC News Daily Update on Monday.

The proposed rule, which was made public Friday and published in the Federal Register on Monday, stipulates that nursing homes administer the flu vaccine unless residents resist or can't receive them for medical reasons. It would be up to facilities to determine whether residents were up to date in their vaccinations, a potential research and documentation nightmare, providers fear. Failure to follow the rule could mean termination of Medicare and Medicaid funding for a facility.

Ironically, Centers for Medicare and Medicaid Services Administrator Mark McClellan praised the input of nursing home association leaders in the creation of the rule. Zalen, however, said providers were blindsided. She said that the creation of something as rigid as a new regulation was never brought up in her talks with CMS officials.

She also said the truncated, 15-day comment period – at a time when many people are on vacation – seems suspicious. "It's almost as if they're doing everything they can to avoid" getting official objections, she said. The association will send comments to CMS urging the use of current measures, and expanding tools and education rather than instituting a new rule. Zalen said she would also like to see feedback from the new "W" section for vaccination info on the MDS form before a new rule is put in place.

She said there was also concern because providers are already supposed to have given vaccine pre-orders for the upcoming flu season. She called the rule relatively short (17 pages), leading to further fears that surveyors would be able to enforce the rule with wider personal discretion.