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Metadata: Indicator Instance

Some College | CMS_US | 2008

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• Estimates were obtained from data reported to the Minimum Data Set (MDS) maintained by the Centers for Medicare & Medicaid Services (CMS) collected during assessments of nursing home residents. MDS assessments are conducted by staff of individual nursing homes for all residents admitted to CMS-certified nursing homes and skilled nursing facilities for the purposes of monitoring quality of care, determining Medicare and Medicaid payment, and providing consumer access to nursing home information. Information collected during assessments included data on pneumococcal vaccination status along with data such as functional status, medical conditions, and current medications. Assessments are conducted at admission, discharge, quarterly, annually, and when there is a significant change in the patient’s status. Assessments are conducted by medical record review when possible, or by directly questioning the residents or their caretakers.

• Prior to 2016, pneumococcal vaccine was recommended for all adults 19 years and older residing in nursing homes and other long-term care facilities. Currently, pneumococcal vaccine is recommended for all adults ≥65 years and adults 19-64 years at increased risk for pneumococcal disease. Pneumococcal vaccination status should be assessed for all residents of nursing homes and other long-term care facilities due to the potential for outbreaks of pneumococcal disease in these settings.

• Coverage estimates are for all adult residents ≥18 years who resided in CMS-certified nursing homes and had at least one resident assessment conducted during 2006-2016.

• Prior to 2015, residents were considered to be vaccinated with pneumococcal vaccine if a “yes” response was reported on any assessment conducted during a resident’s history in the MDS for the question “Is the resident's pneumococcal vaccination up to date?”

• In September of 2014, the Advisory Committee on Immunization Practices revised the pneumococcal vaccination recommendation for adults 65 years and older to include both the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23). Therefore, residents who were considered vaccinated before 2015 may not have been vaccinated according to the new recommendation. For 2015 and all subsequent years, residents were considered to be vaccinated with pneumococcal vaccine if a “yes” response was reported on any assessment conducted during the calendar year in the MDS for the question “Is the resident’s pneumococcal vaccination up to date?”

• Race/ethnicity was determined based on a single question in the resident assessment instrument, for which multiple categories could be selected. Residents with "Hispanic or Latino" selected were considered to be of Hispanic ethnicity, regardless of the other races selected.

• Beginning in October 2010, “Asian or Pacific Islander” was separated into two categories on the resident assessment instrument, “Asian” and “Native Hawaiian or other Pacific Islander”.

• These data represent a census of all residents of CMS-certified nursing homes during the year of interest.

• Healthy People 2020 objective IID-13.3: Increase the percentage of institutionalized adults (persons aged 18 years and older in long-term or nursing homes) who are vaccinated against pneumococcal disease.

• NR = not reported because population size <5 residents.

• NA = Not available.

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