Nurses fired for refusing flu vaccine - page 9

by BrandybunsRN 16,884 Views | 132 Comments

While I personally do not like the flu shot either.... I have been required to get a Hep B vaccine, MMR all current, etc etc .... so not sure how this is so different?... Read More


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    Quote from CrunchRN
    Wow. Olddragger, but why do you think the CMS et al are forcing this issue? What underlies their instituting this whole push?
    Crunch,

    This is a wonderfully revealing question. What possible motivation could CMS have to force this issue? I do believe that knowing that CMS has this regulation definitely reveals why hospitals are getting so strict with enforcing this policy. It's almost always about the money. But then why is CMS interesting in this? Generally they have a money motivation for their reimbursement policies and how do you think that requiring staff vaccinations would affect CMS' costs of caring for their clients?
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    CMS ISSUES FINAL RULE FOR FIRST YEAR OF HOSPITAL VALUE-BASED PURCHASING PROGRAM

    BACKGROUND: Hospital payments account for the largest share of Medicare spending, and Medicare is the largest single payer for hospital services. In 2009, more than 7 million Medicare beneficiaries experienced more than 12.4 million inpatient hospitalizations. One in seven Medicare patients will experience some “adverse” event such as a preventable illness or injury while in the hospital. One in three Medicare beneficiaries who leave the hospital today will be back in the hospital within a month. Every year, as many as 98,000 Americans die from errors in hospital care.

    In addition to adding to the suffering of patients and their caregivers, these errors lead to significant unnecessary health care spending. Medicare spent an estimated $4.4 billion in 2009 to care for patients who had been harmed in the hospital, and readmissions cost Medicare another $26 billion.

    The Hospital VBP program is a major step forward in a longstanding effort by CMS to forge a closer link between Medicare’s payment systems and improvements in the quality and delivery of health care in all settings, including inpatient hospital stays. It is one of many reforms included in the Affordable Care Act that are changing how Medicare pays hospitals for their services.

    CMS has previously undertaken a number of initiatives to transform Medicare from a passive payer of claims to a prudent purchaser of health care services. This includes implementing the Hospital Inpatient Quality Reporting (Hospital IQR) program (previously known as the “Reporting Hospital Quality Data for Annual Payment Update” or RHQDAPU program) which reduces by 2.0 percentage points the applicable percentage increase for hospitals that do not participate or do not successfully report data on measures at a time and in a manner specified by the Secretary. Since 2005, CMS has published each participating hospital’s measure rates on the Hospital Compare website athttp://www.hospitalcompare.hhs.gov. However, unlike the Hospital VBP program, the Hospital IQR program is a pay-for-reporting program, and does not tie payment directly to a hospital’s reported measure rate.

    In future years, CMS will be implementing other provisions of the Affordable Care Act that are designed to improve care while reducing costs. For example, beginning in 2013, hospitals will receive a payment reduction if they have excess 30-day readmissions for patients with heart attacks, heart failure, and PNEUMONIA. By 2015, a portion of Medicare payments to most hospitals will also be linked to whether they meaningfully use information technology to communicate within the hospital to deliver better, safer, more coordinated care. Also beginning in 2015, hospitals with certain hospital acquired conditions will receive additional payment reductions from Medicare.
    END.

    In reference to the capitalized pneumonia above-- Influenza and pneumonia are classified as the same by CMS.

    Higher influenza Vaccination Coverage among Healthcare Personnel is one of the indicators that signifies "improved quality of care". CMS believes increased hcw influenza vaccinations will decrease the amount of patients that need to be treated for influenza. So far I dont believe that approach has worked very well?

    This is part of the same package that is reducing payments to acute care facilities for readmission's with in 30 days ( related diagnosis) and nosocomical infections.
    This means that the readmission within 30 days after d/c of the non complient diabetic or dialysis patients will not be paid for. It also means that if that chronic foley patient that develops an UTI while in the hospital will have a reduced payment.
    It's all about the money.
    morte likes this.
  3. 0
    Sooo, flu vaccination of caregivers reduces health care costs by reducing complications in vulnerable patients?

    If so then it does seem like a reasonable expectation to have nurses take the flu vaccine.

    Ok, let me have it!
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    If their supposition were correct. The new study quoted in the NYT casts much doubt. Also, remember, OSHA is NOT behind mandatory flu vaccines for HCWs.
    Quote from CrunchRN
    Sooo, flu vaccination of caregivers reduces health care costs by reducing complications in vulnerable patients?

    If so then it does seem like a reasonable expectation to have nurses take the flu vaccine.

    Ok, let me have it!
  5. 1
    "Sooo, flu vaccination of caregivers reduces health care costs by reducing complications in vulnerable patients?
    [COLOR=#000000]If so then it does seem like a reasonable expectation to have nurses take the flu vaccine."[/COLOR]

    [COLOR=#000000]The trouble with this is that the influenza vaccination effectiveness is questionable. By all information that I can gather it is at BEST only 60% effective overall. Also remember that it is only designed to protect agaisnt 3 viruses that the CDC guess will be the ones that are prevalent this season. There are over 200 different viruses that can cause influenza. Its a gamble.
    I have no problem with the influenza vaccination per se-- i do have a problem with business's and government when they start mandating yearly ineffective vaccinations. A thought...if it was effective then they would not have to mandate it would they?

    Visitor control and proper infection disease precautions will go further to reduce "possible" nosocomical infections than staff vaccinations in an acute care facility. But--those types of things are not popular with hospital administrations. Visitor control ( both is visiting and visitors being made to do proper infection control) and staff infection control cost the hospital bad public relations and money. How does it cost the hospital money--because proper isolation/infection control measures and lower patient to nurse ratios cost more.
    That type of approach would also reduce the amount of MRSA, HIV, [/COLOR]
    pneumococcal[COLOR=#000000] pneumonia ( and THAT may be coming as the next mandatory vaccination!) and various other infections we are so familiar with.


    [/COLOR]
    Kareylea likes this.
  6. 0
    Oldragger - I have read that also. My point really is that if this is true and it does not save CMS money then again, what is their motivation or are they just totally misinformed?

    CMS is behind it so I think we should leave hospitals et al out of it because we know their motivation is always money.
  7. 0
    CrunchRN--have you ever seen a governmental program that saves money? Yes, statistics can be made to say just about whatever you want them to say, but in reality I have never seen one--unless something was eliminated--lol!

    But, you miss the point and perhaps I didn't explain it well enough. I will try to explain my thoughts a little better.
    CMS did not make the shots mandatory. CMS stated that 90% of an acute care facility hcws must have had the influenza vaccination by the year ( I believe) 2015 in order to meet the their quality standard. Hospitals also have to report yearly the percentages of their staff's vaccination AND the reasons some didnt get it.
    Hospitals chose to make it mandatory. That is the easiest way of accomplishing that required goal. Voluntary programs do work but they also require more effort and money on the hospitals part. So which one do you think they will choose? Right-make it mandatory. Hospitals are the focus IMHO.

    I do believe that CMS has been feed misinformation from the CDC. For example the 36,000 deaths per year that is quoted a lot came from averaging over a period of years in the 90's. Thats right---- 20 years ago. There is a LOT of misinformation going around concerning the Influenza vaccination.

    One of my main concerns in this is mandatory vaccination sets a precedent. Once a precedent is set that opens the door for other "money saving mandatory" policys.
    The influenza vaccination is different from other vaccinations as it is very limited and it is never ending. I personally do not think it deserves the title of vaccination. I think by calling it a flu shot is misleading in itself. Yes, it can possibily protect a person agaisnt 3 different type of virus's that can cause the flu for a limited period of time. But there are hunderds of different virus's than can cause the flu or influenza like illness (ILI) and it does nothing toward the remaining.
  8. 0
    I agree that the precedent set is worrisome. I am just not sure we have gotten down to the true motivation. I can tolerate the lack of free choice if it really does save lives/health care dollars. Benefit vs. risk.

    If that is not the case then I still would really like to know what is the motivation behind it?

    Hospitals saving money on sick time? If that is the case it would seem to be that it must be effective.

    I am the cynical type deep down.
  9. 0
    Quote from BostonFNP
    The only vaccines containing aluminum in current use at the variates of DTaP and HiB, both of which provide immunity to fatal communicable diseases.
    Ok.......I've been checking MSDS. What Australian / New Zealand kids recieve.

    Aluminium is present in the Hep B, Hep A vaccines.
    Aluminium is present in some pneumococcal vaccines like Prevnar 13

    And given the frequency in which these are given to children at an early stage in their lives, is quite frankly frightening.

    How can I recommend any vaccines which have this crap in them? For the good of the children? Rubbish.
  10. 2
    Quote from Garethaus
    How can I recommend any vaccines which have this crap in them? For the good of the children? Rubbish.
    It sounds like you have a bit of research to do on vaccines, both the good and the bad. You are very early in your nursing/medical education an you will learn that often there are no ideal solutions to a problem. You need to weigh the benefits and the risks and formulate your plan as best you can. It sounds like you have googled the potential risks of vaccines. Have you googled the benefits? Take a look at the M&M data of infectious diseases in the pediatric population in the past century or in the US vs other countries. Does it also paint a compelling picture?
    SoldierNurse22 and Laidback Al like this.


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