Oregon Health Care Workers Influenza Vaccination Annual Report

2017–2018 Season Oregon Health Care Worker Influenza Vaccination Annual Report

PUBLIC HEALTH DIVISION Acknowledgments

This publication was prepared by the Oregon Health Authority Healthcare-Associated Infections (HAI) Program, including: Monika E. Samper, RN Dat J. Tran, MD, MS

Oversight provided by: Zintars Beldavs, MS Acute and Communicable Disease Prevention Section Manager This report would not have been possible without the efforts of Oregon’s HAI prevention partners, including the Healthcare-Associated Infections Advisory Committee and the health care facilities included in this report.

For more information contact: Monika E. Samper, RN [email protected] Dat J. Tran, MD, MS [email protected]

April 2019 Please cite this publication as follows: Oregon Public Health Division. Oregon health care worker influenza vaccination annual report: 2017–2018. Oregon Health Authority. Portland, OR. 2019 April.

2 Acknowledgments | Oregon Health Care Worker Influenza Vaccination Contents

»»Acknowledgments...... 2 »»Contents...... 3 »»Executive summary...... 5 »» Figure 1. Influenza vaccination rates for all HCWs by health care facility type and season.....6 »» Figure 2. Mean HCW influenza vaccination rates for all facility types...... 6 »» What can facilities do to increase rates of HCW influenza vaccination?...... 7 »»Health care worker vaccination data...... 8 »» Table 1. Aggregate HCW influenza vaccination rate data for the 2017–2018 influenza season by facility type and HCW classification...... 8 »» Facility-specific data...... 9 »» Facility-specific table elements...... 10 »» Table 2. Rates of health care worker influenza vaccination, declination and unknown vaccination status for the 2017–2018 influenza season: hospitals (n=63)...... 11 »» Figure 3. Oregon hospitals sorted by HCW influenza vaccination rates for the 2017–2018 influenza season (n=63)...... 14 »» Table 3. Rates of health care worker (HCW) influenza vaccination, declination and rates of unknown vaccination status for the 2017–2018 influenza season: Oregon ambulatory surgery centers (n=86)...... 16 »» Figure 4. Oregon ambulatory surgery centers, by HCW influenza vaccination rate for the 2017–2018 influenza season (n=86)...... 20 »» Table 4. Rates of health care worker (HCW) influenza vaccination, declination and unknown vaccination status for the 2017–2018 influenza season: Skilled nursing facilities (n=136)...... 22 »» Figure 5. Oregon skilled nursing facilities, by HCW influenza vaccination rate for the 2017–2018 influenza season (n=136)...... 28 »» Table 5. Rates of health care worker (HCW) influenza vaccination, declination and unknown vaccination status for the 2017–2018 influenza season: Dialysis facilities (n=71)...... 32 »» Figure 6. Oregon dialysis facilities, by HCW influenza vaccination rate for the 2017–2018 influenza season (n=71) ...... 35 »» Improving Oregon health care worker vaccination rates...... 37 »»References...... 38 Oregon Health Care Worker Influenza Vaccination | Contents 3

Executive summary

The influenza virus can cause mild to severe respiratory illness, commonly called “the flu.” According to the Centers for Disease Control and Prevention (CDC), the 2017–2018 flu season was particularly severe. In the United States, an estimated 48.8 million people were sick with the flu; 22.7 million individuals sought health care providers; 959,000 ill people were hospitalized; and 79,400 died from the flu. (1) The Portland area alone reported 1,537 flu-related hospitalizations in 2017–2018. Flu has also been responsible for eight Oregon children’s deaths over the past six years. Serious complications are more likely for people with certain health conditions, the elderly and the young. In health care facilities, the best way to avoid the spread of influenza is to immunize health care workers (HCWs). Patients, coworkers and family members may become infected with the influenza virus from affected HCWs. Facilities and staff need to take extra care to prevent the spread of the flu among HCWs and patients. Widespread government and local facility educational campaigns focus on the importance of HCW immunization. The Oregon Health Authority (OHA) has required Oregon hospitals to report their HCW influenza vaccination rates since 2009. OHA added skilled nursing facilities in 2010 and ambulatory surgery centers in 2011. As of the 2015–2016 influenza season, OHA required dialysis facilities to report. The U.S. Department of Health and Human Services developed the Healthy People program, which provided 10-year national objectives for improving the health of all Americans. For influenza vaccination in health care facilities, the Healthy People goals were immunization rates of 75% by 2015 and 90% by 2020. Oregon hospitals and dialysis facilities have met the 2015 Healthy People target rate of 75% for the 2017–2018 influenza season. While ambulatory surgery centers were very close, neither they nor the skilled nursing facilities met the 2015 Healthy People target. (Figure 1).

Oregon Health Care Worker Influenza Vaccination | Executive summary 5 Figure 1. Influenza vaccination rates for all health care workers (HCWs) by health care facility type and influenza season 100% Healthy People 2020 goal (90%) 88 90 90% 85 82 79 78 79 80% 77 Healthy People 2015 goal (75%) 71 70 72 73 70% 67 67 68 63 60 59 60% 54 56 57 57 50 50% 47 40% Vaccination rate Vaccination 30% 20% 10% N/A N/A N/A N/A 0% Hospitals Ambulatory surgery centers Skilled nursing facilities Dialysis facilities Health care facility type 2011–2012 2012–2013 2013–2014 2014–2015 2015–2016 2016–2017 2017–2018

Vaccination rates vary by year and facility type. Fortunately, overall vaccination rates among Oregon HCWs have been increasing since reporting began. Figure 2 shows the mean vaccination rates for all facility types that reported data for the last seven influenza seasons. 2017–2018 is the first season that met the 2015 Healthy People mean rate goal.

Figure 2. Mean HCW influenza vaccination rates for all facility types, by influenza season

100% Healthy People 2020 goal (90%) 90%

73 76 80% Healthy People 2015 goal (75%) 69 70 67 70% 64

60% 52 50% 40% 30% 20% 10% 0% 2011–2012 2012–2013 2013–2014 2014–2015 2015–2016 2016–2017 2017–2018

6 Executive summary | Oregon Health Care Worker Influenza Vaccination What can facilities do to increase rates of HCW influenza vaccination?

Encourage their employees to be vaccinated at the beginning of every influenza season.

Participate in and encourage promotional strategies such as: • Mass vaccination fairs • Peer vaccination • No-cost vaccines • Incentive programs • Documentation of all HCWs’ vaccination status and required declination forms.

Oregon Health Authority has released a Healthcare Provider Influenza Vaccination Tool Kit to support facility vaccination programs: Go to https://go.usa. gov/xETst.

CDC information and guidance: http://www.cdc.gov/flu/health careworkers.htm

Oregon Health Care Worker Influenza Vaccination | Executive summary 7 Health care worker vaccination data

HCW influenza vaccination data for the 2017–2018 influenza season is reflected in Table 1. It shows the proportion of vaccinated HCWs among HCWs without medical contraindication to vaccination. The table also includes the declination and unknown status rates among eligible HCWs for each facility type. The change in vaccination rate since the 2016–2017 season is the final calculation. HCW rates are in aggregate and are stratified by HCW classifications. These classifications include all employees, facility-licensed independent practitioners, students, volunteers and other contractors. Vaccination rates for health care workers varied by worker type during the 2017–2018 influenza season. • The “other contractor” category of HCW had the highest vaccination rate in hospitals. • Ambulatory surgery centers had the highest vaccination rates among their independent practitioners. • HCWs classified as employees had the highest vaccination rates in skilled nursing facilities. • All provider types in dialysis facilities had a vaccination rate of 85% or higher. • Students and volunteers had the lowest vaccination rates in all facility types except in dialysis facilities. It is important to note that the high proportion of workers with unknown vaccination status may drive low vaccination rates. This highlights the need to improve vaccination status documentation.

Table 1. Aggregate HCW influenza vaccination rate data for the 2017–2018 influenza season, by facility type and HCW classification Rate of Rate of Rate of Percent influenza influenza unknown change in vaccination vaccine vaccination HCW influenza Health care worker HCWs eligible among eligible declination by status among vaccination rate classification for vaccination* HCWs eligible HCWs eligible HCWs since 2016 Hospitals All HCWs 106,057 83% 8% 9% 1% Employees 82,174 85% 9% 6% 1% Independent practitioners 8,957 78% 4% 19% 5% Students and volunteers 12,845 76% 4% 20% 4% Other contractors 2,081 82% 10% 8% -7%

8 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Rate of Rate of Rate of Percent influenza influenza unknown change in vaccination vaccine vaccination HCW influenza Health care worker HCWs eligible among eligible declination by status among vaccination rate classification for vaccination* HCWs eligible HCWs eligible HCWs since 2016 Ambulatory surgery centers All HCWs 5,089 76% 14% 10% 1% Employees 2,667 76% 20% 4% 4% Independent practitioners 1,979 78% 8% 15% 0% Students and volunteers 178 70% 0% 30% -9% Other contractors 265 71% 16% 13% -4% Skilled nursing facilities All HCWs 17,202 56% 15% 29% 2% Employees 14,517 59% 17% 24% 3% Independent practitioners 437 47% 2% 51% 10% Students and volunteers 1,682 39% 3% 58% -13% Other contractors 566 48% 11% 41% -9% Dialysis facilities All HCWs 3,195 86% 5% 8% 9% Employees 1,966 87% 7% 5% 2% Independent practitioners 1,200 85% 1% 14% 29% Students and volunteers 8 88% 13% 0% 25% Other contractors 21 86% 10% 5% 3% *This is the total number of health care workers (HCWs), including employees, licensed independent practitioners, students, volunteers and other contractors without documented medical contraindication for influenza vaccination. Facility-specific data Tables 2 through 5 show facility-specific vaccination, declination and unknown status rates for all HCWs combined for each facility type. Two additional columns designate whether facilities met or did not meet the HCW influenza vaccination Healthy People 2015 (HP2015) and 2020 (HP2020) goals of 75% and 90%, respectively. The last column specifies the number of additional HCWs needed to vaccinate to reach the HP2020 target of 90%. Figures 2 through 5 display facility-specific vaccination rates for hospitals, ambulatory surgery centers, skilled nursing facilities and dialysis facilities, respectively. Data.oregon.gov also has maps displaying HCW influenza vaccination rates. For facility-specific maps, see https://data.oregon.gov/.

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 9 Facility-specific table elements Facility name: Includes list of facilities that reported HCW influenza vaccination data for the 2017–2018 season. Number of HCWs eligible for influenza vaccination: Includes the total number of HCWs. This includes employees, licensed independent practitioners, other contractors, students and volunteers. None had documented medical contraindications for influenza vaccinations. Rate of influenza vaccination for eligible HCWs: Calculated as (total number of HCWs vaccinated at the facility + total number of HCWs vaccinated elsewhere)/ (total number of HCWs eligible for influenza vaccination). Rate of vaccine declination by eligible HCWs: Calculated as (total number of HCWs who declined to receive the influenza vaccine)/(total number of HCWs eligible for influenza vaccination). Rate of unknown vaccination status by eligible HCWs: Calculated as (total number of HCWs with unknown vaccination status)/(total number of HCWs eligible for influenza vaccination). Percent change in vaccination rate since last season: Calculated as (2017–2018 vaccination rate minus 2016–2017 vaccination rate)/(2016–2017 vaccination rate). Benchmarks: The following symbols indicate a facility’s performance in relation to the Healthy People goals: Vaccination rates met the HP2015 or HP2020 goal Vaccination rates did not meet the HP2015 or HP2020 goal Additional HCWs needed to vaccinate to reach HP2020: Calculated as (total HCWs eligible for vaccination * 0.9) – (total number of HCWs vaccinated at the facility + total number of HCWs vaccinated elsewhere).

10 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Table 2. Rates of health care worker (HCW) influenza vaccination, declination and unknown vaccination status for the 2017–2018 influenza season: hospitals (n=63) Each hospital’s vaccination rate is included. Forty-nine (78%) of the 63 hospitals met the HP2015 goal. Twelve (19%) met the HP2020 goal. Compared to last season, 37 (58%) reported increases in their vaccination rates.

Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Adventist Medical Center 2,349 82% 13% 5% 6% 195 Asante Ashland 567 70% 15% 15% -6% 113 Community Hospital Asante Rogue Regional 4,644 74% 20% 6% 4% 722 Medical Center Asante Three Rivers 1,561 79% 19% 1% 6% 167 Medical Center Bay Area Hospital 1,546 76% 18% 6% 1% 223 Blue Mountain Hospital 206 94% 2% 3% 28% Cedar Hills Hospital 329 57% 22% 21% -5% 108 Columbia Memorial 682 82% 16% 2% -6% 58 Hospital Coquille Valley Hospital 255 74% 18% 8% 32% 42 Cottage Grove Community 251 87% 2% 11% -1% 8 Hospital Curry General Hospital 421 91% 9% 0% 20% Good Samaritan Regional 2,892 81% 8% 11% 3% 258 Medical Center Good Shepherd Medical 962 83% 4% 13% -4% 64 Center Grande Ronde Hospital 1,001 88% 11% 1% 4% 18 Harney District Hospital 217 69% 16% 15% 3% 45 Kaiser Permanente 2,838 83% 10% 7% 7% 194 Sunnyside Medical Center Kaiser Permanente 1,198 84% 4% 12% 4% 71 Westside Medical Center Lake District Hospital 356 93% 7% 0% 81% Legacy Emanuel Medical Center and Randall 5,660 88% 11% 1% -1% 112 Children’s Hospital Legacy Good Samaritan 3,198 88% 10% 2% 1% 65 Medical Center

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 11 Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Legacy Meridian Park 1,998 89% 10% 1% -1% 18 Medical Center Legacy Mt. Hood Medical 1,561 87% 13% 1% 2% 53 Center Legacy Silverton 985 88% 11% 1% 1% 20 Lower Umpqua Hospital 283 49% 12% 39% -2% 116 McKenzie-Willamette 1,060 82% 13% 5% 8% 84 Medical Center Mercy Medical Center 1,827 63% 7% 30% -23% 497 Mid-Columbia Medical 1,196 89% 5% 6% 14% 7 Center Oregon Health & Science 17,788 90% 5% 5% 5% 26 University Oregon State Hospitals 2,732 65% 12% 23% 0% 677 PeaceHealth Peace Harbor 382 90% 5% 5% -3% Medical Center Pioneer Memorial Hospital 67 87% 0% 13% -8% 2 — Heppner Providence Hood River 619 81% 7% 12% 11% 56 Memorial Hospital Providence Medford 1,755 68% 11% 21% -1% 387 Medical Center Providence Milwaukie 788 78% 5% 18% 1% 95 Hospital Providence Newberg 728 79% 4% 17% 1% 77 Medical Center Providence Portland 4,667 78% 7% 15% 3% 561 Medical Center Providence Seaside 595 81% 4% 15% -9% 55 Hospital Providence St. Vincent 5,621 78% 4% 17% -6% 652 Medical Center Providence Willamette 1,119 72% 9% 19% 4% 205 Falls Medical Center Sacred Heart Medical 4,389 83% 4% 13% 3% 307 Center at RiverBend Sacred Heart Medical 785 80% 3% 17% 14% 78 Center University District Salem Hospital 6,619 86% 8% 7% 1% 294

12 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Samaritan Albany General 1,287 82% 8% 10% 5% 106 Hospital Samaritan Lebanon 943 85% 8% 8% 5% 52 Community Hospital Samaritan North Lincoln 486 84% 8% 8% 4% 28 Hospital Samaritan Pacific Health 596 81% 7% 12% -2% 51 Systems Santiam Memorial 480 87% 9% 4% -6% 13 Hospital Shriners Hospitals for 506 92% 2% 5% 3% Children — Portland Sky Lakes Medical Center 1,710 74% 10% 16% 9% 273 Southern Coos Hospital 173 74% 15% 11% 16% 2 and Health Center St. Alphonsus Medical 214 81% 16% 3% -6% 20 Center — Baker City St. Alphonsus Medical 674 96% 4% 0% 21% Center — Ontario St. Anthony Hospital 585 94% 6% 1% 0% St. Charles Medical Center 4,580 92% 4% 5% -2% — Bend St. Charles Medical Center 179 88% 8% 4% -5% 4 — Madras St. Charles Medical Center 225 93% 2% 5% 0% — Prineville St. Charles Medical Center 642 91% 3% 6% -1% — Redmond Tillamook Regional 713 73% 21% 6% -2% 118 Medical Center Tuality Healthcare 1,954 85% 4% 10% -3% 89 Vibra Specialty Hospital 333 71% 7% 22% 8% 64 Wallowa Memorial 190 88% 9% 3% 0% 4 Hospital West Valley Hospital 238 84% 7% 8% 3% 13 Willamette Valley Medical 652 95% 5% 0% 1% Center

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 13 Figure 3. Oregon hospitals sorted by HCW influenza vaccination rates for the 2017–2018 influenza season (n=63)

St. Alphonsus Medical Center — Ontario 96.3% Willame�e Valley Medical Center 94.9% Blue Mountain Hospital 94.2% St. Anthony Hospital 93.7% St. Charles Medical Center — Prineville 93.3% Lake District Hospital 93.0% Shriners Hospitals for Children — Portland 92.3% St. Charles Medical Center — Bend 91.7% Curry General Hospital 91.2% St. Charles Medical Center — Redmond 90.8% Oregon Health & Science University 89.9% PeaceHealth Peace Harbor Medical Center 89.8% Mid-Columbia Medical Center 89.4% Legacy Meridian Park Medical Center 89.1% Grande Ronde Hospital 88.2% Legacy Emanuel Medical Center and Randall Children's Hospital 88.0% Legacy Silverton 88.0% Legacy Good Samaritan Medical Center 88.0% Wallowa Memorial Hospital 87.9% St. Charles Medical Center — Madras 87.7% San�am Memorial Hospital 87.3% Co�age Grove Community Hospital 86.9% Legacy Mt. Hood Medical Center 86.6% Pioneer Memorial Hospital — Heppner 86.6% Salem Hospital 85.6% Tuality Healthcare 85.5% Samaritan Lebanon Community Hospital 84.5% West Valley Hospital 84.5% Samaritan North Lincoln Hospital 84.2% Kaiser Permanente Westside Medical Center 84.1% Good Shepherd Medical Center 83.4%

10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

14 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Figure 3. continued

Kaiser Permanente Sunnyside Medical Center 83.2% Sacred Heart Medical Center at RiverBend 83.0% McKenzie-Willame�e Medical Center 82.1% Samaritan Albany General Hospital 81.7% Adven�st Medical Center 81.7% Columbia Memorial Hospital 81.5% Samaritan Paciﬁc Health Systems 81.4% Good Samaritan Regional Medical Center 81.1% Providence Hood River Memorial Hospital 80.9% St. Alphonsus Medical Center — Baker City 80.8% Providence Seaside Hospital 80.8% Sacred Heart Medical Center University District 80.1% Providence Newberg Medical Center 79.4% Asante Three Rivers Medical Center 79.3% Providence St. Vincent Medical Center 78.4% Providence Portland Medical Center 78.0% Providence Milwaukie Hospital 77.9% Bay Area Hospital 75.5% Asante Rogue Regional Medical Center 74.5% Sky Lakes Medical Center 74.0% Southern Coos Hospital and Health Center 74.0% Coquille Valley Hospital 73.7% Tillamook Regional Medical Center 73.5% Providence Willame�e Falls Medical Center 71.7% Vibra Specialty Hospital 70.9% Asante Ashland Community Hospital 70.0% Harney District Hospital 69.1% Providence Medford Medical Center 68.0% Oregon State Hospitals 65.2% Mercy Medical Center 62.8% Cedar Hills Hospital 57.1% Lower Umpqua Hospital 49.1%

0 10% 20% 30% 40% 50% 60% 70% 80% 90%

Facility with percentage of HCW vaccinated ≥90% Facility with percentage of HCW vaccinated 60%–74% Facility with percentage of HCW vaccinated 75%–90% Facility with percentage of HCW vaccinated ≤59% For facility-specific maps, see http://www.oregon.gov/oha/PH/DISEASESCONDITIONS/ COMMUNICABLEDISEASE/HAI/Pages/Reports-and-Data.aspx. Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 15 Table 3. Rates of health care worker (HCW) influenza vaccination, declination and unknown vaccination status for the 2017–2018 influenza season: Oregon ambulatory surgery centers (n=86) Each ambulatory surgery center’s vaccination rate is included. Fifty-one (59%) of the 86 ambulatory surgery centers met the HP2015 goal. Twenty (23%) met the HP2020 goal. Compared to last season, 47 (55%) reported increases in their vaccination rates.

Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Aesthetic Breast and 12 100% 0% 0% 0% Cosmetic Surgery Center Aesthetic Surgery Center 23 91% 9% 0% -9% of Eugene Alberty Surgery Center 88 60% 13% 27% -25% 26 Ambulatory Surgery 132 85% 11% 4% 7% 7 Center at Tanasbourne Ashland Surgery Center 37 41% 24% 35% -19% 18 Athenix Body Sculpting 16 13% 88% 0% N/A 12 Institute Beaver Sports Medicine 28 71% 29% 0% 49% 5 ASC Bend Surgery Center 227 91% 9% 0% -3% Cascade Endoscopy 27 89% 11% 0% -2% 1 Center Cascade Spine Center 26 65% 35% 0% 31% 6 Cascade Surgery Center 20 65% 35% 0% 37% 5 LLC Cascade Surgicenter, LLC 163 87% 13% 0% 1% 5 Cataract and Laser Institute of Southern 54 69% 31% 0% 26% 12 Oregon Cedar Hills Ambulatory 5 80% 20% 0% 40% 1 Surgery Center Center for Cosmetic & 12 92% 8% 0% -2% Plastic Surgery Center for Specialty 114 89% 11% 0% 1% 1 Surgery Central Oregon Surgery 14 7% 14% 79% N/A 12 Center Columbia Gorge Surgery 16 63% 38% 0% -32% 4 Center

16 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Columbia River Surgery 84 92% 8% 0% 15% Center Cornell Surgery Center 60 77% 13% 10% 7% 8 Deschutes Surgery Center 11 64% 36% 0% N/A 3 Doctors Park Surgery 45 89% 7% 4% -3% 1 Center East Oregon Surgery 20 10% 20% 70% 0% 16 Center East Portland Surgery 81 25% 12% 63% -49% 53 Center Eastern Oregon Regional 3 33% 67% 0% 0% 2 Surgery Center Eye Health Eastside 63 68% 27% 5% -8% 14 Surgery Center Eye Surgery Center — 22 86% 9% 5% 27% 1 Albany Eye Surgery Institute 38 55% 8% 37% 5% 13 Gateway Pediatric Surgery 14 100% 0% 0% N/A Center Grants Pass Surgery 80 58% 41% 1% -14% 26 Center, LLC Kaiser Permanente Skyline 39 77% 13% 10% 3% 5 Kaiser Permanente South 84 86% 7% 7% 4% 4 Interstate Kaiser Permanente 94 85% 13% 2% 1% 5 Sunnybrook Klamath Surgery Center 38 37% 8% 55% -40% 20 Lane Surgery Center 32 75% 9% 16% 25% 5 Laser and Surgical Eye 51 33% 55% 12% -30% 29 Center, LLC Lovejoy Surgicenter 53 49% 9% 42% 11% 22 McKenzie Surgery Center 165 47% 16% 38% -18% 72 Meridian Center for 13 100% 0% 0% 0% Surgical Excellence Mt. Scott Surgery Center 88 73% 20% 7% 68% 15 North Bend Medical 80 84% 10% 6% 10% 5 Center Northbank Surgical Center 121 43% 13% 44% -38% 57

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 17 Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Northwest Ambulatory 94 91% 3% 5% 3% Surgery Center Northwest Center for 9 100% 0% 0% 0% Plastic Surgery, LLC Northwest 55 95% 5% 0% -4% Gastroenterology Clinic Northwest Spine and 85 86% 14% 0% -4% 4 Laser Surgery Center Ontario Surgery Center 12 75% 25% 0% 18% 2 Oregon Ear, Nose, and Throat Surgery Center, 38 84% 16% 0% 12% 2 LLC Oregon Endoscopy Center, 50 88% 12% 0% -5% 1 LLC Oregon Eye Surgery 50 68% 30% 2% -2% 11 Center, Inc. Oregon Outpatient Surgery 123 56% 20% 24% 36% 42 Center Oregon Specialists 142 55% 24% 21% -20% 50 Surgery Center, LLC Oregon Surgicenter 49 86% 14% 0% 4% 2 Pacific Cataract and Laser 16 44% 31% 25% -5% 7 Institute — Portland Pacific Cataract and Laser 16 69% 25% 6% 15% 3 Institute — Tualtin Pacific Digestive 11 73% 27% 0% 94% 2 Endoscopy Center Pacific Surgery Center 62 97% 3% 0% 32% Pearl SurgiCenter 29 79% 21% 0% 7% 3 Petroff Center 14 93% 7% 0% 8% Plaza Ambulatory Surgery 139 86% 9% 4% 2% 5 Center, LLC RiverBend Ambulatory 154 95% 4% 1% 6% Surgery Center River Road Surgery Center 42 86% 14% 0% 3% 2 Rogue Valley Surgery 11 55% 45% 0% -9% 4 Center, LLC Salem Endoscopy Center 68 90% 1% 9% -10%

18 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Salem Laser and Surgery 49 71% 12% 16% -10% 9 Center Samaritan Endoscopy 26 77% 23% 0% 18% 3 Center Slocum Surgery Center 104 88% 3% 9% 3% 2 South Coast Surgery 44 73% 27% 0% -13% 8 South Portland Surgical 69 84% 14% 1% 5% 4 Center, LLC Spine Surgery Center of 46 87% 13% 0% 14% 1 Eugene Sunset Surgical Centre 11 91% 0% 9% 1% Surgery Center of 228 75% 24% 2% 6% 35 Southern Oregon The Corvallis Clinic 100 83% 17% 0% 2% 7 Surgery Center The Oregon Clinic 101 98% 2% 0% 25% Gastroenterology East The Oregon Clinic Gastroenterology — 92 96% 4% 0% 34% Oregon City The Oregon Clinic Gastroenterology — 92 96% 4% 0% 35% Tualatin The Oregon Clinic 88 92% 6% 2% 11% Gastroenterology West The Portland Clinic 53 79% 15% 6% 1% 6 Surgery Centers Two Rivers Surgical 59 51% 14% 36% -31% 23 Center Valley Plastic Surgery 9 44% 56% 0% 0% 4 Vision Surgery and Laser 35 80% 20% 0% 115% 4 Center Waverly Lake Surgery 44 61% 23% 16% N/A 13 Center Westside Surgery Center 40 73% 20% 8% 9% 7 Willamette Surgery Center 80 94% 6% 0% -2% Wilshire Surgery Center 49 76% 14% 10% -4% 7 Yamhill Valley Surgical 8 88% 13% 0% 5% 1 Center N/A: Percentage change could not be calculated if no vaccination data reported in the previous season.

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 19 Figure 4. Oregon ambulatory surgery centers, by HCW influenza vaccination rate for the 2017– 2018 influenza season (n=86)

Northwest Center for Plas�c Surgery, LLC 100.0% Meridian Center for Surgical Excellence 100.0% Gateway Pediatric Surgery Center 100.0% Aesthe�c Breast and Cosme�c Surgery Center 100.0% Salem Endoscopy Center 98.4% The Oregon Clinic Gastroenterology East 98.0% Paciﬁc Surgery Center 96.8% The Oregon Clinic Gastroenterology — Tuala�n 95.7% The Oregon Clinic Gastroenterology — Oregon City 95.7% RiverBend Ambulatory Surgery Center 95.5% Northwest Gastroenterology Clinic 94.5% Willame�e Surgery Center 93.8% Petroﬀ Center 92.9% The Oregon Clinic Gastroenterology West 92.0% Columbia River Surgery Center 91.7% Center for Cosme�c & Plas�c Surgery 91.7% Northwest Ambulatory Surgery Center 91.5% Aesthe�c Surgery Center of Eugene 91.3% Sunset Surgical Centre 90.9% Bend Surgery Center 90.7% Center for Specialty Surgery 89.5% Doctors Park Surgery Center 88.9% Cascade Endoscopy Center 88.9% Slocum Surgery Center 88.5% Oregon Endoscopy Center, LLC 88.0% Yamhill Valley Surgical Center 87.5% Cascade Surgicenter, LLC 87.1% Spine Surgery Center of Eugene 87.0% Eye Surgery Center — Albany 86.4%

70% 80% 90% 100%

20 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Figure 4. continued

Northwest Spine and Laser Surgery Center 85.9% River Road Surgery Center 85.7% Oregon Surgicenter 85.7% Kaiser Permanente South Interstate 85.7% Kaiser Permanente Sunnybrook 85.1% Ambulatory Surgery Center at Tanasbourne 84.8% Oregon Ear, Nose, and Throat Surgery Center, LLC 84.2% South Portland Surgical Center, LLC 84.1% North Bend Medical Center 83.8% The Corvallis Clinic Surgery Center 83.0% Vision Surgery and Laser Center 80.0% Cedar Hills Ambulatory Surgery Center 80.0% Pearl SurgiCenter 79.3% The Portland Clinic Surgery Centers 79.2% Samaritan Endoscopy Center 76.9% Kaiser Permanente Skyline 76.9% Cornell Surgery Center 76.7% Wilshire Surgery Center 75.5% Ontario Surgery Center 75.0% Lane Surgery Center 75.0% Surgery Center of Southern Oregon 74.6% South Coast Surgery 72.7% Paciﬁc Diges�ve Associates 72.7% Mt. Sco� Surgery Center 72.7% Westside Surgery Center 72.5% Salem Laser and Surgery Center 71.4% Beaver Sports Medicine ASC 71.4% Paciﬁc Cataract and Laser Ins�tute — Tuala�n 68.8%

0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 21 Table 4. Rates of health care worker (HCW) influenza vaccination, declination and unknown vaccination status for the 2017–2018 influenza season: Skilled nursing facilities (n=136) Each skilled nursing facility’s vaccination rate is included. Forty-one (30%) of the 136 skilled nursing facilities met the HP2015 goal. Nineteen (14%) met the HP2020 goal. Compared to last season, 79 (58%) reported increases in their vaccination rates.

Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Aidan Senior Living at 37 95% 5% 0% 5% Reedsport Avamere Court at Keizer 427 31% 11% 58% 60% 252 Avamere Crestview of 155 20% 16% 64% -46% 109 Portland Avamere Health Services 98 39% 18% 43% 55% 50 of Rogue Valley Avamere Medford at Three 260 18% 3% 78% -68% 187 Fountains Avamere of Junction City 75 92% 8% 0% 7% Avamere of Newport Rehabilitation and 68 71% 29% 0% 97% 13 Specialty Care Avamere Rehabilitation of 172 63% 13% 24% -24% 47 Beaverton Avamere Rehabilitation of 71 92% 8% 0% 699% Clackamas Avamere Rehabilitation of 81 11% 38% 51% -84% 64 Coos Bay Avamere Rehabilitation of 109 66% 28% 6% 8% 26 Eugene Avamere Rehabilitation of 202 30% 10% 60% 17% 121 Hillsboro Avamere Rehabilitation of 90 23% 6% 71% -27% 60 King City Avamere Rehabilitation of 87 29% 9% 62% -30% 53 Lebanon Avamere Rehabilitation of 190 0% 0% 100% -100% 171 Oregon City Avamere Riverpark of 263 35% 19% 47% 144% 146 Eugene Avamere Transitional Care 97 49% 1% 49% 86% 39 at Sunnyside Avamere Twin Oaks of 36 67% 33% 0% 69% 8 Sweet Home Baycrest Village 90 57% 43% 0% 102% 30

22 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Bend Transitional Care 106 72% 4% 25% 27% 19 Blue Mountain Care 40 85% 13% 3% 36% 2 Center Care Center East 123 36% 12% 52% -44% 67 Cascade Manor 131 40% 0% 60% -35% 66 Cascade Terrace 107 50% 43% 7% 10% 42 Chehalem Health and 51 61% 33% 6% 34% 15 Rehabilitation Clatsop Care Center 75 57% 12% 31% -41% 25 Coast Fork Nursing Center 78 53% 6% 41% -33% 29 Columbia Basin Care 118 72% 13% 15% 63% 21 Facility Columbia Care Center 62 50% 32% 18% 20% 25 Cornerstone Care Option 69 71% 28% 1% 16% 13 Corvallis Manor Nursing 123 72% 4% 24% 26% 23 and Rehabilitation Center Creekside Rehab and 59 46% 25% 29% -8% 26 Nursing Creswell Health and 77 56% 44% 0% 27% 26 Rehabilitation Center Dallas Retirement Village 262 50% 0% 50% 6% 106 East Cascade Retirement 28 36% 61% 4% -61% 15 Community EmpRes Hillsboro 77 91% 1% 8% 4% Fernhill Estates 71 25% 21% 54% 28% 46 Forest Grove Rehabilitation 77 62% 13% 25% -6% 21 and Care Center French Prairie Nursing and 110 99% 1% 0% 4% Rehab Center Friendship Health Center 351 37% 14% 49% 11% 186 Gateway Care & 87 60% 17% 23% -33% 26 Retirement Glisan Care Center 103 46% 44% 11% -50% 46 Good Samaritan — Curry 124 27% 8% 65% -31% 79 Village Good Samaritan Society 77 90% 10% 0% 83% — Eugene Village Good Samaritan Society 119 78% 18% 3% 8% 14 — Fairlawn Village

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 23 Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Gracelen Terrace 132 100% 0% 0% 13% Green Valley Nursing and 152 97% 3% 0% 18% Rehabilitation Center Healthcare at Foster Creek 227 40% 35% 26% 20% 114 Hearthstone Nursing & 115 99% 1% 0% 84% Rehabilitation Center Highland House Nursing 154 94% 6% 0% 43% and Rehabilitation Center Hillside Brookdale 266 20% 23% 57% 61% 187 Hillside Heights 81 93% 7% 0% 16% Holladay Park Plaza 134 56% 22% 22% 35% 46 Hood River Care Center 88 55% 2% 43% -30% 31 Independence Health and 65 98% 2% 0% 0% Rehab La Grande Post Acute 49 88% 12% 0% 31% 1 Rehab Lakeview Gardens 46 80% 20% 0% -16% 4 Laurel Hill Nursing and 61 36% 44% 20% -45% 33 Rehab Center Laurelhurst Village 57 32% 47% 21% 22% 33 Life Care Center of Coos 126 71% 24% 5% 17% 23 Bay Lifecare Center 142 28% 41% 31% -11% 88 McMinnville Linda Vista Nursing & 106 46% 23% 31% 3% 46 Rehabilitation Marian Estates 143 52% 43% 5% 175% 55 Marquis Autumn Hills 87 47% 20% 33% 55% 37 Marquis Centennial 147 89% 11% 0% 8% 1 Marquis Forest Grove 87 78% 13% 9% 33% 10 Marquis Mt. Tabor 223 29% 29% 42% 52% 136 Marquis Newberg 82 76% 24% 0% -19% 12 Marquis Oregon City Post 100 41% 5% 54% -55% 49 Acute Rehab Marquis Piedmont 137 67% 18% 15% 29% 31 Marquis Plum Ridge 153 42% 22% 36% 18% 74

24 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Marquis Post Acute Rehabilitation at Hope 133 80% 19% 1% 43% 13 Village Marquis Post Acute Rehab 124 48% 1% 52% -37% 53 at Mill Park Marquis Silver Gardens 42 90% 2% 7% 34% Marquis Springfield 201 46% 54% 0% -7% 88 Marquis Tualatin Post 226 29% 1% 69% 8% 137 Acute Rehab Marquis Vermont Hills 100 61% 3% 36% -23% 29 Marquis Wilsonville 210 35% 9% 56% 6% 116 Mary's Woods at 462 51% 15% 34% -17% 180 Marylhurst Maryville Nursing Home 323 80% 19% 1% 19% 33 Meadow Park 102 39% 18% 43% -42% 52 Mennonite Home 276 31% 4% 65% -45% 162 Milton Freewater Health 59 97% 3% 0% 0% and Rehabilitation Center Mirabella Portland 226 41% 26% 33% -5% 110 Molalla Manor Care Center 81 54% 11% 35% -16% 29 Myrtle Point Care Center 47 51% 15% 34% 33% 18 Nehalem Valley Care 44 66% 34% 0% 98% 11 Center Oregon City Health Care 66 41% 33% 26% -16% 32 Center Oregon Veterans' Home, 274 40% 3% 57% -26% 137 Lebanon Oregon Veterans' Home, 239 74% 26% 0% 9% 38 The Dalles Pacific Health & 109 25% 4% 72% 115% 71 Rehabilitation Park Forest Care Center 55 60% 40% 0% 53% 17 Pilot Butte Rehab 52 62% 38% 0% -13% 15 Pioneer Nursing Home 128 58% 19% 23% -14% 41 Porthaven Care Center 98 62% 33% 5% 4% 27 Portland Health and Rehab 87 87% 2% 10% -12% 2 Prestige Care & Rehab of 86 58% 35% 7% -11% 27 Menlo Park

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 25 Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Prestige Care and Rehab 73 64% 36% 0% -27% 19 of Reedwood Prestige Post-Acute Care & Rehabilitation Center — 123 45% 11% 45% -29% 56 Gresham Prestige Post-Acute and Rehabilitation Center — 46 30% 30% 39% -58% 27 McMinnville Prestige Post-Acute and Rehabilitation Center — 56 86% 14% 0% 15% 2 Milwaukie Providence Benedictine 395 80% 8% 12% 4% 40 Providence Child Center 323 84% 6% 10% -6% 20 Regency Albany 69 78% 22% 0% 146% 8 Regency Care of Central 73 58% 34% 8% 8% 24 Oregon Regency Care of Rogue 104 48% 27% 25% -14% 44 Valley Regency Florence 78 76% 24% 0% -15% 11 Regency Gresham Nursing 121 80% 13% 7% 8% 12 and Rehabilitation Center Regency Hermiston Nursing and Rehabilitation 122 94% 6% 0% 5% Center Regency Prineville Rehabilitation and Nursing 65 48% 15% 37% -27% 28 Center (FKA: Ochoco Care Center) Regency Redmond Rehabilitation and Nursing 128 41% 6% 52% -35% 62 Center (FKA: Redmond Health Care Center) Robison Jewish Health 184 63% 9% 28% 38% 50 Center Rogue Valley Manor 170 46% 20% 34% -8% 74 Rose City Nursing Home 30 87% 13% 0% 492% 1 Rose Haven Nursing 123 96% 4% 0% 40% Center Rose Linn Care Center 152 33% 7% 60% 12% 87 Rose Villa Senior Living 211 83% 17% 0% 15% 15

26 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Royale Gardens Health 175 88% 12% 0% 2% 4 and Rehabilitation Center Salem Transitional Care 172 77% 23% 0% 101% 23 Secora Rehabilitation of 63 27% 6% 67% 56% 40 Cascadia Sheridan Care Center 119 31% 11% 58% -36% 70 Sherwood Park Nursing & 62 56% 44% 0% -2% 21 Rehab Center South Hills Rehabilitation 102 98% 2% 0% 3% Center The Dalles Health and 74 54% 0% 46% -46% 27 Rehabilitation The Pearl at Kruse Way 187 12% 0% 88% -59% 145 Tierra Rose Care Center 160 55% 11% 34% -1% 56 Timberview Care Center 88 57% 5% 39% -22% 29 Town Center Village Rehab 210 73% 0% 27% 115% 36 Umpqua Valley Nursing 144 95% 3% 2% 139% and Rehabilitation Center Valley West Health Care 50 80% 16% 4% 134% 5 Center Village Health Care 127 64% 25% 11% -4% 33 Village Manor 78 63% 0% 37% N/A 21 West Hills Health and 199 68% 10% 23% 3% 44 Rehab Willamette View Health 77 77% 12% 12% 2% 10 Center Willowbrook Terrace 72 65% 18% 17% 24% 18 Windsor Health and 74 97% 3% 0% -3% Rehabilitation N/A: Percentage change could not be calculated if no vaccination data reported in the previous season.

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 27 Figure 5. Oregon skilled nursing facilities, by HCW influenza vaccination rate for the 2017–2018 influenza season (n=136)

Gracelen Terrace 100.0% Hearthstone Nursing & Rehabilita�on Center 99.1% French Prairie Nursing and Rehab Center 99.1% Independence Health and Rehab 98.5% South Hills Rehabilita�on Center 98.0% Windsor Health and Rehabilita�on 97.3% Green Valley Nursing and Rehabilita�on Center 96.7% Milton Freewater Health and Rehabilita�on Center 96.6% Rose Haven Nursing Center 95.9% Umpqua Valley Nursing and Rehabilita�on Center 95.1% Aidan Senior Living at Reedsport 94.6% Regency Hermiston Nursing and Rehabilita�on Center 94.3% Highland House Nursing and Rehabilita�on Center 94.2% Hillside Heights 92.6% Avamere of Junc�on City 92.0% Avamere Rehabilita�on of Clackamas 91.5% EmpRes Hillsboro 90.9% Marquis Silver Gardens 90.5% Good Samaritan Society — Eugene Village 89.6% Marquis Centennial 89.1% Royale Gardens Health and Rehabilita�on Center 88.0% La Grande Post-Acute Rehab 87.8% Portland Health and Rehab 87.4% Rose City Nursing Home 86.7% Pres�ge Post-Acute and Rehabilita�on Center — Milwaukie 85.7% Blue Mountain Care Center 85.0% Providence Child Center 83.9% Rose Villa Senior Living 82.9% Marquis Post Acute Rehabilita�on at Hope Village 80.5% Lakeview Gardens 80.4% Regency Gresham Nursing and Rehabilita�on Center 80.2% Providence Benedic�ne 80.0% Valley West Health Care Center 80.0% Maryville Nursing Home 79.9% 0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

28 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Figure 5. continued

Regency Albany 78.3% Marquis Forest Grove 78.2% Good Samaritan Society — Fairlawn Village 78.2% Salem Transi�onal Care 76.7% Willame�e View Health Center 76.6% Regency Florence 75.6% Marquis Newberg 75.6% Oregon Veterans' Home, The Dalles 74.1% Town Center Village Rehab 72.9% Columbia Basin Care Facility 72.0% Bend Transi�onal Care 71.7% Corvallis Manor Nursing and Rehabilita�on Center 71.5% Life Care Center of Coos Bay 71.4% Cornerstone Care Op�on 71.0% Avamere of Newport Rehabilita�on and Specialty Care 70.6% West Hills Health and Rehab 67.8% Marquis Piedmont 67.2% Avamere Twin Oaks of Sweet Home 66.7% Avamere Rehabilita�on of Eugene 66.1% Nehalem Valley Care Center 65.9% Willowbrook Terrace 65.3% Pres�ge Care and Rehab of Reedwood 64.4% Village Health Care 63.8% Robison Jewish Health Center 63.0% Village Manor 62.8% Avamere Rehabilita�on of Beaverton 62.8% Forest Grove Rehabilita�on and Care Center 62.3% Porthaven Care Center 62.2% Pilot Bu�e Rehab 61.5% Marquis Vermont Hills 61.0% Chehalem Health and Rehabilita�on 60.8% Park Forest Care Center 60.0% Gateway Care & Re�rement 59.8% Pres�ge Care & Rehab of Menlo Park 58.1% 0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 29 Figure 5. continued

Pioneer Nursing Home 57.8% Regency Care of Central Oregon 57.5% Clatsop Care Center 57.3% Timberview Care Center 56.8% Baycrest Village 56.7% Sherwood Park Nursing & Rehab Center 56.5% Holladay Park Plaza 56.0% Creswell Health and Rehabilita�on Center 55.8% Tierra Rose Care Center 55.0% Hood River Care Center 54.5% Molalla Manor Care Center 54.3% The Dalles Health and Rehabilita�on 54.1% Coast Fork Nursing Center 52.6% Marian Estates 51.7% Mary's Woods at Marylhurst 51.1% Myrtle Point Care Center 51.1% Cascade Terrace 50.5% Columbia Care Center 50.0% Dallas Re�rement Village 49.6% Avamere Transi�onal Care at Sunnyside 49.5% Regency Care of Rogue Valley 48.1% Regency Prineville Rehabilita�on andNursing Center 47.7% Marquis Post Acute Rehab at Mill Park 47.6% Marquis Autumn Hills 47.1% Rogue Valley Manor 46.5% Marquis Springﬁeld 46.3% Linda Vista Nursing & Rehabilita�on 46.2% Creekside Rehab and Nursing 45.8% Glisan Care Center 45.6% Pres�ge Post-Acute Care & Rehabilita�on — Gresham 44.7% Marquis Plum Ridge 41.8% Regency Redmond Rehabilita�on and Nursing Center 41.4% Mirabella Portland 41.2% Marquis Oregon City Post Acute Rehab 41.0% 0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

30 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Figure 5. continued

Oregon City Health Care Center 40.9% Oregon Veterans' Home, Lebanon 40.1% Cascade Manor 39.7% Healthcare at Foster Creek 39.6% Meadow Park 39.2% Avamere Health Services of Rogue Valley 38.8% Friendship Health Center 37.0% Laurel Hill Nursing and Rehab Center 36.1% Care Center East 35.8% East Cascade Re�rement Community 35.7% Marquis Wilsonville 34.8% Avamere Riverpark Of Eugene 34.6% Rose Linn Care Center 32.9% Laurelhurst Village 31.6% Mennonite Home 31.2% Sheridan Care Center 31.1% Avamere Court at Keizer 30.9% Pres�ge Post-Acute and Rehabilita�on Center — McMinnville 30.4% Avamere Rehabilita�on of Hillsboro 30.2% Marquis Tuala�n Post Acute Rehab 29.2% Marquis Mt. Tabor 29.1% Avamere Rehabilita�on of Lebanon 28.7% Lifecare Center McMinnville 28.2% Secora Rehabilita�on of Cascadia 27.0% Good Samaritan — Curry Village 26.6% Fernhill Estates 25.4% Paciﬁc Health & Rehabilita�on 24.8% Avamere Rehabilita�on of King City 23.3% Avamere Crestview of Portland 20.0% Hillside Brookdale 19.5% Avamere Medford at Three Fountains 18.1% The Pearl at Kruse Way 12.3% Avamere Rehabilita�on of Coos Bay 11.1% Avamere Rehabilita�on of Oregon City 0.0% 0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 31 Table 5. Rates of health care worker (HCW) influenza vaccination, declination and unknown vaccination status for the 2017–2018 influenza season: Dialysis facilities (n=71) Each dialysis facility’s vaccination rate is included. Sixty-seven (94%) of the 71 dialysis facilities met the HP2015 goal. Forty (56%) met the HP2020 goal. Compared to last season, 36 (51%) reported increases in their vaccination rates.

Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Blue Mountain Kidney 11 100% 0% 0% 0% Center Cornell Road 23 91% 9% 0% 13% FMC Albany 26 92% 8% 0% -8% FMC Bend 56 86% 11% 4% 3% 2 FMC Coos Bay 44 82% 14% 5% -4% 4 FMC Corvallis 42 90% 5% 5% -3% FMC Dialysis Services of 131 84% 4% 12% 35% 8 Mt. Hood FMC Emerald Valley 20 100% 0% 0% 0% FMC Eugene 71 83% 7% 10% -10% 5 FMC Florence 11 91% 0% 9% -9% FMC Lebanon 46 91% 4% 4% -2% FMC Madras Dialysis 35 83% 17% 0% 29% 3 FMC Maywood Park 126 80% 4% 16% 19% 12 FMC Milton Freewater 13 85% 8% 8% -15% 1 FMC Newport 20 100% 0% 0% 7% FMC Redmond 35 89% 11% 0% -11% 1 FMC Salem 99 91% 6% 3% 1% FMC Sandy Dialysis 66 83% 3% 14% 30% 4 FMC Scholls Ferry 58 90% 9% 2% -5% FMC Springfield 57 93% 7% 0% -1% FMC West Salem 47 91% 4% 4% 5% Four Rivers Dialysis 26 100% 0% 0% 0% Center Fresenius Kidney Care 27 93% 7% 0% N/A Piedmont

32 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 Fresenius Kidney Care 11 100% 0% 0% 20% Tualatin Fresenius Rose Quarter 144 75% 3% 22% -4% 22 Dialysis Center Grants Pass II Dialysis 17 100% 0% 0% 5% Gresham Station Dialysis 9 89% 0% 11% N/A Hermiston Community 15 100% 0% 0% 9% Dialysis Hillsboro Dialysis Center 24 96% 4% 0% -4% Hilltop Dialysis 100 81% 4% 15% 32% 9 Kaiser Sunnybrook 9 89% 0% 11% 33% Peritoneal Dialysis Facility Klamath Falls Dialysis 26 96% 0% 4% 7% Lake Road Dialysis Center 41 88% 12% 0% 2% 1 Lancaster Drive Dialysis 12 100% 0% 0% N/A McMinnville Dialysis 27 100% 0% 0% 0% Meridian Park Dialysis 28 93% 7% 0% -7% Center NE Salem Dialysis 17 100% 0% 0% 10% Noble Woods Dialysis 46 91% 7% 2% 7% Clinic Northeast Portland Renal 96 83% 4% 13% -12% 6 Center OHSU Pediatric Outpatient 14 86% 14% 0% N/A 1 Peritoneal Dialysis Oregon Kidney Center 35 80% 0% 20% -20% 4 PNRS Beaverton Dialysis 31 58% 16% 26% -32% 10 Center PNRS Clackamas 138 83% 5% 12% 28% 10 PNRS Columbia River The 18 100% 0% 0% 15% Dalles PNRS Eastern Oregon 23 100% 0% 0% 8% Dialysis PNRS Emanuel Pediatric 18 100% 0% 0% 0% Dialysis PNRS Hollywood Dialysis 136 63% 5% 32% 45% 36 Center

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 33 Rate of Additional Number Rate of Rate of unknown Percent HCWs of HCWs influenza vaccine vaccination change in Met Met needed to eligible for vaccination declination status for vaccination HP2015 HP2020 vaccinate influenza for eligible by eligible eligible rate since target target to reach Facility name vaccine HCWs HCWs HCWs last season (75%) (90%) HP2020 PNRS McMinnville Kidney Center (FKA PNRS 26 100% 0% 0% 15% Evergreen) PNRS Newberg Dialysis 106 77% 8% 15% 27% 13 Center PNRS North Coast Dialysis 100 83% 5% 12% 0% 7 Clinic PNRS Portland Home Dialysis (Pacific NW Home 18 100% 0% 0% 58% in NHSN) PNRS St. Helens Dialysis 37 89% 8% 3% 57% 0 PNRS Tualatin Kidney 132 85% 3% 12% 10% 7 Center PNRS Twin Oaks 64 86% 9% 5% 20% 3 PNRS/THC Raines Dialysis 118 83% 3% 14% -1% 8 Center Portland Gateway Dialysis 35 97% 3% 0% 2% Portland MLK Dialysis 16 88% 13% 0% -9% Ray Yasui Dialysis Center 20 90% 10% 0% 1% Redwood Dialysis 16 100% 0% 0% 0% Rogue Valley Dialysis 67 100% 0% 0% 0% Roseburg/Mercy Dialysis 39 87% 13% 0% 16% 1 Salem Dialysis 74 100% 0% 0% 46% Salem North Dialysis 36 94% 6% 0% 3% Sherwood Dialysis Center 20 100% 0% 0% 0% Tillamook Dialysis Center 10 90% 10% 0% 0% USRC Gresham Dialysis 20 70% 30% 0% -9% 4 Center USRC Portland Dialysis 22 86% 14% 0% 8% 1 Center USRC Portland Home 6 67% 33% 0% 0% 1 Therapies West Linn Dialysis Center 13 100% 0% 0% 0% Willamette Valley Renal 35 100% 0% 0% 3% Center Woodburn Dialysis 40 95% 5% 0% 94% N/A: Percentage change could not be calculated if no vaccination data reported in the previous season.

34 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Figure 6. Oregon dialysis facilities, by HCW influenza vaccination rate for the 2017–2018 influenza season (n=71)

Willame�e Valley Renal Center 100.0% West Linn Dialysis Center 100.0% Sherwood Dialysis Center 100.0% Salem Dialysis 100.0% Rogue Valley Dialysis 100.0% Redwood Dialysis 100.0% PNRS Portland Home Dialysis (Paciﬁc NW Home in NHSN) 100.0% PNRS McMinnville Kidney Center (FKA PNRS Evergreen) 100.0% PNRS Emanuel Pediatric Dialysis 100.0% PNRS Eastern Oregon Dialysis 100.0% PNRS Columbia River The Dalles 100.0% NE Salem Dialysis 100.0% McMinnville Dialysis 100.0% Lancaster Drive Dialysis 100.0% Hermiston Community Dialysis 100.0% Grants Pass II Dialysis 100.0% Fresenius Kidney Care Tuala�n 100.0% Four Rivers Dialysis Center 100.0% FMC Newport 100.0% FMC Emerald Valley 100.0% Blue Mountain Kidney Center 100.0% Portland Gateway Dialysis 97.1% Klamath Falls Dialysis 96.2% Hillsboro Dialysis Center 95.8% Woodburn Dialysis 95.0% Salem North Dialysis 94.4% FMC Springﬁeld 93.0% Meridian Park Dialysis Center 92.9% Fresenius Kidney Care Piedmont 92.6% FMC Albany 92.3% FMC West Salem 91.5% Noble Woods Dialysis Clinic 91.3% FMC Lebanon 91.3% Cornell Road (FKA: Walker Road Dialysis) 91.3% 0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 35 Figure 6. continued

FMC Corvallis 90.5% Ray Yasui Dialysis Center 90.0% Tillamook Dialysis Center 90.0% FMC Scholls Ferry 89.7% PNRS St. Helens Dialysis 89.2% Gresham Sta�on Dialysis 88.9% Kaiser Sunnybrook Peritoneal Dialysis Facility 88.9% FMC Redmond 88.6% Lake Road Dialysis Center 87.8% Portland MLK Dialysis 87.5% Roseburg/Mercy Dialysis 87.2% USRC Portland Dialysis Center 86.4% PNRS Twin Oaks 85.9% OHSU Pediatric Outpa�ent Peritoneal Dialysis 85.7% FMC Bend 85.7% PNRS Tuala�n Kidney Center 84.8% FMC Milton Freewater 84.6% FMC Dialysis Services of Mt. Hood 84.0% Northeast Portland Renal Center 83.3% FMC Sandy Dialysis 83.3% FMC Eugene 83.1% PNRS/THC Raines Dialysis Center 83.1% PNRS North Coast Dialysis Clinic 83.0% FMC Madras Dialysis 82.9% PNRS Clackamas 82.6% FMC Coos Bay 81.8% Hilltop Dialysis 81.0% FMC Maywood Park 80.2% Oregon Kidney Center 80.0% PNRS Newberg Dialysis Center 77.4% Fresenius Rose Quarter Dialysis Center 75.0% USRC Gresham Dialysis Center 70.0% USRC Portland Home Therapies 66.7%

0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

36 Health care worker vaccination data | Oregon Health Care Worker Influenza Vaccination Improving Oregon health care worker vaccination rates Oregon Health Authority’s Healthcare-Associated Infections (HAI) Program works directly with health care facilities to track and improve vaccination rates. In the current season, the HAI Program reached out to all skilled nursing facilities to promote health care worker flu vaccination, as vaccination rates in this setting have remained lower than in other facility types. Objectives for this outreach included: • Provide data for action. Vaccination rates for Oregon skilled nursing facilities relative to Healthy People goals were sent directly to facilities. • Motivate facilities to improve documentation of health care worker vaccination status. Low vaccination rates may be, in part, due to poor documentation of health care worker vaccination. Facilities were encouraged and given resources to support a systematic data collection process. • Provide toolkits. Skilled nursing facilities received CDC and OHA health care worker vaccination toolkits. These toolkits detail strategies for improving health care worker flu vaccination. • Follow up in person or by phone. OHA followed up with all 136 skilled nursing facilities to confirm they received the above information, to inquire about vaccination progress and to offer technical support. • Identify high-performing facilities and share best practices. Facilities with high or notably improved vaccination rates as well as those with innovative practices in promoting health care worker flu vaccination were recognized and asked to present their experience to colleagues from other facilities. The Oregon Health Authority will evaluate the impact of this outreach over the next year and, if successful, extend the outreach to other facilities to improve health care worker vaccination rates in Oregon.

Oregon Health Care Worker Influenza Vaccination | Health care worker vaccination data 37 References

1. Centers for Disease Control and Prevention. Estimated influenza illnesses, medical visits, hospitalizations, and deaths averted by vaccination in the United States. [cited 2018 March 6]. Available from: https://www.cdc.gov/flu/about/ disease/2015-16.htm.

38 References | Oregon Health Care Worker Influenza Vaccination

PUBLIC HEALTH DIVISION Healthcare-Associated Infections (HAI) Program Phone: 971-673-1111 FAX: 971-673-1100

You can get this document in other languages, large print, braille or a format you prefer. Contact the Healthcare-Associated Infections (HAI) Program at 971-673-1111 or email [email protected]. We accept all relay calls or you can dial 711.

OHA 8628 (04/19)