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COVID-19 Update May 13, 2020

Posted By Leslie Roseboro, Thursday, May 21, 2020


May 13, 2020

 

COVID-19 Update

 

Q and A with Cindy Deporter
Cindy Deporter with DHSR sent two clarifications yesterday afternoon that we want to share:
Question: Facilities are calling the state about their residents that are in the assisted living area of the nursing home. In NC we call these combination homes. They are asking should they include both the assisted living and the SNF numbers on the reporting data? It does not seem that this is covered in the QAs.
Answer: The data should only include those residents and staff in the certified portion of the facility.
Question: Does CMS expect that providers in states that are licensed only have to report COVID information through the CDC?
Answer: The Reporting requirement is a federal requirement for participation, and does not apply to non-certified or licensed only nursing homes.

CDC/NSHN Issues Continue to Plague System

LeadingAge continues to field a number of questions about reporting requirements and even more concerns about issues with enrollment with the National Healthcare Safety Network (NHSN), which nursing homes will soon be required to use to report COVID-19 data. LeadingAge is sharing concerns with CMS. While the CDC will be the body to address actual enrollment issues, LeadingAge feels it is important for CMS to understand that the process is not running smoothly and that providers want to comply but may be unable to do so for reasons beyond their control. Please share your concerns with LeadingAge's Jodi Eyigor at jeyigor@leadingage.org.

CMS Issues Additional Blanket waivers

Late yesterday, CMS announced that they are issuing additional blanket waivers. The waivers include:

Flexibility to allow hospitals to establish “swing beds” to accommodate patients who no longer require acute care but are unable to find placement in a SNF. To qualify for the Swing Bed waiver, hospitals must not use the swing beds for acute care, must comply with the hospital and SNF conditions of participation in 42 CFR 482.58(b) to the extent not waived, and be consistent with the state’s emergency preparedness/pandemic plan. To establish swing beds pursuant to the waiver, the hospital must call the CMS MAC enrollment hotline to add swing bed services and attest that they have made a good faith effort to exhaust all other options, there are no skilled nursing facilities within the hospital’s catchment area that under normal circumstances would have accepted SNF transfers, but are currently not willing to accept or able to take patients because of the COVID-19 public health emergency. This waiver is permissible for swing bed admissions during the COVID-19 PHE with an understanding that the hospital must have a plan to discharge swing bed patients as soon as practicable, when a SNF bed becomes available, or when the PHE ends, whichever is earlier.
Paid Feeding Assistants. CMS is modifying the requirements at regarding required training for paid feeding assistants to reduce the training from a minimum of 8 hours to a minimum of 1 hours. CMS is not waiving any of the requirements related to paid feeding assistants or the required training content.

Certain Life Safety Codes were also waived, they include:
Alcohol-based Hand Rub (ABHR) Dispensers: CMS is waiving prescriptive requirements related to the placement of ABHR dispensers for use by staff and others due to the need for the increased use of ABHR in infection control. However, ABHRs do contain ethyl alcohol which is considered flammable so do need to have restricted access by certain resident populations to prevent accidental ingestion, and bulk containers of ABHR (over 5 gallons) should still be stored in a protected hazardous materials area. (See 483.90(a)(4) for more information).
Fire Drills: CMS will permit a documented orientation training program related to the current fire plan, which considers current facility conditions in lieu of drills that move and mass staff together. The training will instruct employees on their duties, life safety procedures and the fire protection devices in their assigned areas.
Temporary Construction: CMS is waiving requirements that would otherwise not permit temporary walls and barriers between patients.

Provider Relief Fund
Nick Uehlecke, Senior Advisor to HHS Secretary Azar, spent some time on the 3:30 LeadingAge national call yesterday talking about the Provider Relief Fund. One caveat: this conversation was not “official policymaking;” but Nick recognized he was talking to 950 people, too. He indicated that HHS is thinking that the funds can be used for any purpose related to dealing with COVID, including for example increased costs of laundry or food. He said more FAQs are continually being written based on the thousands of questions the department receives. He added that there’s a new question (either just posted or appearing soon) that talks about all the CARES Act funding sources and suggests how to view Provider Relief Funds in coordination with those other sources. He encouraged LeadingAge members to send more questions – if members, send questions to Nicole Fallon at nfallon@leadingage.org.

National Gallery of Art Guided Meditation for Front Line Staff

The National Gallery of Art created a guided meditation for front line workers that is free and simple to use.

Association of Professionals in Infection Control and Epidemiology Free LTC Resources
The Association of Professionals in Infection Control and Epidemiology (APIC.org) is offering LTC-focused resources free to non-members, until September, 2020. The library includes APIC's Infection Prevention Guide to Long Term Care.

HEROES Act Relief Bill
U.S. House of Representatives Democrats released their draft $3 trillion relief package yesterday afternoon. The Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act proposal includes many LeadingAge requests or elements that address our asks in part. Here’s an article on the housing highlights.

Here are some health highlights:

  • Two of LeadingAge national's big Medicaid asks are included: FMAP is increased by a total of 14% from July 1, 2020 through June 30, 2023, giving states additional funds to help recover. MFAR, the Medicaid Fiscal Accountability Regulation that we lobbied vigorously to rescind, cannot be finalized under the end of the COVID-19 public health emergency.
  • The health care provider relief fund is increased by $175 billion, with $100 billion for providers and $75 billion for testing, contact tracing, vaccines and other items.
  • For aging services employers who want to provide some extra pay to their essential staff, the Heroes Fund that was developed in the Senate, is included.
  • There are a number of provisions addressing nursing homes: The only new reporting requirement is to report age, race/ethnicity and preferred language of residents with COVID 19 or symptoms and all residents who have died, an effort to understand the impact on minority communities that we support. LeadingAge national asked for funds to help nursing homes develop extended care centers and the bill contains incentive payments for SNFs that want to develop a COVID-only treatment center. We have asked for assistance not punishment, and the bill contains funds for state strike force teams to provide assistance to nursing homes with COVID cases, and a provision for the QIOs to provide assistance with infection control, which is not exactly what we asked for but does indicate that some of our concerns were heard. Much more, so stay tuned.

LeadingAge National Coronavirus Daily Member Updates
LeadingAge is sharing the very latest with members twice daily. Morning updates go out via email, and they are hosting daily live online updates each weekday afternoon. Subscribe to "LeadingAge Need to Know" via communications preferences in your MyLeadingAge account to receive email updates. Register for live online updates. You can find an archive of all member updates there.

Practical Ideas From Members
LeadingAge is offering even more ways for members to learn from one another by gathering examples of the innovative solutions you’re deploying. Read new stories on topics including:

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

Margaret Atwood wrote in The Handmaid's Tale, "We were the people who were not in the papers. We lived in the blank white spaces at the edges of print. It gave us more freedom. We lived in the gaps between the stories."

Check in questions: How many residents have lived under your care? How many resident stories have you heard and retold? How many of their joys have you shared? How many of their tears have you dried? But, what about you as a caregiver? Don’t you have a story to tell about the value of the work you do? The focus always seems to be on someone else – the other heroes, the other caregivers, the other essential employees. No longer is it acceptable to live in the white spaces of print or in the gaps between the other stories. Our time has come. What is the story you will tell and to whom will you tell it? Help share our message of compassionate care and keeping individuals safe.

COVID-19 Information Pages
In addition to these daily email updates, LeadingAge North Carolina is updating our COVID-19 resource page every day with information from trusted sources, including from our business members. Click here to view the entire page. Click here to view the section of the page that highlights business member expertise in areas such as investments, financing, human resources, and rehabilitation as those topics relate to COVID-19. In addition, LeadingAge national keeps their COVID-19 resource page updated. Be sure to bookmark these pages today!

 

LeadingAge North Carolina | 222 N. Person Street, Raleigh, NC 27601
919-571-8333 | info@leadingagenc.org | www.leadingagenc.org







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