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*Updates are listed by date with the most recent listed first.

2/23/21: An announcement from Jenifer concerning DHHS add-on payments: Hello LeadingAge Nebraska Members-This morning, LeadingAge Nebraska was notified by DHHS CEO, Dannette Smith and DHHS MLTC Director, Kevin Bagley, that the $20/day add-on for Medicaid Nursing Facilities and Assisted Living providers will be continued. As you may remember, the $20/day add-on ended December 31, 2020. The Public Health Emergency was subsequently extended, which resulted in the continued increased Federal Match to the state Medicaid agency. LeadingAge Nebraska has been advocating since the end of last year for an extension of the $20/day rate add-on. We are grateful that the $20/day add-on will be retroactive to January 1, 2021 and continue through June 30, 2021. There will be more to follow on the detail of how and when payments will be generated. This is good news!

We will continue to advocate for an increased provider rate at the DHHS Budget hearing before the Appropriations Committee on Thursday. Join us in that effort by contacting your state senator. Click HERE for more information.

2/22/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • HHS is looking for COVID-19 variants in Nebraska long-term care facilities.  If you have a resident who may have had vaccine break through, which would be a resident who has a positive COVID diagnosis 7-14 days following the second dose of vaccine please share that information with ICAP.  DHHS is also looking for information on any large scale outbreaks, given that the fast spread is a characteristic of the variant.  There have been a few reports of COVID positive cases in residents post vaccine (likely in individuals exposed prior to vaccination).  If you see either 1) a case of vaccine break through or 2) a quick spread outbreak,  please contact ICAP.  Dr. Donahue with DHHS is working with ICAP and the Nebraska Public Health Lab to obtain positive samples for sequencing to determine if any are variant related. For more information related to COVID-19 variant strains, join the ICAP call (information below).
  • On Thursday, Feb 18, DHHS provided an update guidance related to visitation in Assisted Living Facilities. 
  • For ALFs with >75% staff AND >90% residents vaccinated, DHHS is providing the option to allow increased indoor visitation for vaccinated individuals two weeks after the 75% of staff and 90% of residents received the 2nd dose of vaccine in the series. This option for increased visitation will be available even for ALFs in red counties. All other infection control measures must remain in place, including following the Core Principles of COVID-19 Infection Prevention, recommended limitations on the numbers of visitors, and visitation changes in the event of a facility outbreak. 
  • If you have a resident who qualifies for the administration of Bamlanivimab (monoclonal antibodies), go HERE for more information and to fill out a request.  Nebraska residents have been incredibly fortunate to have this program available and for UNMC and ICAP for the work in overseeing this pilot project. Nebraska still has near 500 doses available. 
  • Total COVID-19 positives in LTC for the week that ended last week: 4 residents and 21 staff members.  

2/22/21: Treasury Department Eases Access to Emergency Rental Relief: The Treasury Department updated guidance for the new Emergency Rental Assistance (ERA) program, which helps cover housing costs for renter households financially impacted by COVID-19. On January 29, LeadingAge sent a letter to the Treasury Department, the White House, and to HUD, urging them to ease access to the rent relief for older adults with low incomes. Under its updated FAQs, the Treasury Department has eased access for qualifying households, including allowing HUD-assisted older adults to be eligible for ERA assistance and allowing applicants to self-certify their financial hardship eligibility for the program, two key LeadingAge asks. The $25 billion Emergency Rental Assistance program will help bring stability to some of the estimated 30-40 million renter households at risk of eviction, and will help reimburse housing providers for rent receipt loss during the ongoing crisis.

2/22/21: Paycheck Protection Program: Temporary pause for some applicants: The White House announced today that starting Wednesday, only organizations with 20 or fewer employees will be able to apply for PPP loans. This limit will last for 14 days, after which all eligible applicants can resume seeking PPP loans. Prospective borrowers with more than 20 employees who have not yet applied for the loans and are planning to might want to work with their bank to ensure the application is submitted before Wednesday, or plan to wait until March for the application to go in the system. More details in this PPP fact sheet.

2/22/21: Mental Health Insights on the Pandemic: Dr. Bill Mansbach, CEO and President of behavioral health provider Counterpoint Health Services,  joined the Coronavirus Update Call. He discussed research regarding older adults and shared concrete tools targeted to both staff and older adults. The interview is summarized here.

2/22/21: Nursing Home Staffing During COVID: Today the Institute for Healthcare Improvement and Project ECHO released "Staffing During the COVID-19 Pandemic: A Guide for Nursing Home Leaders."  The short document outlines steps to reduce or eliminate urgent staff shortages, particularly shortages of direct care workers.  The tips and steps provided in the document were contributed by ECHO participants and other experts.  IHI plans to update the document as new resources become available.

2/22/21: Transitioning from the Long Term Care Pharmacy Partnership to the Retail Pharmacy Program: Dr. Ruth Link-Gelles from the CDC shared information about the sunsetting of one partnership and ramping up the next. Read a summary of the interview here.  Here's the link to the CDC Retail Pharmacy Program.

2/22/21: Medicare Part B Rate Calculator Available: The member-only Medicare Part B rate calculator is now available here. The tool allows a member to identify their location specific rates for Part B services including therapy. It accounts for the rate changes from the year-end legislation that increased rates from those published in the final rule.

2/22/21: Vaccine Allocations Roll Out to Community Health Centers: Affordable senior housing communities may have another vaccine partner resource in community health centers. The week of February 15, the Health Resources and Services Administration (HRSA) and the CDC launched a program to directly allocate a limited supply of COVID-19 vaccine to select HRSA-funded health centers. More information is here.

2/22/21: National Forum on COVID-19 Vaccine: The National Forum on COVID-19 Vaccine is a virtual event, February 22 - 24,  that will unite representatives from across the US government, with tribal, state, local, and territorial leaders and representatives from public health, healthcare systems, national and community-based non-governmental organizations, education, private industry, unions, and faith-based organizations. All have a role in supporting COVID-19 vaccination. The Forum aims to promote the most effective strategies to build trust and confidence in COVID-19 vaccines, use data to optimize vaccine implementation, and provide participants with practical information for increasing vaccine access in communities nationwide, especially for persons at increased risk of COVID-19 disease and those who may face barriers to vaccination. View a  resource page for the event.  The Forum is free, open to the public, and will be live streamed here.

2/22/21: CDC's Vaccine Rollout Recommendations: CDC updated their webpage with recommendations for who should get the vaccine first, then each state makes its own plan. Because the U.S. supply of COVID-19 vaccine is expected to be limited at first, CDC is providing recommendations to federal, state, and local governments about who should be vaccinated first. CDC's recommendations are based on those from the Advisory Committee on Immunization Practices (ACIP), an independent panel of medical and public health experts. While CDC makes recommendations for who should be offered COVID-19 vaccine first, each state has its own plan for deciding who will be vaccinated first and how they can receive vaccines. Please contact your local health department for more information on COVID-19 vaccination in your area. View the resource page on vaccinations

2/22/21: What Older Adults Need to Know about COVID-19 Vaccines: The risk of severe illness from COVID-19 increases with age. This is why CDC recommends that adults 65 years and older are one of the first groups to receive COVID-19 vaccines. Getting a COVID-19 vaccine is an important step to help prevent getting sick from COVID-19. That said, it might take time before enough vaccines are made for everyone who wants to be vaccinated.

2/22/21: Update on Additional Vaccines: On Feb 26th, FDA will be consulting with their independent advisory committee (VRBPAC) on the Johnson and Johnson vaccine and we will hear from them soon after. The AstraZeneca and NovaVax trials are both fully enrolled. They will collect data and then submit their information for an EUA if the data looks good.

2/17/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • HHS is looking for COVID-19 variants in Nebraska long-term care facilities.  If you have a resident who may have had vaccine break through, which would be a resident who has a positive COVID diagnosis 7-14 days following the second dose of vaccine please share that information with ICAP.  DHHS is also looking for information on any large scale outbreaks, given that the fast spread is a characteristic of the variant.  There have been a few reports of COVID positive cases in residents post vaccine (likely in individuals exposed prior to vaccination).  If you see either 1) a case of vaccine break through or 2) a quick spread outbreak,  please contact ICAP.  Dr. Donahue with DHHS is working with ICAP and the Nebraska Public Health Lab to obtain positive samples for sequencing to determine if any are variant related. Dr. Donahue has suggested that providers who may want to keep a PCR test kit from NPHL on-hand should contact their Local Health Department.  DHHS will be communicating this approach with LHDs later this week, so do not be surprised if your LHD has not heard this plan yet. 
  • As of this week the data from CMS related to county positivity rate (color) shows 18 counties in red, 44 counties in yellow, and 31 counties in green.  Remember, this positivity color is used to determine both visitation requirements and testing frequency.
  • In regard to eye protection, per Dr. Ashraf, if you are in a green county in a green facility you do not need eye protection UNLESS you are using for standard precautions (i.e. splash or aerosol generating procedures).  If you are in a red, yellow, or gray zone or a red or yellow county you still need either goggles or a face shield. 
  • If you have a resident who qualifies for the administration of Bamlanivimab (monoclonal antibodies), go HERE for more information and to fill out a request.  Nebraska residents have been incredibly fortunate to have this program available and for UNMC and ICAP for the work in overseeing this pilot project.

2/17/21: Emergency Preparedness Requirements (testing exemption due to actual emergency): CMS updated emergency preparedness requirements in 2019 and released guidance in September 2020 reiterating that providers who activate their emergency plans in response to an actual natural or man-made emergency were exempt from completing their next regularly required full-scale community based or individual facility-based exercise. Remembering that outpatient providers (e.g. PACE, home health) are required to conduct one testing exercise per year and inpatient providers (inpatient hospice, nursing homes, ICF/IIDs) are required to conduct 2 testing exercises per year, with testing exercises for both provider types alternating between full-scale functional exercises and exercises of choice (mock drill, table-top exercise, workshop). If a provider activated the emergency plan in March 2020 due to the COVID-19 public health emergency, the provider is/was exempt from the next required full-scale functional exercise and would proceed with the exercise of choice on the regular schedule. As we approach the 1-year anniversary of the public health emergency declaration and enter year 2 of the PHE, LeadingAge asked CMS: will providers who continue to operate under the emergency plan once again be exempt from the full-scale exercise? The answer is no, there will not be a second exemption for a continuous emergency. Here's an example:

  • A nursing home was planning to complete a full-scale functional exercise in June 2020.
  • The nursing home activated the emergency plan in April 2020 in response to COVID-19.
  • The nursing home was exempt from completing the full-scale functional exercise in 2020 and completed required exercise of choice in 2020.

Though the nursing home continues to operate under the emergency plan, the nursing home must complete the full-scale functional exercise in 2021 in addition to the required exercise of choice.

2/17/21: Provider Relief Fund Article on Incentives and Info on Reporting: Yesterday, LeadingAge posted an article, written by Nicole Fallon, analyzing the final two Nursing Home Infection Control incentive payments.  In regard to Provider Relief, there have been a few questions from members asking when the first reports will be due. There is no set due date for the first report but clearly we can expect it to be in the next couple of months as the second report is due (as of right now) on July 31, 2021. For now, the reporting portal is open but only for providers to register. By registering, providers will be notified when the portal will begin accepting reports and the due date once it is set.

2/17/21: NIH Experts Discuss SARS-CoV-2 Viral Variants: The rise of several significant variants of SARS-CoV-2, the virus that causes COVID-19, has attracted the attention of health and science experts worldwide. In an editorial published today in JAMA: The Journal of the American Medical Association, experts from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, outline how these variants have arisen, concerns about whether vaccines currently authorized for use will continue to protect against new variants, and the need for a global approach to fighting SARS-CoV-2 as it spreads and acquires additional mutations.

2/15/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • Retail Pharmacy Programs kicks off in Nebraska with 33 locations.  Read HERE for more information. 
  • HHS is looking for COVID-19 variants in Nebraska long-term care facilities.  If you have a resident who may have had vaccine break through, which would be a resident who has a positive COVID diagnosis 7-14 days following the second dose of vaccine please share that information with ICAP.  DHHS is also looking for information on any large scale outbreaks, given that the fast spread is a characteristic of the variant.  There have been a few reports of COVID positive cases in residents post vaccine (likely in individuals exposed prior to vaccination).  If you see either 1) a case of vaccine break through or 2) a quick spread outbreak,  please contact ICAP.  Dr. Donahue with DHHS is working with ICAP and the Nebraska Public Health Lab to obtain positive samples for sequencing to determine if any are variant related. For more information related to COVID-19 variant strains, join the ICAP call (information below).
  • If you have a new staff or resident who needs a vaccination, you should contact your Local Health Department.  Approaches to obtaining vaccine vary by locale.  
  • If you have a resident who qualifies for the administration of Bamlanivimab (monoclonal antibodies), go HERE for more information and to fill out a request.  Nebraska residents have been incredibly fortunate to have this program available and for UNMC and ICAP for the work in overseeing this pilot project.

2/15/21: December Nursing Home Infection Control Incentive Payments from Provider Relief: December incentive payments started arriving in bank accounts the end of last week. There was no specific information from HHS on those payments. HHS has finally posted a list of nursing homes receiving incentives for November and December. 

However, if you receive PRF payments and are uncertain what they are for (e.g. Phase 3 vs. Incentive Payment), you can call the Provider Support Line at 866-569-3522 to obtain further information.  LeadingAge national has identified a new contact within HHS responsible for PRF and is working to engage that person related to incentives and other PRF issues that have occurred before and since the transition of administrations.

2/15/21: CDC Updates Quarantine Guidance: LeadingAge received quite a few questions last week about the quarantine guidance released by CDC. The guidance is located here. The LeadingAge review of the guidance is available here. Please note that this guidance explicitly does not apply to "residents in healthcare settings." We know that means nursing homes. What about Assisted Living, Independent Living, and Senior Housing? On our Coronavirus Update Call, guest Kara Jacobs-Slifka from CDC suggested that when speaking about healthcare settings, CDC is referring to nursing homes, assisted living, hospice, and acute care hospitals. With regard to other member settings such as independent living (including IL on a CCRC campus), adult day, senior housing, and home health, it was noted that technically these settings would fall into "community" and could follow the new quarantine guidance, but CDC recommends considering a more conservative approach (a full 14-day quarantine) when these settings are serving higher risk adults with multiple comorbidities.

Please note that this guidance also explicitly states that it can be considered when determining work restrictions for vaccinated healthcare personnel with high-risk exposures as part of a plan to mitigate staffing shortages. Guidance for determining what constitutes a high-risk exposure is available here. Guidance for mitigating staffing shortages is available here. Note that decisions to employ contingency and crisis strategies to mitigate staffing shortages must be made in consultation with state/local public health.

2/15/21: CDC Posts Guidance re: Vaccinating Homebound Persons with COVID-19 Vaccine: COVID-19 vaccination of homebound persons presents unique challenges to ensure the appropriate vaccine storage temperatures, handling, and administration to ensure safe and effective vaccination.  CDC has developed this  guidance on management of vaccines and vaccination for persons vaccinated at home or in small group settings (e.g., residential facilities, group homes).  It also addresses concerns regarding transportation of small numbers of doses, including the transportation of punctured vials. 

2/15/21: Not Now, Not Yet for Relaxing Nursing Home Guidance: Evan Shulman, Director, Division of Nursing Homes at CMS, joined the LeadingAge Coronavirus Update Call last week. He discussed vaccines, Essential Caregiver programs, Phase 3 ROPs, and took issue with the idea of collaborative surveys. An article on the interview is HERE.

2/15/21: HUD: Resident Risk Factors Make COVID-19 Support Critical: A new report from HUD's Office of Policy Development & Research explores how at-risk populations for COVID are represented among tenants of HUD-assisted housing. The HUD piece compares the COVID-19 risk factors of age, disability, race, income and unemployment, and crowding to the profile of HUD-assisted residents. See the article on this new report HERE.

2/15/21: FEMA Vaccination Centers and COVID-19 Response Activities: The U.S. Army Corps of Engineers (USACE) is supporting FEMAs COVID-19 state-led, federally supported community vaccination centers response. USACE is coordinating with FEMA and the CDC to design walk-up, drive-through and mobile vaccination centers. Vaccination center size and location are decided by state, local, tribal and territorial governments.  The intent of these designs is the use of existing infrastructure when available. The U.S. National Guard Bureau is providing 1,108 vaccinators, to 364 vaccination centers in 40 states and territories. The CDC Vaccine Task Force and Data Analysis & Visualization Task Force launched the CDC COVID Data Tracker Vaccinations Trends page. This page includes the overall trends of vaccinations over time in the United States and for the Federal Pharmacy Partnership for Long-Term Care Program. FEMA is working with the Ad Council to encourage hesitant or underrepresented people to get vaccinated. This research-driven public education campaign provides federal, non-profit and medical stakeholders with insights and communications strategies to tailor communications to reach diverse audiences.

2/10/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • DHHS is looking for COVID-19 variants in Nebraska long-term care facilities.  If you have a resident who may have had vaccine break through, which would be a resident who has a positive COVID diagnosis 7-14 days following the second dose of vaccine please share that information with ICAP.  DHHS is also looking for information on any large scale outbreaks, given that the fast spread is a characteristic of the variant.  There have been a few reports of COVID positive cases in residents post vaccine (likely in individuals exposed prior to vaccination).  If you see either 1) a case of vaccine break through or 2) a quick spread outbreak,  please contact ICAP.  Dr. Donahue with DHHS is working with ICAP and the Nebraska Public Health Lab to obtain positive samples for sequencing to determine if any are variant related. For more information related to COVID-19 variant strains, join the ICAP call (information below).
  • If you have a new staff or resident who needs a vaccination, you should contact your Local Health Department.  Approaches to obtaining vaccine vary by locale.  
  • Regarding vaccine administration- As of Monday of this week, DHHS has requested the LTC Pharmacy Partners NOT to administer first doses of vaccine for staff or residents at 3rd clinics. 
  • Dan Taylor shared during today's member call that recertification surveys are happening.  This week there were ZERO FIC surveys (Congratulations LTC providers!).  Dan indicated that they are trying to accomplish 1 recertification survey per week per available team and that they are also handling high level complaints. 
  • LTC surveyors continue to be COVID tested the beginning of each work week.  Dan shared that surveyors should be complying with whatever PPE the facility is requiring based on each facility's unique situation.  
  • The AL IC Template is still not available.  Dan shared today that absent the template, AL surveyors will be looking the following:
    • Policies and procedures on infection control and prevention.  Indicate in your P&P what you are basing your approach on, whether it is guidance from CMS, CDC, or ICAP.  Look for evidence-based approaches.  Dan indicated that surveyors will be looking at hand hygiene, appropriate use of PPE, PPE ordering and stock on-hand, how screening and monitoring are being handled for residents and staff, how group activities are being handled in regard to social distancing and cleaning, policies on staff illness and return to work, staffing, and general disaster preparedness.  These are some examples.  He said that these expectations have been communicated to the AL surveyors.
  • Dan and Becky shared that CMS indicated to DHHS on their weekly calls that they are still reviewing the data on how vaccines are working and potential of carrying the disease post vaccine.  This data will prove critical in regard to any potential changes to the CMS visitation guidance. 
  • If you have a resident who qualifies for the administration of Bamlanivimab (monoclonal antibodies), go HERE for more information and to fill out a request.  Nebraska residents have been incredibly fortunate to have this program available and for UNMC and ICAP for the work in overseeing this pilot project.

2/10/21: NHSN Training Webinars This Week on POC Reporting Updates: The CDC has announced two new webinar dates to provide training on updates to the POC Test Reporting tool in the NHSN LTC Module.  Register in advance for these webinars HERE. After registering, you will receive a confirmation email about joining the webinar.

2/10/21: OSHA COVID-19 Guidance for Nursing Home and Long-Term Care Facility Workers: A few providers have indicated that they have received visits from OSHA to review COVID-19 practices for staff.  HERE is a publication from OSHA related to considerations for LTCF workers. 

2/10/21: Ventilation in Buildings: SARS-CoV-2 viral particles spread between people more readily indoors than outdoors. When outdoors, the concentration of viral particles rapidly reduces with the wind, even a very light wind.  When indoors, ventilation mitigation strategies help to offset the absence of natural wind and reduce the concentration of viral particles in the indoor air.

2/10/21: CDC National Forum on Vaccines: CDC is hosting a virtual National Forum on COVID-19 Vaccine (Feb. 22-24, 2021) that will bring together practitioners and vaccine champions from national, state, tribal, local, and territorial levels who are engaged in vaccinating communities across the nation. You can learn more about the event, and the specific sessions being offered: National Forum for COVID-19 Vaccine | CDC. The Forum will facilitate the information exchange on the most effective strategies to:

  • Build trust and confidence in COVID-19 vaccines
  • Use data to drive vaccine implementation
  • Provide practical information for optimizing and maximizing equitable vaccine access

Registration is open until Feb. 16, 2021 and can be completed here: https://cvent.me/bOaPGb. If you have questions, please reach out to COVIDVaccineForum@cdc.gov.

2/8/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • In the past week the number of residents and staff COVID-19 positives have continued to reduce. Good news!  Last week there were 17 new resident cases and 30 new staff cases statewide.  
  • There have been 527 doses of Bamlanivimab administered in long-term care.  If you have a resident who qualifies for the administration of monoclonal antibodies, go HERE for more information and to fill out a request.  Nebraska residents have been incredibly fortunate to have this program available and for UNMC and ICAP for the work in overseeing this pilot project.

2/8/21: Toolkit on Opening Activities: LeadingAge and Pathway Health have created a toolkit to help members establish guidelines and policies for opening up to holding activities.  The toolkit is grounded in infection control and staff competencies to help nursing homes prepare. Included in the toolkit are policies, checklists and a training plan. 

2/8/21: PPE Toolkit: LeadingAge and Pathway Health have collaborated to create a PPE resource.  This toolkit focuses on the adequate PPE for an organization and their staff.  There is a leaders guide, competencies, checklists and training components.  The toolkit also has specific resources for both leadership and management as well as all staff.

2/8/21: Continued Vaccine Access: Today, the CDC shared three ways long-term care communities can continue their vaccine access after the imminent ending of the Pharmacy Partnership for Long-Term Care. First, communities can work with long-term care pharmacies enrolled with the Federal Retail Pharmacy Program. Second, communities can work with long-term care pharmacies enrolled with their state to provide the vaccine. For both the first and second options, it is possible that the community could enroll to be a subcontractor to facilitate vaccine distribution. Third, the community could follow its state's immunization provider guidelines to become a COVID-19 vaccine administrator itself. Read more about the CDC's continuity suggestions here.

2/8/21: More on 1st Dose at 3rd Clinic: Today, the CDC shared an FAQ, which should be published on its website soon, on third clinics conducted as part of the Pharmacy Partnership for Long-Term Care Program. The CDC addresses a common question as long-term care communities hold their last of three clinics under the Program: whether staff and residents can receive their first vaccine dose at a community's third clinic. While the CDC wants to optimize vaccination opportunities, "some jurisdictions have asked pharmacy partners not to initiate first dose vaccinations at third clinics. In this case, [long-term care communities] and pharmacy partners should follow jurisdictional guidance," the CDC's FAQ says. The FAQ addresses how to approach staff or residents receiving their first dose of the Pfizer-BioNTech or the Moderna vaccine at the third on-site clinic. The guidance between the two differs because of the Pfizer-BioNTech vaccine's unique cold chain requirements. "It is important to determine in advance how staff and residents who receive their first dose of Pfizer-BioNTech vaccine at a third clinic will access their second dose," the CDC says. Read the FAQ here

2/8/21: LeadingAge Vaccine FAQs Updated: LeadingAge has updated their LeadingAge FAQs on vaccines to reflect progress on the new Johnson & Johnson vaccine.  The first hearing on the J&J EUA is set for February 26. 

2/8/21: House Committees Releasing Sections of Relief Bill: This evening, House Committees of jurisdiction are releasing pieces of the COVID relief package that will be considered through the budget reconciliation process.  Ways & Means Chair Richard Neal's release includes the nine legislative proposals under the Committee's jurisdiction; these nine proposals include provisions specific to nursing homes, as well as other big ticket items such as like direct assistance for working families, unemployment benefits, and others.  They make up more than half of the total $1.9 trillion package.  The Education & Labor Committee sections of the bill released by Chair Robert C. "Bobby" Scott include raising the minimum wage to $15 by 2025, OSHA worker protections, and funding for Elder Justice and Older Americans Act programs.  The Financial Services Committee, charged with drafting legislation totaling $75 billion released a bill that includes housing provisions and will convene Wednesday. LeadingAge national awaits several other Committee releases, including the Committee on Energy and Commerce and the Small Business Committee. In the coming days they will offer articles and analyses and will provide information on Update Calls later this week.

2/8/21: CMS Webinar on Staff Resilience: On Wednesday, February 10, at Noon Eastern time, CMS's "CCSQ Lessons from the Front Line Call" will focus on health care professional well-being and resilience.  Here's the announcement and registration link: 

CCSQ Lessons from the Front Line Call: Discussion on Health Care Professional Well-being & Resilience:  Join The Office of Clinician Engagement (OCE) at the Center for Medicare & Medicaid Services (CMS), the American Medical Association (AMA) and the American Nurses Association (ANA) for a discussion on Health Care Professional Well-being & Resilience.  Panelists:
·   Dr. Barry Marx, Director, Office of Clinician Engagement, Center for Clinical Standards and Quality (CMS)
·   Dr. Susan Bailey, President, American Medical Association
·   Holly Carpenter, BSN, RN, Senior Policy Advisor, Innovation Nursing Practice & Work Environment, American Nurses Association  

Target  Audience:  Health care professionals, institutions, and representative organizations.    Register in advance for this webinar (After registering, you will receive a confirmation email):  https://cms.zoomgov.com/webinar/register/WN_iPKPQCmrToeixrXzCGGctg    

2/8/21: Relationship Between Hospitalization Growth Rates and Mask Mandates: CDC released an MMWR on the decline in COVID-19 hospitalization growth rates associated with statewide mask mandates in 10 states from March to October, 2020. During March 22-October 17, 2020, 10 sites participating in the COVID-19-Associated Hospitalization Surveillance Network in states with statewide mask mandates reported a decline in weekly COVID-19-associated hospitalization growth rates by up to 5.5 percentage points for adults aged 18-64 years after mandate implementation, compared with growth rates during the 4 weeks preceding implementation of the mandate. Mask-wearing is a component of a multipronged strategy to decrease exposure to and transmission of SARS-CoV-2 and reduce strain on the health care system, with likely direct effects on COVID-19 morbidity and associated mortality.

2/8/21: Harvard Fellow on Vaccine Hesitancy, Messaging in Senior Housing: On today's Housing Advisory Group call, LeadingAge hosted Dr. Rachael Piltch-Loeb from the Harvard School of Public Health to discuss vaccine hesitancy and messaging issues in affordable senior housing communities. Dr. Piltch-Loeb covered a variety of strategies for countering both fear-based and cultural-based hesitancy among staff and residents, and suggested tips for increasing vaccine take-up. Above all, Dr. Piltch-Loeb stressed that concerns around medical interventions, including vaccinations, are valid and should be addressed; housing providers on the call also shared successful experiences they have had at communities, including one-on-one conversations with each resident to talk through concerns ahead of a vaccine clinic. A summary of today's call is available here. To join the LeadingAge Housing Advisory Group calls on Mondays at 11:30pm C.T., email Juliana (jbilowich@leadingage.org) or Linda (lcouch@leadingage.org). 

2/3/21: NEED YOUR HELP WITH THIS SURVEY: **DHHS has requested help from providers to get estimates on the number of COVID-19 vaccines that will be needed in each area of Nebraska so that they can ensure that doses are reserved to vaccinate new healthcare workers and new residents. They need your help so that they can help you.  Please fill out the following survey by the end of the day on Thursday.  Results will be collected and shared with DHHS. If you were on today's member call and submitted a response you do not need to complete again.   https://www.surveymonkey.com/r/56N8JJH  **

2/3/21: Need to Know Updates: Information tidbits from the past week (vaccine and non-vaccine related):

  • COVID testing for surveyors started this week. DHHS reports that the testing is going fine.  Surveyor testing results WILL NOT be shared with providers.  However, per Becky Wisell, rest assured that if a surveyor has a positive test he/she will not be sent out to do surveys.  You SHOULD still follow standard screening protocols for everyone, including surveyors.  Surveyors will be tested each week on Monday (or Tuesday if Monday is a holiday).  
  • If you are a facility who has a staff member who would like vaccinated, but you have completed your on-site clinics, remember that healthcare workers continue to be a prioritized group for vaccination.  Contact your Local Health Department for assistance in accomplishing necessary vaccinations outside of the LTC pharmacy partnership clinics.
  • Sara Morgan with DHHS confirmed during the member call today that all facilities enrolled in the LTCPP have had a first clinic.

2/3/21: Senate Power Sharing Agreement: Senator Schumer and Senator McConnell reached power sharing agreement for the 50-50 divided Senate. With Vice President Kamala Harris as the tie breaking vote, the Democrats take control of the chamber. Now that the power sharing agreement has been reached, they can now officially assign senators to individual committees and new committee chairs and ranking members will be put in place. This critical first step allows LeadingAge be able to advocate with the new leadership in senate committees. All eyes are now on Congress as they work to figure out the next COVID-19 relief bill using a process called reconciliation. LeadingAge is closely monitoring and advocating on this bill and will have updates soon.  LeadingAge members can use their power to share their views about the need for reform with their members on the Hill, by responding to this Action Alert on the COVID relief we need now.

2/3/21: Retail Pharmacy Program Launched: The federal government has launched (this link will be available tomorrow) the first phase of the Federal Retail Pharmacy Program for COVID-19 Vaccination. The program is being implemented incrementally based on the available vaccine supply, with select retail pharmacy locations providing COVID-19 vaccine to eligible individuals. The CDC has posted the initial list of 6500 participating pharmacies, which also can be viewed by state. Eventually, more than 40,000 pharmacies will participate in the Retail Pharmacy Program, including most LTC pharmacies.

2/3/21: Article Summarizing New PRF FAQs: LeadingAge national has developed an article summarizing the updated and new FAQs on Provider Relief Funds. The article has a little more detail and discusses some of the implications of the changes. Key items in these FAQs include notice that HHS will only issue one more Nursing Home Infection Control payment for December performance, new FAQs indicating which vaccine related expenses can be covered by PRF, and clarification that when providers calculate lost revenues they must show an annual loss not just a quarterly or monthly loss related to COVID-19. One additional note that the GOP COVID proposal for the next round of legislation indicates it would add $35B to the PRF but set aside 20% of it for rural hospitals. LeadingAge will be asking Congress to support additional appropriations for PRF as part of the next COVID package and asking the Administration to open another opportunity to apply for PRF as soon as possible.

2/3/21: State Profile Reports: HHS and the White House COVID-19 response team have released the weekly state profile snapshot. The purpose of this report is to develop a shared understanding of the current status of the pandemic at the national, regional, state, and local levels.

2/3/21: Healthcare Workers: CDC has updated their information on COVID-19 for healthcare workers. This page provides guidance for managing patients with COVID-19, vaccine administration, and much more.

2/3/21: Message to Long-Term Care Facility Workers and Vaccinations: In response to the CDC MMWR research findings of low rates of vaccination among staff in skilled nursing facilities, CDC posted a message for Long-Term Care facility staff: You have an essential role in fighting COVID-19. Your decision to get vaccinated can help protect more than just your health. You can lead the way for residents, colleagues, and others. Learn more here.

2/2/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • We are still awaiting additional information from DHHS on how vaccine doses will be obtained for new residents and staff following the 3rd on-site clinic.  We have heard from a number of you across the state that you are working with your local health departments, hospitals and your long-term care pharmacy-depending on your location.  We encourage you to continue engaging with your local health departments as these plans are developed and rolled out.  
  • With the issuance of the new DHMs over the weekend which included changes in quarantine requirement post vaccination (in the community), there have been questions how these changes impact LTC.  Per Connie Vogt, quarantine requirements will remain the same in NF and AL at this time (follow QSO 20-39).  DHHS plans to review this requirement for AL as more data becomes available.
  • In the past three weeks the number of COVID-19 positive staff and residents in long-term care has declined: 
    • Three weeks ago- 97 residents and 102 staff
    • Two weeks ago- 50 residents and 87 staff
    • Last week- 28 residents and 50 staff

2/2/21: Reconciliation Process Begins: The House and Senate put out identical budget resolutions today that give instructions to committees of jurisdiction to move forward on the budget reconciliation process. The way that this process works is that the resolution has a topline number - $1.9 trillion dollars - that cannot be exceeded for the reconciliation bill. Committees that will be involved in drafting the reconciliation bill are given instructions as to how much spending done by program under their jurisdiction can add to the deficit. The House is expected to take up the resolution for a vote tomorrow. The Senate is expected to vote on Friday. Each individual committee's bill is due to House and Senate budget committee by Feb 16 so this process is going to move fast! Take action at: https://leadingage.org/grassroots/make-your-voice-heard to make sure your voices are heard in this process!

2/2/21: Updated/New PRF FAQs: The new FAQs were released the end of last week provide a little more detail about some of the new reporting provisions now that Targeted Distributions can be redistributed by a parent organization to its other subsidiaries. One notable change is the FAQs confirm that HHS has revised its approach on the Nursing Home Infection Control Incentive payments and will now only be issuing 4 monthly payments covering nursing home performance for September, October, November and December of 2020. In other words, the once promised aggregate payment will not happen. This will hurt those nursing home members who had data issues early on that prevented them from receiving earlier payments, as they will no longer have the opportunity to be financially rewarded for strong performance during those months. LeadingAge national will be providing an article summarizing the entirety of the FAQ updates this week.

2/2/21: PRF Payments Received Last Week: LeadingAge continues to piece together information about the PRF payments that providers received this week. It now looks like both Phase 3 as well as Nursing Home Infection Control incentive payments for November began arriving in providers' bank accounts as early as Monday, January 25.  Since the terms and conditions are different for these two types of distributions, it is important for providers to know what the funds they received were for. Providers can look in the payment description and if somewhere within the line of text it says "NH PMT HHS.GOV" then it is a nursing home incentive payment. If, however, it says something like "HHS Stimulus" it is more likely to be a Phase 3 payment.  Some LeadingAge members received both types of payments last week.

2/2/21: PREP Act Declaration to Increase the Workforce of Authorized Vaccinators: HHS issued a fifth amendment to the Declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) to add additional categories of qualified persons authorized to prescribe, dispense, and administer COVID-19 vaccines authorized by the U.S. Food and Drug Administration. Note that this is not specific to the Pharmacy Partnership for LTC.  Among other things, the amendment:

  • Authorizes any healthcare provider who is licensed or certified in a state to prescribe, dispense, and/or administer COVID-19 vaccines in any other state or U.S. territory.
  • Authorizes any physician, registered nurse, or practical nurse whose license or certification expired within the past five years to prescribe, dispense and/or administer COVID-19 vaccines in any state or U.S. territory so long as the license or certification was active and in good standing prior to the date it went inactive.
  • Requires any healthcare professional described above to complete CDC COVID-19 Vaccine Training and, for healthcare providers who are not currently practicing or whose license or certification is expired, requires an on-site observation period by a currently practicing healthcare professional.

2/2/21: Deep Dive: Next Steps for HUD's Physical Inspection Overhaul: LeadingAge will be publishing a detailed look at HUD's new physical inspection changes, which the agency published in a January 19 proposed rule. The changes run parallel to the current NSPIRE demonstration program and take the first steps to overhauling HUD's approach to physical inspections. Proposed changes impacting senior housing providers include requiring electronic agency reporting of annual unit self-inspections; adjusting REAC's risk-based inspection schedule; consolidating inspectable areas and elevating the importance of in-unit conditions; aligning inspection requirements across programs, including for mixed finance properties; and more. LeadingAge national is compiling comments on the proposed rule by HUD's March 15th deadline. To submit feedback on HUD's proposed changes, email Juliana with LeadingAge national at jbilowich@leadingage.org.

2/2/21: CDC Officially Extends Eviction Moratorium: Ahead of the January 31 expiration, the CDC has ordered the extension of the current eviction moratorium for non-payment of rent. The order prevents residential evictions until March 31; tenants have to self-certify eligibility for the protections. The extension keeps the moratorium largely unchanged, and tenants who previously submitted the self-certification should not have to resubmit. In the meantime, LeadingAge is advocating with the Administration to quickly provide rent relief for senior housing communities impacted by COVID-19.

2/2/21: HUD Presents Webinar on Avoiding COVID-19 Scams: HUD and the Federal Trade Commission (FTC) have announced a free webinar on February 3 at 2pm on avoiding COVID-19 scams. Called "Protecting Communities from Coronavirus Scams and Fraud," the webinar will cover common coronavirus-related scams and fraud and how to report them to the FTC. Registration for the free webinar is available online.

2/2/21: Clarification from CDC About First Doses at Third LTCPP Clinics: On Friday night LeadingAge national received clarification from CDC that Walgreens and CVS "plan to vaccinate staff with first does at third clinics.  Potentially also residents in states that chose Moderna for the LTC program," which is not a large number of states and does not include Nebraska.  CDC further confirmed this in a meeting with CVS and Walgreens on Saturday.  The rationale is that staff are able to get around in the outside community to obtain a second dose of the Pfizer vaccine.  However, since onsite clinics operated under the soon to be rolled out Retail Pharmacy Program will use the Moderna vaccine, after the third PPLTC clinic, no additional Pfizer doses will be available in onsite clinics.

2/2/21: New MMWR from CDC on vaccination rates in nursing homes: Today CDC issued a new Morbidity and Mortality Weekly Report summarizing the data from the first month of COVID-19 vaccinations of state and residents in nursing homes, through the Pharmacy Partnership for Long-Term Care Program.  The report shows that nearly 80 percent of residents in skilled nursing facilities received the COVID-19 vaccine during early federal vaccination efforts. However, the data also reveal that less than 40 percent of staff in these facilities were vaccinated.  CDC emphasizes that "ensuring long-term care staff have access to COVID-19 vaccination - and confidence in the safety and effectiveness of these vaccines - is a public health priority to protect more people from getting COVID-19 infections."  It's important to note that this only applies to nursing homes, not other provider settings under the Pharmacy Partnership.  In addition, this MMWR only includes data from the first month of the program.  In the announcement, CDC added that the agency is committed to working with partners to continue to build vaccine confidence among staff and residents. The announcement also reminded everyone about existing resources that can help provider communities:

2/2/21: BD Long Term Care Provider Survey on Testing: BD is seeking feedback from long term care providers on their experiences with COVID-19 testing.  They request that nursing home providers take five (5) minutes to answer this brief survey about your current approaches to testing staff and residents, as well as any barriers they are encountering.  The survey is available here. BD appreciates provider feedback! 

2/2/21: CDC Cases, Data, and Surveillance Page Updated: Cases, Data, and Surveillance: CDC has updated their page with COVID-19 cases, data, and surveillance. On this page you can find more information about vaccinations in the US, COVID-19 trends, and more. 

2/2/21: COVID-19 Frequently Asked Questions: FDA updated their FAQs about COVID-19. The updated guidance includes a new question-and-answer regarding whether FDA considers receipt of medical products authorized under an emergency use authorization for use in clinical care, such as a vaccine to prevent COVID-19, or a monoclonal antibody to treat COVID-19, to be receipt of "investigational" medical products.

2/2/21: Variant Cases: CDC Updated Page on Variant Cases: The emerging variants CDC is closely monitoring have mutations in the virus genome that alter the characteristics and cause the virus to act differently in ways that are significant to public health (e.g., causes more severe disease, spreads more easily between humans, requires different treatments, changes the effectiveness of current vaccines). It's important to understand that genetic mutations are expected, and some variants can spread and become predominant while others subside.

2/2/21: Vaccination: CDC Updated Resource Page on COVID-19 Vaccinations: On the COVID-19 Vaccinations page you can find the benefits of the vaccine, community mitigation framework, toolkits, and more.