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

6/28/21: Governor Ricketts announces end to Public Health Emergency but extends training requirements for Nurse Aides and Medication Aides: The Governor announced today, June 28, 2021, that he is lifting Nebraska's declared public health emergency, effective June 30, 2021, at 11:59 pm.

He is extending Executive Order 20-12, waiving training requirements for nurse aides and medication aides through 8.27. 21.  This means that you can continue to utilize temporary nursing aides and temporary medication aides until August 27, 2021. 

Here is a link to Executive order 20-12: https://govdocs.nebraska.gov/docs/pilot/pubs/eofiles/20-12.pdf

6/11/21: Updates From Wednesday's Call: If you were able to join us Wednesday for our weekly member call, you know that we experienced significant technical difficulties.  Much of the information that was shared in the Chat was lost. One of the issue discussed was risk assessment use by providers in determine approach to certain activities.  The ICAP Eye Protection Risk Assessment template and Outings Risk Assessment template were referenced as useful tools as well as templates for other risk assessments that a provider may want to develop.  

ICAP has also provided a Respiratory Protection Plan (RPP) template that is helpful.  There is additional work being done by ICAP and partners (like LeadingAge Nebraska) to develop more robust RPP resources and training.

6/11/21: Monoclonal Antibody Treatment Webinar: LeadingAge, AHCA, and AMDA are jointly collaborating with the federal COVID response team to hold a live event, "Update on the Use of Monoclonal Antibody (mAB) Therapies for COVID-19: A Review of New Treatments and At-Risk Populations."  The event is set for June 15 at 2:00 PM CT, and will be available on the AHCA Education platform.  Dr. Michael Anderson of the federal COVID response team will present an overview, followed by a panel with a representative from each of the three associations talking about experiences, obstacles, and opportunities with mAB.  Register here for the event.

Nebraska DHHS put out this Health Alert Network (HAN) today related to monoclonal antibody treatment and sequencing. 

6/11/21: OSHA Emergency Temporary Standard for Healthcare Settings: Yesterday the Department of Labor's Occupational Safety and Health posted an emergency temporary standard for health care settings; it focuses on healthcare workers most likely to have contact with someone infected with COVID. It will be effective immediately upon publication in the Federal Register and employers will have to comply with most requirements within two weeks.  Here is a brief summary of the provisions of the rule.

6/11/21: Vaccination Reporting: CMS included the first round of vaccination data in today's data update on the nursing home data site (data.cms.gov).  The data reported is for reporting week Monday, May 24 - Sunday, May 30. LeadingAge is hearing that only about 28% of nursing homes have reported this data thus far. Recall that enforcement begins Monday, June 14, which means nursing homes must begin including vaccination and therapeutics data in weekly reporting by this Sunday, June 13 at 11:59pm. NHSN has provided several resources to assist providers in reporting this data, available here. Some to highlight: training video and slides, the Tables of Instructions and printable forms for data collection,  Guidance to COVID-19 Data Entry Screens, Uploading Group Data, Data Tracking Worksheets and Reference Guide, and Line Lists of COVID-19 Vaccination Data.

Here are a couple of FAQs LeadingAge has received lately:

  • When/how often do I report?  CDC wants the data to be as accurate as possible. The reporting week is Monday - Sunday so they say you can report on Mondays for the previous week or you can report on your regular day, then go back in later to correct the data. CMS says, "As long as you report once per week, you are in compliance."
  • What does "cumulative" reporting mean in this requirement? The rule was effective May 21, and QSO-21-19-NH states that nursing homes must "begin including vaccination and therapeutics data . . .by 11:59pm Sunday, June 13." When you report, you are reporting on any eligible resident or staff member in that reporting week, regardless of whether they were vaccinated that week or 6 months ago, and regardless of whether they were vaccinated in your nursing home or at a location in the community.

Comments on this rule are due July 12. LeadingAge will be submitting comments on the rule and has encouraged states and individual members to do so as well. They have developed this resource to assist in the process of submitting comments. 

6/11/21: HUD Publishes Guide for Virtual Service Coordination: Yesterday, HUD published an appendix to its Service Coordinator Resource Guide that reviews strategies and considerations for virtual Service Coordination. The publication comes after many HUD-assisted senior housing properties shifted Service Coordinators to off-site or remote job functions during the pandemic. The 6-page document discusses technology and equipment needs and outlines methods for maintaining resident connection throughout remote Service Coordination. The document is available here

6/11/21: ACL Webinar on Housing Plus Services: The Administration on Community Living is offering a webinar, "What it Takes to Age in Place: Bringing Housing and Home and Community-Based Services Together," on Thursday, June 17 from 2:00 - 3:00 PM ET.  Speakers from the National Center on Law and Elder Rights will present information on the connection between housing and services and talk about how Medicaid funds HCBS.  The webinar is free but registration is required.

6/11/21: CDC Updated Information for Older Adults on COVID-19: CDC clarified and consolidated their information for Older Adults into the following sections: increased risk of severe illness from COVID-19; protect yourself and other from getting COVID-19; if you are sick or think you were exposed to COVID-19; visiting older adults in residential communities; and further resources.

6/11/21: CMS Increases Reimbursement Rate for Homebound Vaccinations: CMS announced that they are increasing the rate for providing the vaccine to those who administer the vaccine in home to those who are having trouble accessing the vaccine. LeadingAge has been engaged in advocacy around the critical need to provide vaccines in the home and community and are excited to see CMS respond with some additional financial support for those who are having trouble vaccinations from vaccine sites. An article on this new guidance can be found HERE

6/11/21: Provider Relief Fund News: HHS Secretary Becerra indicated earlier this week that the department will be releasing new guidance soon (in June) that will address: what providers can do with unspent Provider Relief Funds, how providers can "apply for and make use, good use, of their monies," and also hinted that there would be some changes to how the remaining $24B in PRF monies is distributed. He would NOT say whether the  deadline to spend Provider Relief Funds is June 30, 2021 will be adjusted in this guidance. Members should continue to spend their PRF monies by June 30, if possible.

6/11/21: LeadingAge Supports New "Audio-Only" Telehealth Legislation Targeting Rural, Underserved Areas: Wednesday, Senators Joe Manchin (D-WV), Joni Ernst (R-IA), Jeanne Shaheen (D-NH), and Jerry Moran (R-KS) introduced the bipartisan Protecting Rural Telehealth Access Act to make current telehealth flexibilities under the Medicare program permanent, after the COVID-19 pandemic. LeadingAge is one of the 20 stakeholder organizations that support this bill.

This legislation would primarily ensure rural and underserved community healthcare providers are able to continue offering telehealth services after the current public health emergency ends. These services include the ability to offer audio-only telehealth appointments because many rural Americans don't have reliable, affordable broadband access. Additionally, it would permanently waive the geographic restriction allowing patients to be treated in their homes, and lift the restrictions on "store and forward" technologies, and allow new telehealth services for critical access hospitals and rural health and federally qualified health clinics. Background information on the Protecting Rural Telehealth Access Act can be found here. Bill text can be found here.

6/1/21: Updates From Last Week's Wednesday Call: If you were able to join us last Wednesday for our weekly member call, you would have heard updates on the following:

  • ICAP and DHHS have confirmed that they will be following the CMS guidance on unvaccinated residents and masking/social distancing specific residents.  Staff members who may be unvaccinated will be masking as required in healthcare settings.  For example, if an unvaccinated staff member enters an area of vaccinated residents, those residents do not need to mask.  If an unvaccinated resident enters the area, appropriate masking when not eating and social distancing of the unvaccinated residents should occur per QSO-20-39-NH Revised. 
  • Eye protection is in place to protect staff.  Most residents are vaccinated.  Eye protection is still necessary in red, yellow and gray zones.  If a facility is green- a self assessment of risk should be undertaken (including consideration of community positivity levels) to determine if eye protection is necessary.  Both ICAP and DHHS support this approach.
  • If a resident is fully vaccinated he/she does not need to quarantine upon return unless they have a known exposure.  Provide information to residents on how to avoid risky situations.  If the resident returns from a high risk outing, best practice would be to test twice weekly for two weeks.  If they return from a low risk activity, then there is not a need for additional testing. 

6/1/21: Nursing Facility Rate Update: LeadingAge Nebraska (Jenifer) visited with Jeremy Brunssen, Deputy Director of Finance with Medicaid & Long-Term Care last week.  Jeremy provided the following update related to 2021-2022 NF rates:

  • Rate sheets were supposed to go out last Friday.
  • Q4 of 2020 was used to determine Medicaid days.
  • The appropriation from the Legislature included about a 3.5% increase.
  • All Medicaid nursing facility providers received an increase.  
  • The range of increases to the base rate ranged from just over $7/day to around $39/day.  This was a 15.99% inflation factor.
  • The average NF provider rate was $26/day.
  • Jeremy's team will continue to monitor utilization and if toward the end of this year utilization increases there may need to be an adjustment to the January- June rates. 
  • Jeremy is unsure at this point if the $20/day COVID rate increase will continue past June.  More to come on this.

6/1/21: Guidance for Fully Vaccinated People: CDC updated their guidance for fully vaccinated people. The updated guidance includes an updated "Choosing Safer Activities" infographic with new considerations for the example activity for outdoor gatherings with fully vaccinated and unvaccinated people.

6/1/21: EEOC Guidance Says Employers May Offer Incentives for Vaccination: The Equal Employment Opportunity Commission (EEOC) updated its COVID-19 guidance today regarding employers and COVID-19 vaccines. Employers may offer incentives to employees who provide documentation of receiving the COVID vaccine outside of work because requesting proof of vaccination is not "a disability-related inquiry" or an "unlawful request" under federal anti-discrimination laws. The revised guidance also says that employers are required to keep their staff's vaccination information confidential because it is medical information about the employee. The EEOC also posted today a new resource for job applicants. The Administration on Community Living published this summary of the new EEOC guidance. Key points are: 

  • The guidance makes clear that federal EEO laws do not prevent an employer from requiring all employees entering the workplace be vaccinated, as long as other laws not under EEOC jurisdiction are not violated.
  • Federal law permits incentives to be offered.
  • Employers must not offer coercive incentives.
  • Employers may provide employees and their families information to educate them about COVID-19 vaccines.

6/1/21: HCS Home Care and Hospice Salary and Benefits Study: Hospital and Healthcare Compensation Service (HCS) is has announced that they are currently conducting 2021-2022 Home Care and Hospice Salary and Benefits studies, now underway and invites LeadingAge members to participate.  The deadline for participation in this year's study is August 2, 2021. The published results cover marketplace data for 60 jobs and 21 fringe benefits.  The results cover job data by salary, hourly, and per visit rates with data breakouts by auspice, revenue size, region, state, and CBSA.  Planned salary increases, turnover, caseload, and shift differential data are also covered.

Directions to Participate in the Home Care or Hospice Salary & Benefits Study:

  • Download the questionnaire from the HCS website: https://www.hhcsinc.com
  • Email Rosanne Zabka with HCS, RZabka@hhcsinc.com to confirm your planned participation.
  • Email your completed questionnaire to Rosanne by August 2nd.

Study participants save over 50% off the Report price. The pre-paid participant rate is $185 (payment due by 8/31/2021); the billed participant rate is $205.  The standard report pricing for nonparticipants is $375.

6/1/21: Monoclonal Antibody Treatment Webinar: LeadingAge, AHCA, and AMDA are jointly collaborating with the federal COVID response team to hold a live event, "Update on the Use of Monoclonal Antibody (mAB) Therapies for COVID-19: A Review of New Treatments and At-Risk Populations." The event is set for June 15 at 2:00 PM CT, and will be available on the AHCA Education platform. Dr. Michael Anderson of the federal COVID response team will present an overview, followed by a panel with a representative from each of the three associations talking about experiences, obstacles, and opportunities with mAB. Register here for the event.

6/1/21: Background Rationale and Evidence for Public Health Recommendations for Fully Vaccinated People: Last week CDC updated their background rationale and evidence for public health recommendations for fully vaccinated people. Data were added from studies published since the last update that further demonstrate currently authorized COVID-19 vaccines are effective against SARS-CoV-2 infection, symptomatic and severe disease, and hospitalization with COVID-19. Data were added suggesting that currently authorized mRNA vaccines provide protection against variants of concern, including the B.1.1.7 strain that is predominant in the United States. Data were added from studies published since the last update that further demonstrate people who are fully vaccinated with a currently authorized mRNA vaccine are protected against asymptomatic infection and, if infected, have a lower viral load than unvaccinated people.

6/1/21: Nebraska MLTC Provider Bulletin for Tribal Providers: This provider bulletin is being issued to give tribal providers updated guidance on temporary changes to the Medicaid program meant to improve access to COVID-19 testing and vaccines at IHS and Tribal 638 Clinics. Through an emergency State Plan Amendment (eSPA), COVID-19 testing and vaccination services are able to be billed as an encounter when provided at an IHS/Tribal 638 facility. Additionally, RNs can now provide these services 'incident to' the physician or other qualifying practitioner even if the RN is the only health professional on site. These services can be billed as an encounter and will be paid at the all-inclusive-rate. The eSPAauthority will be in effect until the end of the Public Health Emergency.  Find the full Provider Bulletin HERE.

6/1/21: REGISTRATION OPEN - The HQRP - Understanding the Composite Quality Measure Webinar (Repost): The Centers for Medicare & Medicaid Services (CMS) will be hosting a webinar on Wednesday, June 2, 2021 from 1:00 to 2:30 p.m. CT. The purpose of this training is to provide a general overview of the Hospice Quality Composite Measure and how it differs from individual quality measures. Specific topics include:

  • What is a Composite Measure?
  • Current HQRP Composite Measure.
  • Calculation of a Composite Measure.
  • Interpreting and Using Composite Measure Results.

Please register only if you know you will be able to attend the webinar, as space is limited. If you would like your name placed on a list to receive an email notification when the recorded version of the webinar is available, please CLICK HERE to be placed on an email notification list.

CLICK HERE to register for The HQRP - Understanding the Composite Quality Measure Webinar.

COVID-19 Updates June 2021