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

Need to Know Updates 

3/30/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • CDC guidance: CDC updated infection control guidance for nursing homes yesterday (here). The information and recommendations have not changed, but CDC has provided clarification around many of the recommendations. Remember that CMS defers to CDC guidance for much of the recommendations around COVID-19. While CDC is not the enforcer, CMS / state agencies can enforce CDC guidance as nationally recognized standards when recommendations have not otherwise been spelled out in specific CMS guidance or requirements.
    • CDC Guidance Update (Long-Term Care): CDC gave a major make-over to long-term care guidance yesterday. The guidance "Preparing for COVID-19 in Nursing Homes," has been renamed "Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes" and includes two prior documents, "Responding to COVID-19 in Nursing Homes" and "Performing Facility-wide SARS-CoV-2 Testing in Nursing Homes" which were merged with this guidance.
    • The recommendations in this document were updated and organized to clarify infection prevention and control practices and stress those that should remain in place whether or not nursing homes are experiencing outbreaks. Additional guidance was included to address circumstances when quarantine is recommended for new admissions and for residents who leave the facility, as well as a section addressing quarantine and work exclusion considerations for asymptomatic residents and healthcare providers who are within 90 days of resolved infection. Finally, this guidance is intended to apply regardless of vaccination status. For modifications to recommended infection prevention and control practices following vaccination please refer to CDC's Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.
  • WAY TO GO, NE LTC PROVIDERS!  Dr. Ashraf shared during a briefing today that there were ZERO, that's right 0, resident cases in Nebraska LTC. Awesome! What an amazing accomplishment! Just a reminder to be on guard for vaccine breakthrough cases.  There have been a number of COVID variant cases around the state. Click HERE to access the Reinfection and Vaccine Failure reporting form.
  •  Have more BINAX card tests than you can use before their expiry date?  As was set out a few months ago, the expiry date on many tests was extended 90 additional days. IF you have more cards on-hand than you can use in that timeframe, Becky Wisell shared during the call that Angela Ling has approved facilities moving unopened boxes to other facilities who may need them and who are set up with CLIA and reporting. It would be good practice to make a note of how many tests were moved and where, but DHHS says they do not believe this will be tracked.  IF you have excess BINAX cards and want to find another provider who may be able to use them, please feel free to contact us at LAN and we can help facilitate information flow. (jenifer.acierno@leadingagene.org).  
  • ICAP has pulled together a group of UNMC experts, the Associations, and others to work on the development of a Respiratory Protection Program for Nebraska NF providers.  More to come on this.

3/30/21: PPP Application Period Extended: President Biden signed legislation today extending the PPP deadline to May 31 for borrower applications and  June 30 for banks to process applications. The program was set to expire tomorrow, but prospective borrowers now have until the end of May to get applications in. See more here: https://leadingage.org/legislation/ppp-loan-application-period-extended-may-31.

3/30/21: FCC Posts Emergency Broadband Benefit FAQ: Today, the FCC posted a new consumer FAQ on the Emergency Broadband Benefit, which provides up to $50 per month off of internet service for income-qualifying households. The FAQ provides answers to common questions on benefit eligibility, how the discount will be applied to broadband service costs, and program length. A section on enrollment will be added once the program's official start date is announced. On a recent LeadingAge Housing Advisory Group call, FCC staff provided an overview of the benefit to LeadingAge affordable housing members and heard feedback from housing providers. More info here.

3/30/21: CMS Instructs MACs to Hold Claims Pending House Vote on Sequestration Moratorium: LeadingAge national has shared that in anticipation of possible Congressional action to extend the 2% sequester reduction suspension, CMS instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April 1, 2021. They instructed them to do so "for a short period without affecting providers' cash flow" - we do not know at this time what would constitute "affecting cash flow." CMS notes that this policy will minimize the volume of claims the MACs must reprocess if Congress extends the suspension; the MACs will automatically reprocess any claims paid with the reduction applied if necessary. The earliest that the House could vote on the sequestration moratorium extension is the evening of April 13th.

3/30/21: New LeadingAge Resources for Visitation: As CMS updated visitation guidance for nursing homes, LeadingAge national collaborated with Pathway Health on a Visitation during Covid-19 Toolkit for members. The 10 segment toolkit helps an organization navigate visitation guidance through a leader's guide, implementation checklists, competency tools for managers and all staff, and a pre and post test for all staff. The toolkit can be modified or edited to your organization's needs. The elements of the toolkit also may be used by various providers and service line in the continuum of care.

3/30/21: CDC Extends Eviction Moratorium Through June: Today, just days ahead of the March 31 expiration, the CDC extended the current eviction moratorium for non-payment of rent through June, 2021. Order stated that the 90-day extension will allow for assessments of changes to the COVID-19 incidence, the influence of new variants, and the expansion of vaccine coverage. In response to the CDC announcement, the White House released a fact sheet with additional resources, including an explanation of how various federal entities will help enforce and spread the word about the extended eviction moratorium. HUD's Office of Multifamily said in an email on March 29 that it will include revised guidance on this extension in its forthcoming COVID-19 Questions & Answers. LeadingAge national supports the extension of the eviction moratorium and will continue to work with Congress, the White House, and HUD to provide financial solutions for residents and housing providers during the moratorium. More info here.

From LeadingAge National's Weekly meeting with CMS- Q&A:

  • Visitors and core principles of infection prevention: Can a nursing home deny entry to a visitor who does not adhere to core principles of infection prevention? Yes, but . . . CMS says "be reasonable." Nursing homes should make every effort to educate visitors on the core principles of infection prevention. If visitors fail to adhere to core principles, the nursing home should attempt to resolve the issue in collaboration with the visitor. If the visitor refuses to comply, even after education and support from the nursing home, then the nursing home may ask the visitor to leave / restrict the visitor.
  • Physical contact during visits: Can residents who are unable to wear a mask have physical contact during a visit? Residents who are unable to wear a mask would "ideally" be vaccinated and should not have physical contact. However, nursing homes are not expected to police visits. The nursing home should inform the resident and the visitor of the core principles of infection prevention, including the importance of source control (masks) and social distancing but residents have the right to privacy during visits.
  • Visitors and testing: How should nursing homes handle situations where the state requires testing of visitors and the visitor refuses to be tested? CMS strongly encourages testing of visitors and states that testing is as important as it has ever been; however, CMS has also stated that testing cannot be a condition of visitation. In states that require testing of visitors, consult with the state on how to handle visitors who refuse to be tested and contact your CMS regional office to discuss restrictions and conflicts state requirements and federal CMS guidance.

3/30/21 Webinar: When 1135 Waivers End: Calling all members in nursing home and acute care settings! Are you ready for when 1135 waivers sunset and regular safety surveys resume? Join LeadingAge national on April 8  for a live webinar to review what you need to know and the items your plan should include. Register today, $99 for members.

3/26/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • DHHS put out a news release yesterday which includes updated information on Retail Pharmacy locations that have been activated across the state.  Some of these pharmacies have received very limited doses of vaccine. A list of updated eligible pharmacies is also included.  These pharmacies are approved to participate but have not yet received vaccine doses.
  • TMF (the QIO for Nebraska) has asked that this be shared with LAN members: As you know, the COVID-19 pandemic shifted all our efforts and resources to infection prevention and control to support reducing spread of COVID-19 in nursing homes. As the pandemic is slowing CMS has again shifted focus somewhat, and in addition to the efforts related to infection prevention and control, we are also working with nursing homes on vaccines - to include Influenza, Pneumonia, and COVID-19 vaccines.  CMS is strongly urging nursing home staff to complete their CMS Targeted COVID-19 Training for Frontline Nursing Home Staff and Management training series. This scenario-based training has been designed specifically with COVID-19 prevention in nursing homes in mind. The program features a tailored course that incorporates the most recent lessons learned from nursing homes and teaches frontline staff best practices they can implement to address issues related to COVID-19. CMS has asked that TMF promote the training and urge participation.  CMS is closely monitoring who is and is not participating.  The CMS one-pager is attached here:  https://qsep.cms.gov/  and https://qsep.cms.gov/COVID-Training-Instructions.aspx.
  • If you were able to join the Wednesday weekly member call or the Spring Conference last week, you had the opportunity to hear from Dan Dwyer with OSHA.  Dan provided helpful information.  He received approval to share his slide deck from the Wednesday call.  The slides are attached HERE (pdf).  Dan provided information on how to received the OSHA QuickTakes biweekly newsletter, the OSHA tip of the day, OSHA guidance specific to LTC, fit testing (we are working with CMS and OSHA on further conversation related to initial fit testing requirements during the pandemic) and how to request an on-site consultation through Nebraska DOL.  
  • WAY TO GO, NE LTC PROVIDERS!  Dr. Ashraf shared during the Wednesday call that in the past two weeks there were 4 residents and 27 staff who tested positive in Nebraska.  Last week there were 2 residents diagnosed, which places Nebraska 2nd in the nation for the lowest number of cases in LTC. That is an amazing accomplishment. That being said, be on guard for vaccine breakthrough cases.  There is at least one verified vaccine breakthrough case last week.  Remember if someone looks like they have COVID-type symptoms, even if they are fully vaccinated, that they need to be tested.  Also, there have been a number of COVID variant cases around the state. Click HERE to access the Reinfection and Vaccine Failure reporting form.
  • During the call on Wednesday, Dan Taylor, with DHHS Survey, indicated that they have seen a rise in complaints related to skin issues in both NF and AL.  He also indicated that they are close to having a plan in place related to occupancy certificates. He has been working with Doug Hohbein at the State Fire Marshal's office. Dan says if your license expires at the end of the month, don't panic. You will not go in to a lapsed status.  They are working on issuing a 1 year emergency certification as they work this year to get back on track with surveys.  This will apply to NF and AL. 
  •  Have more BINAX card tests than you can use before their expiry date?  As was set out a few months ago, the expiry date on many tests was extended 90 additional days.  IF you have more cards on-hand than you can use in that timeframe, Becky Wisell shared during the call that Angela Ling has approved facilities moving unopened boxes to other facilities who may need them and who are set up with CLIA and reporting.  It would be good practice to make a note of how many tests were moved and where, but DHHS says they do not believe this will be tracked.  IF you have excess BINAX cards and want to find another provider who may be able to use them, please feel free to contact us at LAN and we can help facilitate information flow. (jenifer.acierno@leadingagene.org)
  • On Friday, LeadingAge Nebraska was able to meet with staff from the CMS Regional team to discuss questions and concerns related to COVID-19 guidance and guidelines.  We were able to share many of the thoughts and concerns that providers have shared with us.  The CMS folks took down a great deal of information and we are hopeful that hearing these concerns will help them move forward with their next steps for guidance and planning.
  • ICAP has shared an approved (by DHHS) template/beginnings document for providers to develop a Suggested Plan for Managing New Admissions, Readmissions and Return from Community Outings- link HERE.

3/26/21: BINAX Cards -US HHS Will Continue to Distribute: LeadingAge national met with HHS Office of the Secretary staff on Wednesday to discuss how HHS is handling distribution of the 50 million BINAX cards they announced they (and the Department of Defense) purchased.  All nursing homes and all assisted living providers with CLIA waivers that are in red or yellow counties should be continuing to receive sufficient numbers of BINAX cards directly from HHS.  There has been no interruption in the distribution process.  If you meet the description of a provider who should be receiving BINAX cards but are not receiving the cards from HHS please send a note to Jenifer (jenifer.acierno@leadingagene.org) with the following information and it will be provided to LA national to be shared with US HHS:  provider identification number; name of provider organization; name of contact person; address to which the cards should be sent. 

LeadingAge Webinar On BD Veritor Imagemover App For Members: On Tuesday, March 23, LeadingAge national held a member only learning session with BD on a new app.  BD recently announced that Veritor users will now have access to the ImageMover mobile app available on iOS and Android. With the ImageMover app, BD Veritor users will now be able to efficiently register patients, obtain and track consent forms, enter, view and share results, and also automatically report these results to the appropriate state and federal agencies. The session overview includes a power point presentation from BD team members and a Q and A about the capabilities of the app.  Access the LeadingAge national training webinar with BD staff to learn more about this tool. The on-demand training can be found here.

3/26/21: Reminder on Accelerated and Advanced Payments: For those providers that took Medicare accelerated or advanced payments, the recoupment will likely start next month - April - because that is when a majority of the loans were made. If you took them at a different time of year, the repayments start 1 year from when you took the loan. Here is an article from LeadingAge national describing the revised terms of the Medicare accelerated and advanced payment program that passed in September for which LeadingAge advocated.

3/26/21: Last Call for Your Provider Relief Fund Needs: This is the last call for folks to share their experience with Provider Relief Funds and whether more is needed through our Provider Relief Fund Survey. Your responses are critical to helping LeadingAge national make the case to Congress for why we need them to appropriate more to PRF to survive the effects of the coronavirus. Thanks to all who have already contributed to the survey.  

3/26/21: Funeral Costs for COVID-19-Related Deaths: In early April, FEMA will begin providing financial assistance for funeral expenses incurred after Jan. 20, 2020 for deaths related to coronavirus (COVID-19) to help ease some of the financial stress and burden caused by the pandemic. The policy was finalized yesterday, and FEMA is now moving rapidly to implement this funeral assistance program nationwide. To find out if you qualify, view the COVID-19 funeral assistance program policy.

3/26/21: New HUD Guides for Multifamily Housing Released: On March 22, HUD's Office of Multifamily Housing released new tools for residents and owners. HUD has a new guide for tenants and owners, "Rights and Responsibilities for Tenants & Property Owners" and a new guide for tenants, "Managing Your Finances During COVID-19 Pandemic." The Rights and Responsibilities guide is an easy-to-read breakdown of HUD and CDC guidance with "rights and responsibilities" columns for owners and tenants on several COVID-19 topics: keeping units safe, keeping common areas safe, accessing units for repairs or inspection, eviction protection, protections and accessibility modifications for people with disabilities, and moving. Read the new Rights and Responsibilities for Tenants & Property Owners here in English and here in Spanish. Read the new Managing Your Finances During COVID-19 Pandemic here in English and here in Spanish. Read the article here.

3/16/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • DHHS put out a news release yesterday reminding folks of how to register for the COVID-19 vaccine and a great deal of informational and downloadable material.  You can access that information HERE.

3/16/21: Biden Administration Increases Reimbursement Rate for Administering COVID-19 Vaccines: Effective for COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies, and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished.

LeadingAge will continue to dig into the pricing changes in the hope that the combination of increased reimbursement, more supply coming online, and easier to store vaccine product will hopefully allow our members who have appropriate staff - such as nursing homes, assisted living, home health, hospice, and PACE - to more easily set up ongoing processes to continue vaccinating their own staff, residents, and patients, including those who are homebound. 

3/16/21: CMS Infographic on Visitation: CMS, in collaboration with the CDC, issued updated guidance on visitation requirements last week. CMS released this information graphic for families and friends of residents in nursing homes.  It outlines in detail steps on how and when you may visit, safely.

3/16/21: MedPAC Releases Report to Congress with Payment Recommendations: The Medicare Payment Advisory Commission (MedPAC) released is March 2021 Report to Congress. This report includes chapters on all Medicare services with recommendations to Congress on updates to payment policy. For LeadingAge members, this includes chapters on home health, hospice, and skilled nursing facilities. As was noted in an earlier article from LeadingAge, these recommendations suggest that their should be no payment update for hospice and skilled nursing facilities. Additionally for hospice, the report recommends a reduction in the aggregate cap by 20%. The recommendation is for a 5% payment reduction for home health. It should be noted that these recommendations are often not taken by Congress. LeadingAge continues to advocate for appropriate Medicare payment policy to support the mission-driven services of our members.

3/16/21: LeadingAge calls for feasibility, clarity in HUD NSPIRE overhaul: Today, LeadingAge national submitted comments on HUD's NSPIRE proposed rule to overhaul physical inspections of HUD-assisted properties. LeadingAge's feedback was generated from member input and highlighted the need for a robust yet feasible inspection protocol. In particular, LeadingAge called for an enhanced risk-based inspection schedule and an NSPIRE implementation schedule adapted for COVID-19. LeadingAge also requested clarity from HUD on several proposed changes, including a proposed requirement to submit annual unit self-inspections to HUD; the comments also suggested several alternatives to streamline the inspection process while incentivizing good living conditions at HUD-assisted communities. More information about the proposed rule and LeadingAge's comments is available here. To join LeadingAge's HUD Oversight Workgroup, which meets monthly to discuss HUD's portfolio oversight mechanisms, email Juliana jbilowich@leadingage.org.

3/16/21: LeadingAge and AHCA Join Forces on Implementing Policy Recommendations for Nursing Homes: On Monday, LeadingAge and the American Health Care Association (AHCA) announced a set of policy recommendations aimed at ensuring quality in Nursing Homes. The recommendations below are outlines to achieve bills for Nursing Home challenges that we've faced for many years. Funding is imperative to achieve the desired outcomes, which is laid out in the recommendations.  Read the recommendations for policy and practice changes below.  You may view the virtual press event here and access the written press release.

3/16/21: LeadingAge Webinar On BD Veritor Imagemover App For Members: BD recently announced that Veritor users will now have access to the ImageMover mobile app available on iOS and Android. With the ImageMover app, BD Veritor users will now be able to efficiently register patients, obtain and track consent forms, enter, view and share results, and also automatically report these results to the appropriate state and federal agencies.  Find out how to get started during the webinar and we will have time to answer your questions. LeadingAge members can Register Here.

3/16/21: HCBS FMAP Increase Estimates: Kaiser Family Foundation issued state level estimates as to how much each state might receive from the 10 point FMAP bump. They estimate states will receive more than $11 billion specifically for Medicaid HCBS. See here 

3/16/21: CMS Webinar Training for SNF Quality Reporting Program: CMS is hosting a webinar on March 30 from 1-2:30p ET to help Skilled Nursing Facilities receive the full SNF Quality Reporting Program rate adjustment (called Annual Payment Update, which can impact as much 2% of SNF's Medicare rates). Members can register hereEach year, CMS updates the elements of the MDS that are used for calculating measures for the SNF QRP program and this is a good way for the staff to familiarize themselves with the changes. Space is limited so folks should only register if able to attend. Alternatively, SNFs can sign up to be notified when the recording of the session becomes available. This will also be posted on the LeadingAge website: https://leadingage.org/regulation/march-30-cms-webinar-maximize-snf-qrp-adjustment.

3/10/21: Hello LeadingAge Nebraska Members: This afternoon CMS provided an update to the guidance for visitation in nursing facilities as outlined in Revised QSO 20-39.  Read the LeadingAge national summary here. The guidance allows nursing homes to expand visitation options in a safe and responsible manner, regardless of vaccination status of the resident or visitor. CMS has outlined certain scenarios that would limit visitation using community positivity rates and nursing home resident vaccine percentages.  Nursing homes will need to emphasize the importance of infection control protocols and continued testing. 

Concurrent with the new guidance from CMS, CDC also updated guidance for infection prevention and control recommendations in healthcare settings. The guidance on visitation is consistent with CMS's visitation guidance to nursing homes. CDC has updated recommendations for work restrictions and quarantine following exposure for fully-vaccinated individuals. While CDC continues to recommend that nursing home residents quarantine for a full 14 days following exposure regardless of vaccination status, healthcare personnel are no longer required to be restricted from work. This is a change from the previous recommendation that healthcare personnel were exempt from work restrictions in cases of staffing shortages only. CDC no longer recommends quarantine for fully vaccinated residents being admitted to nursing homes provided they have had no close contact with anyone with COVID-19 infection in the past 14 days.

3/10/21: Join us tomorrow on the Nebraska ICAP call to unpack the new guidance and how it impacts Nebraska nursing facilities.  Thursday, March 11, 2021 at 12:00pm CT  Join the Nebraska ICAP team for the Weekly Long-Term Care call: Join via Zoom:  https://unmc.zoom.us/j/94892899060?pwd=WXZhQWxuOUpuNU5HZjZUMWJINWR0UT09

Passcode: 042010 Join the Centers for Medicare and Medicaid Services and The Centers for Disease Control and Prevention for a National Nursing Home Stakeholder Call on Thursday, March 11 at 2:30 p.m. CT. You must register in advance for this Zoom call: https://cms.zoomgov.com/webinar/register/WN_ycA-sbK4TW-lg5HzX_YpqA

3/9/21: Information tidbits from the past week (vaccine and non-vaccine related): 

  • Expiration Dates for Some License Types Extended to June 30-  Nebraska DHHS issued a news release on Monday. On March 27, 2020, Governor Pete Ricketts signed Executive Order 20-10 which suspended several statutes and their implementing regulations from the Uniform Credentialing Act, pushing back the renewal deadline for several licenses until 30 days after the COVID-19 State of Emergency is lifted.  Today's news release provides information for Licensees whose renewal was impacted by Executive Order 20-10 who choose to renew prior to the closing date of the executive order may now do so. Licensees are being notified via postcard when renewal is available. 
  • DHHS issued a Health Alert yesterday related to billing for COVID-19 vaccinations.  All organizations and providers participating in the CDC COVID-19 Vaccination Program must administer vaccine with no out-of-pocket cost to recipients.

3/9/21: CDC Released Public Health Recommendations Regarding Fully Vaccinated Individuals in Non-Healthcare Settings: CDC released public health recommendations today to guide the activities of fully vaccinated individuals in non-healthcare settings. Read the LeadingAge analysis here. "Fully vaccinated" means 2 weeks since the final dose in your vaccination series. Healthcare settings include nursing homes, assisted living, and inpatient hospice. Non-healthcare settings would refer to our other membership settings and our healthcare personnel in their personal lives. This guidance does not apply to healthcare settings, so does not change current nursing home visitation guidance. LeadingAge does not believe it impacts testing requirements for nursing home staff. Continued research is being completed on how long the vaccination remains effective once administered. The CDC emphasized that they are continuing to study if someone can transmit COVID-19 after completing vaccination. We know that CMS and CDC have been working together to review long-term care guidance and we expect updates from CDC to long-term care guidance and from CMS on nursing home guidance soon. 

3/9/21: Abbott Announces Longer Expiration Dates on BinaxNOW Cards: Many long-term care providers received Abbott BinaxNOW COVID-19 Ag cards from HHS.  Some of the cards were set to expire soon. Abbott released new guidance which indicates that studies support extending the shelf life of the tests from the original 6 month period to 9 months (an additional 3 months). Going forward, all BinaxNOW Ag cards have a 9 month expiry date. The announcement includes an Attachment that lists lot numbers of the kits, original expiration dates and extended expiration dates.  Providers who may have cards with extended expiry dates should keep a copy of the document to demonstrate the expiration extension.

3/9/21: American Rescue Plan and HCBS: Please see an article from LeadingAge detailing how the American Rescue Plan bill affects HCBS providers, including different ways they may get funding. This covers the Medicaid HCBS FMAP bump, state/local aid, rural provider relief, PPP, and Older Americans Act dollars. 

3/9/21: Pathway Health Toolkits: LeadingAge national has 2 new toolkits for members from Pathway Health. The Activities Reopening toolkit addresses the reintroduction of group activities into the nursing home community while the Access to Adequate PPE for Staff toolkit covers PPE optimization strategies. These and the existing COVID-19 toolkits from Pathway Health are updated as guidance is updated and are available with member login here.

3/9/21: New report from PHI offers comprehensive look at direct care workforce: Today, PHI released "Caring for the Future: The Power and Potential of America's Direct Care Workforce. PHI developed the report because 2020's two large scale challenges - the pandemic and the need to address the consequences of gender and racial disparities on direct care workers - brought issues related to the LTC workforce to the fore. The report presents a statistical overview of the demographics, socio-economic characteristics and employment projections for this workforce; in addition, it describes the changing role of aging services workers in home care, residential care, and nursing homes. Did you know 24% of all direct care workers are over age 55?  Or that 42% require some form of public assistance?  The report goes on to present the case for LTC financing reform, beginning with the premise that Medicaid is not the answer. It presents ideas to elevate the role of direct care workers, emphasizing training, upskilling, career ladders, and integration with care teams.  It provides details on the quality of LTC jobs.  PHI offers eight key areas of recommendations, beginning with LTC financing reform. Many of these recommendations align with LeadingAge's priorities and goals.

3/9/21: Project Firstline ICAP Survey: Nebraska ICAP (Infection Control and Assessment Program), a CDC grant funded program, is excited to be developing infection control training opportunities to healthcare workers. We have partnered with the CDC's Project Firstline to bring this training to every frontline healthcare worker. 

ICAP is interested in your responses as they develop the curriculum for the training.  This infection control activity is highly recommended by the CDC and is an opportunity for the infection control needs of frontline healthcare workers to be heard.  ICAP is looking at closing the survey at the end of March, so any completion of this as soon as possible will be very helpful!

The short infection control survey can be found at the following link or by scanning the QR code that is below: https://redcap.nebraskamed.com/surveys/?s=K3Y4XYJPKR .

3/3/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • FACEBOOK LIVE EVENT- Becky Wisell and Dan Taylor with the NE DHHS Licensure area will participate in a Facebook Live event on Thursday, March 4 at noon CT to answer questions for the public (including residents and resident family members) related to visitation, testing, PPE and other matters. This event is at the request of the LTC associations, in an effort for families to be able to hear directly from the state regulators on these issues. Please share the link to the event with your residents, resident family members, and others who may be interested in more information on these topics: Facebook.com/NEDHHSThe event will be recorded and posted to the DHHS site following.  
  • Expiration Dates for Some License Types Extended to June 30-  Nebraska DHHS issued a news release on Monday. On March 27, 2020, Governor Pete Ricketts signed Executive Order 20-10 which suspended several statutes and their implementing regulations from the Uniform Credentialing Act, pushing back the renewal deadline for several licenses until 30 days after the COVID-19 State of Emergency is lifted.  Today's news release provides information for Licensees whose renewal was impacted by Executive Order 20-10 who choose to renew prior to the closing date of the executive order may now do so. Licensees are being notified via postcard when renewal is available. 
  • DHHS issues a Health Alert today related to SARS-CoV-2 variants of concern identified in Nebraska.

3/3/21: DHHS Temporary Rate Increases for Nursing Facility and Assisted Living: DHHS issued a Provider Bulletin yesterday that includes information regarding the $20/day Medicaid increase for NF and AL providers. The increase is for dates of service of 1/1/21 through 6/30/21. Jeremy Brunssen, Deputy Director with Medicaid & LTC, shared that he expects NF claims to be updated this week and that the retroactive claims will process and pay next week. He indicated that the AL claims will take a little bit longer, but he expects they will update in the next 2 weeks with the retroactive claims and will be paid no later than three weeks from now. DHHS MLTC staff are currently working to get the State Plan Amendment submitted, Appendix K updated, and to do the MMIS work to update prospective and retroactive payments. Jeremy said the experience for providers should be very similar to the last round of temporary rate increase payments.

3/3/21: DOL Inspector General Calls for Binding COVID-19 Workplace Standard: The Department of Labor's Inspector General issued a report today that recommends that OSHA improve its inspection strategy by prioritizing very high and high-risk employers for COVID-19 onsite inspections; ensure inspections are tracked retroactive to February 1, 2020; compare remote inspections to onsite inspections; and determine whether establishing an infectious disease specific Emergency Temporary Standard (ETS) is necessary as employees return to worksites.  If OSHA replaces its current guidance (under an executive order) with an ETS, employers would be legally obligated to comply with it.

3/3/21: LTC Financing Reform Proposal: On March 23 from 1:00 - 2:00 Eastern time, Representative Tom Suozzi - and a panel that includes Marc Cohen, Co-Director of the LeadingAge LTSS Center @ UMASS Boston, will discuss the Congressman's WISH Act (Well-Being Insurance for Seniors to be at Home Act) at the monthly meeting of the Long-Term Care Discussion Group. The WISH Act would involve a payroll contribution of .5% to fund catastrophic LTC insurance. The insurance benefit is tied to the individual's lifetime earnings.  WISH envisions that private LTC insurance products would be developed to fill the gap between triggering the need for services and the start of the catastrophic benefit. More information and zoom details are here. No pre-registration needed.

Top 10 Survey Citations (nationally) and Tips for Success (from Janine Finck-Boyle): State survey agencies have resumed annual surveys in nursing homes.  LeadingAge staff analyzed the top 10 findings and deficiencies using the Quality, Certification, and Oversight Reports (QCOR).  While some deficiencies are consistent with past reports there were many differences, including related to new F-tags.  The pandemic has changed the top 10 landscape.  Here is an article on the new top 10 along with tips for success on each one.

3/3/21: Vaccination Toolkit: CDC updated their COVID-19 vaccination toolkit. You can find sample messages and posts for social media outlets about the COVID-19 vaccine.

3/1/21: Information tidbits from the past week (vaccine and non-vaccine related):

  • FACEBOOK LIVE EVENT- Becky Wisell and Dan Taylor with the NE DHHS Licensure area will participate in a Facebook Live event on Thursday, March 4 at noon CT to answer questions for the public (including residents and resident family members) related to visitation, testing, PPE and other matters.  This event is at the request of the LTC associations, in an effort for families to be able to hear directly from the state regulators on these issues.  Please share the link to the event with your residents, resident family members, and others who may be interested in more information on these topics: Facebook.com/NEDHHS.  The event will be recorded and posted to the DHHS site following.  
  • Expiration Dates for Some License Types Extended to June 30-  Nebraska DHHS issued a news release today. On March 27, 2020, Governor Pete Ricketts signed Executive Order 20-10 which suspended several statutes and their implementing regulations from the Uniform Credentialing Act, pushing back the renewal deadline for several licenses until 30 days after the COVID-19 State of Emergency is lifted.  Today's news release provides information for Licensees whose renewal was impacted by Executive Order 20-10 who choose to renew prior to the closing date of the executive order may now do so. Licensees are being notified via postcard when renewal is available. 
  • 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 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 available doses.

3/1/21: LeadingAge asks CMS, CDC, White House to Expand Visitation: The end of last week, LeadingAge (national) sent a letter to the White House Domestic Policy Council, CMS, and the CDC to urge expanded visitation in nursing homes. This letter is available here. They discussed actions that nursing homes are currently taking and can continue to address to make nursing home visitation safe, such as having visitation plans to address core principles of COVID-19 infection control, communicating clearly with residents and families about the realities and risks of visitation during COVID times, and working to increase staff vaccination rates. In turn, they requested federal leadership to make important changes to policies to include ensuring prioritization of nursing homes in the Retail Pharmacy Program for continued vaccine access, removing community prevalence-based (county positivity rate) visitation restrictions, expanding visitation options during outbreak, and utilizing available resources such as continuing to supply point of care testing to nursing homes and allowing for the use of Provider Relief Funds to purchase PPE to help lower transmission risks.  

3/1/21: Essential Caregivers Report: The LeadingAge report on Essential Caregiver programs is available here. For this report, LeadingAge reviewed 17 state programs to identify key components of essential caregiver programs. The report notes similarities, notable outliers, and how it all squares with CMS guidance. The report includes observations in the for who essential caregivers may help bridge the gap between pre-pandemic visitation practices and our current state of social isolation. While essential caregivers existed long before the pandemic, the role has been magnified in a way that it was not before. It will be interesting to see how this role and the associated programs evolve as nursing home visitation edges toward more flexibility.

3/1/21: Long-Term Care Pharmacy Locator: Last Friday evening, the American Society of Consultant Pharmacists (ASCP) posted on their website a map of LTC contracted Federally for vaccine distribution.  This resource is interactive and visual on the ASCP webpage www.ascp.com/CovidvaccineIn addition, ASCP shared the list of LTC pharmacies that have contracted with the federal government to acquire and deliver vaccines and vaccine services in nursing homes, assisted living and other congregate environments. ASCP will update the list and the map daily if necessary to identify pharmacies capable of helping. ASCP warns that these resources do not solve the confusion around state jurisdictions and allocations. It will be necessary to engage states as they release their plans to ensure LTC is not overlooked or saddled with onerous rules and regulations that ultimately block access.

3/1/21: Nebraska Infection Control Citations Data- 3/20 to 1/21: Based on data reported to CMS, Nebraska nursing facilities received 164 Infections Control Citations.  You can see the detail below.

  • Tag 880- 145 citations: Provide and implement infection prevention and control program. 
    • #2 most cited nationally in Jan 2021.
  • Tag 881-4 citations: Implement a program that monitors antibiotic use.
  • Tag 882-5 citations: Designate a qualified infection preventionist to be responsible for the infection prevention and control program in the Nursing Home.
  • Tag 883-1 citation: Develop and implement policies and procedures for flu and pneumonia vaccines.
    •  #7 most cited nationally in Jan. 2021.
    • Make sure that you have policies and procedures in place to ensure that residents are given the opportunity to receive the vaccinations.  If the resident refuses, document refusal and that it was offered and available. 
  • Tag 885- 5 citations: Report COVID 19 data to residents and families.
    •  #8 most cited nationally in Jan. 2021. 
    • Make sure to have policies and procedures in place to ensure that residents and resident's families are being timely notified of positive cases and outbreaks.  Make sure that notifications are implemented in accordance with policies.  

3/1/21: COVID-19 Vaccine Town Hall For Frontline Care Workers - Thursday, March 4 -- 6:00-7:30 p.m. Central: LeadingAge, in partnership with the Black Coalition Against COVID (BCAC), is sponsoring a national town hall with the aging services community to address concerns about the COVID-19 vaccine, particularly among direct care workers. The agenda will feature senior leadership from the White House, Centers for Disease Control and Prevention, Historically Black Colleges and Universities' medical schools, the National Black Nurses Association, and a variety of nationally recognized experts. This town hall is open to anyone regardless position in providing care. This national town hall will be broadcast by blackdoctor.org through its Facebook Live and Youtube streaming services. A link to these sites will be available later this week. Please mark your calendars for Thursday, March 4 -- 6:00-7:30 p.m. CT to take part in this important discussion. 

3/1/21: GOAL: Vaccinating 75% of Nursing Home Staff: LeadingAge joined with AHCA/NCAL and CDC last Thursday in setting a goal of getting to 75% of nursing home staff fully vaccinated by the end of June. Read the press release here. According to CDC's COVID data tracker, we are currently around 50%. We can do this! LeadingAge continues to work with CDC regarding issues of continued vaccine access once the Long-Term Care Pharmacy Partnership wraps up (likely by the end of March) and we transition to the Retail Pharmacy Program for continued access. To address vaccine hesitancy, don't forget about the March 4 Town Hall with Black Coalition Against COVID (BCAC) and check out our LeadingAge Vaccine Information and Resources page.

3/1/21: eople with Dementia are More Vulnerable to COVID-19: Dr. Rebecca Edelmayer from the Alzheimer's Association joined the LeadingAge national Coronavirus Update Call to discuss the findings of a recent study exploring the relationships between dementia and COVID-19 risks, hospitalizations, deaths and disparities. An article summarizing the interview can be found here.

3/1/21: LeadingAge Pandemic Playbook Workforce Chapter Updated: Did you know that the Pandemic Playbook is updated regularly? Check out Chapter 7 for new information on workforce management and support, along with Chapter 9 on psychological wellness of staff and residents. The LeadingAge Pandemic Playbook is a great resource on a number of issues. The playbook is available exclusively to LeadingAge provider members.  

3/1/21: Eviction Moratorium Continues Despite Ruling: On February 25, a federal judge in Texas ruled that the federal moratorium on evictions is unconstitutional. The ruling does not include an injunction; the moratorium for evictions for nonpayment of rent remains in effect. However, the decision will bring additional confusion to renters and landlords like on the issue. An article is here.

3/1/21: FCC Adopts Emergency Broadband Benefit Program Rules: On February 25, the Federal Communications Commission (FCC) adopted a "report and order," the FCC's version of a regulation, to establish program guidelines for the new Emergency Broadband Benefit Program (EBBP) authorized by Congress on December 27. The program will provide up to $50 a month to low income households and up to $75 a month to households on Native American land for broadband service. The EBBP will also provide a one-time discount of up to $100 on a computer or tablet for eligible homes. FCC expects the program to be up and running in the next 60 days. An article is here.