11/16/21: Weekly update: This week in the state of Nebraska and beyond, we are seeing an increase in the surge with COVID-19. A recent meeting of the federal partners with Region VII discussed the significantly increasing activity with cases and hospitalizations throughout the states in our area. The Southwest to northeast United States are seeing a high level of transmission with COVID-19. It appears that Nebraska and other Midwest states are following the same trajectory with confirmed cases and hospitalizations. 

The battle for hospital beds continues to be the unvaccinated. In Nebraska, unvaccinated 30 year olds are filling up hospital beds at the same rate as vaccinated 80 year olds. Nebraska is recording 9,500 tests per day, but that is not increasing as much as the number of new cases per day which currently stands at 940 cases per day with 455 active hospitalizations. Test positivity is increasing and continues to be over the established threshold in Nebraska. The current PCR positivity rate is sitting at 14% across the state. 

We continue to see this increase in the LTC communities across Nebraska. The message today is the importance of boosters. While the primary vaccination series is identified as the primary defense against deadly outcomes of COVID-19, the effectiveness of the primary series is decreasing over time. Data shows that Nebraska has given 190,000 booster immunizations. There are still 80 SNFs that have not been able to provide boosters at this time. ICAP will be reaching out to those facilities to offer assistance and support for getting these completed. The big unknown is among ALFs to know the current number of communities that have not yet provided boosters. If you are in need of assistance with booster clinics, please reach out for assistance. 

This past week came with a lot of information from CMS and even more questions about implementation. Today’s update has a lot of information on these updates as well as useful resources and support for members. Please note below the upcoming meetings today and tomorrow to discuss these new QSO’s in more detail and answer questions from members. Thank you to those that have already reached out with questions or concerns regarding the recent updates. As always, please reach out for any assistance you may need. ~Kierstin

11/16/21: Attorney General Peterson Joins 10-State Coalition in Challenging CMS Vaccine Mandate, First States to File Suit: Posted: Wednesday, November 10, 2021: Today the Nebraska Department of Justice filed its third lawsuit challenging the federal government’s recent attempts to mandate COVID-19 vaccinations. Today’s filing seeks to stop the mandate that the Biden Administration’s Centers for Medicare and Medicaid Services (CMS) seeks to impose on healthcare workers throughout Nebraska—and the rest of the nation. As with the other two challenges, we argue that this healthcare worker mandate exceeds the Biden Administration’s powers and violates both the U.S. Constitution and other federal laws. In preparing this lawsuit, we have talked to many healthcare facilities throughout Nebraska, especially in rural communities, and we have heard the same message over and over again: this mandate will force healthcare providers to fire critical employees, including operations personnel who don’t provide patient care, and that will have a devastating impact on many healthcare facilities in greater Nebraska. That, in turn, jeopardizes the ability of Nebraska residents to access necessary healthcare services throughout the state. The lawsuit asserts that state health officials and local hospital administrators are in the best position to address appropriate COVID-19 issues in Nebraska health care facilities. We hope to avoid the detrimental impact that the mandate threatens to healthcare services in Nebraska.

11/16/21: From McKnight's Senior Living by Kimberly Bonvissuto: Legal challenges aside, senior living operators advised to keep preparing for COVID-19 vaccine mandate

11/16/21: CLICK HERE for a summary of the specific changes articulated in the revised guidance QSO-20-39-NH on nursing home visitation.

11/16/21: CLICK HERE for a summary of the specific changes articulated in the revised guidance QSO-22-02-ALL, providing guidance to state survey agencies (SA) on survey activity.

11/16/21: Nebraska Weekly Data Overview: Nebraska has once again met the threshold for public reporting, which has resulted in the dashboard being added back to the DHHS website. This report is now called “Nebraska Hospital Capacity & Respiratory Illness Dashboard”. Data now includes information on Influenza & RSV in addition to COVID-19. The most recent reporting date as of today is November 8, 2021. All Nebraska Data can be found on the DHHS website at https://dhhs.ne.gov/Pages/default.aspx
Data updated through 11/14/21
11/16/21: All Nebraska Data can be found on the DHHS website for Hospital Capacity at: https://dhhs.ne.gov/Pages/default.aspx
11/16/21: County Statistics for COVID 19 Case Rate Last 14 days can be found at: https://datanexus-dhhs.ne.gov/views/Covid/1_CountyStatisticsMap?%3AisGuestRedirectFromVizportal=y&%3Aembed=y
11/16/21: For Nursing Facility Testing Guidelines, please refer to the new testing guidelines from CMS based on county positivity (QSO-20-38-NH Revised). Each county positivity rate will need to be run separately for the county from the CDC COVID Data Tracker
11/16/21: The Weekly Influenza (Flu) Report - 2021-22 Influenza Season Week 43 is now available: Influenza (Flu) (ne.gov)
11/16/21: This is a very good resource for front line staff- and its FREE!!!  https://icap.nebraskamed.com/project-firstline/

11/15/21: Thank you to LeadingAge Iowa for sharing the following guidance and templates to help with compliance with the revised CMS LTC visitation guidance:

Resident and Family Notification Letter Template

Infographic Summary of Revised Visitation Guidance

Detailed Summary of Revised QSO Visitation Memo

Template Sign for Positive COVID-19 Cases in the Building

11/12/21: CMS Memos:

QSO-20-39-NH Nursing Home Visitation - COVID-19

QSO-22-02-ALL Changes to COVID-19 Survey Activities and Increased Oversight in Nursing Homes

11/10/21: Good COVID resource: List of resources on vaccine mandates: https://docs.google.com/document/d/1jdr616sI97kvZI5OfEuAF-UyOXxiLLmv/mobilebasic

11/2/2021: Health Equity & Quality Management ECHO Project for Addressing COVID-19 Disparities Among High-Risk & Under-served Populations in Nebraska

Topics: Introduction to Health Equity and Quality Improvement

Free Live ECHO Project November 3, 2021 CID 53866

ACTIVITY DESCRIPTION Achieving health equity, addressing COVID-19 disparities, and improving the health of all Nebraskans using a quality improvement approach are the goals for our newly launched educational initiative. This COVID-19-focused health equity and quality improvement educational series will use the ECHO model for training healthcare workers.

TARGET AUDIENCE This live activity is intended for physicians, APPs, nurses, social workers, case managers, and anyone else interested in learning about health equity in under-served populations.

EDUCATIONAL OBJECTIVES At the conclusion of this live activity, the participants should be better able to:

  • Define health equity.
  • Describe the difference between equity and equality.
  • Describe how quality improvement will be integrated into the curriculum for this program.
  • Characterize the historical origins of quality improvement in healthcare and other industries

Additional information can be found here.

11/2/2021: Pervasive staffing shortage poses dilemmas for skilled nursing sector: Staffing shortages have become “pervasive” nationwide since the pandemic began, and the acute shortage of nursing staff and aides in skilled nursing facilities likely has not hit rock bottom yet, National Investment Center for Seniors Housing & Care Principal Bill Kauffman and analyst Omar Zahraoui wrote Friday in a blog post. ‘Pervasive’ staffing shortage poses dilemmas for skilled nursing sector

11/2/2021: Biden Administration looks to speed authorization of rapid coronavirus tests The Biden administration announced additional steps on Monday to increase the availability of rapid at-home coronavirus tests and bring down their cost.

The biggest change is a $70 million investment by the National Institutes of Health — using funds from the American Rescue Plan, which was passed earlier this year — to help manufacturers navigate the Food and Drug Administration’s regulatory process. The NIH program aims to speed up the authorization process for new tests by helping manufacturers produce the data regulators need. It will also identify rapid tests that have the potential to be produced and distributed on a large scale. Biden administration looks to speed authorization of rapid coronavirus tests

11/2/2021: Refugees for LTC Workforce Providers would welcome immigrants, including Afghan refugees, into the long-term care workforce in a show of support to their resettlement efforts. 

“Together, we can ensure our nation’s seniors receive the highest quality care while creating a bright future for our new Afghan neighbors,” Clifton Porter II, senior vice president of government relations for the American Health Care Association/National Center for Assisted Living, said in a statement Wednesday. Provider leaders: Bring On Immigrant Refugees For LTC Workforce

11/2/2021: FDA Authorizes Pfizer-BioNTech COVID-19 Vaccine for Children FDA based its decision on a Phase 2/3 trial that found two doses of the Pfizer-BioNTech COVID-19 vaccine to 90.7% effective in preventing COVID-19 in children aged five to 11. Full Story

11/2/2021: Project Firstline Celebrates One Year Anniversary One year ago this month, CDC’s Division of Healthcare Quality Promotion launched Project Firstline a national training collaborative to increase infection control knowledge and understanding among the frontline healthcare workforce. The program has released a variety of infection control resources specific to COVID-19, including a video series featuring CDC’s infectious disease expert Dr. Abby Carlson, explainer videos on infection control basics, and job aids for on-the-go access. This month, Project Firstline released 4 new training session plans on infection control for COVID-19. Individuals interested in hosting infection control trainings for healthcare now have access to a total of 14 session plans and accompanying PowerPoint decks on COVID-19 infection control topics. Bookmark the Project Firstline website, and follow them on Facebook and Twitter for product releases and program updates. 

11/2/2021: Organizations Join Forces to Launch Resource Center & Fundraising Campaign to Support CNAs in Crisis: Carl Junction, Mo. (Nov. 1, 2021): Certified Nursing Assistants (CNAs) for Quality Care (C4QC) and the National Association of Health Care Assistants (NAHCA) have launched the CNA Resource Center, a service designed to address the ongoing and critical daily needs of CNAs as they contend with longstanding financial hardships exacerbated by the consequences of the pandemic.

CNAs have long endured low pay, poor benefits, and high-stress work. However, they are now struggling with an emotional and physical toll that is likely unprecedented in the history of long-term care. This is made even worse by the fact that many were forced to take unpaid leave if they had COVID or were exposed to it while on the job. Many CNAs now have PTSD, depression, and other conditions and issues—in addition to food insecurity and other challenges—that will linger for years without treatment unless someone steps up to help them.

Both NAHCA and C4QC have worked throughout the pandemic to support CNAs through a range of challenges, such as transportation, childcare, food and housing insecurity, and more. The CNA Resource Center was established to formalize this work and launch a fundraising campaign to support the initiative.

The mission of the CNA Resource Center is to help CNAs find answers, assistance, or resources for support that can help them get through a challenge or crisis. The center is available not just to ease worries and anxiety, but also to keep individuals working while preventing them from losing their homes, going hungry, or suffering in other ways.

“CNAs are struggling, and the pandemic has left us grieving, sick, exhausted, and frustrated,” said Sherry Perry, CNA, chair of the NAHCA Board of Directors. “From widespread PPE shortages and then shutdowns that transformed us into becoming the only link between dying residents and their families during their final moments, we have been deeply affected by our experiences in the trenches of COVID-19.”

Like many professionals working in health care, CNAs have had to be strong and stay focused on patient care, regardless of what is happening in their own lives. As caregivers, they often may hesitate to seek care or help for themselves. Even when they do make the decision to seek assistance, CNAs may not know where to turn. The Resource Center is a one-stop location for all questions big and small that affect their work and personal lives.

“The pandemic may seem like it’s over for some, but it is in no way over for CNAs,” said Lori Porter, CEO of NAHCA and founder of C4QC. “They worked harder than ever as they battled the coronavirus and helped their residents, and many contracted COVID themselves. They are tired and sick and in need of our assistance. We owe it to them to give them support in this time of great need.” Donate to the CNA Resource Center HERE. CNAs who need assistance may contact the CNA Resource Center HERE.


All Nebraska Data can be found on the DHHS website for Hospital Capacity at: https://dhhs.ne.gov/Pages/default.aspx

Updated metrics for COVID-19 Variants of Concern are reported by DHHS every Wednesday. Vaccine Breakthroughs are reported monthly for the previous calendar month. 

County Statistics for COVID 19 Case Rate Last 14 days can be found at https://datanexus-dhhs.ne.gov/views/Covid/1_CountyStatisticsMap?%3AisGuestRedirectFromVizportal=y&%3Aembed=y

For Nursing Facility Testing Guidelines, please refer to the new testing guidelines from CMS based on county positivity (QSO-20-38-NH Revised). Each county positivity rate will need to be run separately for the county from the CDC COVID Data Tracker

This is a very good resource for front line staff- and it's FREE! https://icap.nebraskamed.com/project-firstline/