Category: COVID-19

CMS Releases Revised Guidance on Vaccine Mandate IFR

CMS has released revised interpretive guidance for the COVID-19 vaccine mandate interim final rule (IFR). Three memoranda have been updated, including QSO-22-07-ALL-Revised, QSO-22-09-ALL-Revised, and QSO-22-11-ALL-Revised.
The revisions were made to clarify the expectations for assessing compliance with the requirement to ensure all staff are vaccinated. AHCA/NCAL has highlighted key revisions below, but providers are encouraged to review the Long-Term Care and Skilled Nursing Facility Attachment A-Revised, as well as the applicable memo listed above, for detailed changes.

OSHA Announces COVID-19 Focused Inspection Initiative in Health Care

The Occupational Health and Safety Agency (OSHA) announced a time-limited enforcement effort for focused inspections in hospitals, nursing facilities, and assisted living communities treating COVID-19 patients. The intent of this initiative is to magnify OSHA’s presence in health care facilities over a three-month period (March 9- June 9, 2022) to encourage employers in these industry sectors to take the necessary steps to protect their workers against the hazards of COVID-19.

Inspections will be limited to organizations with prior COVID-19-related citations or complaints. Inspections will focus on correction of prior citations and compliance with existing OSHA standards. More detailed information can be found on the OSHA website. ​​​

Vaccination Tracking and Reporting Tools for Nursing Homes

The Agency for Healthcare Research and Quality (AHRQ) wants to make it easy for nursing homes and skilled nursing facilities to track and report COVID-19 vaccination information. You can find free, one-page forms to record vaccinations and boosters for nursing home residents and staff along with a vaccination tracking tool and a user-guide with step-by-step instructions for using the tracking tool. Facilities reporting data to CDC’s National Healthcare Safety Network (NHSN) can use a pre-programmed Excel workbook. Detailed instructions explain how to enter the data electronically or as a paper tool at the time of injection. Use these tools to update your electronic medical records, respond to potential vaccine data requests from local health departments or other regulatory agencies, and plan based on the vaccination administration status and rates of both residents and staff. These tools are part of AHRQ’s ever-growing Nursing Home COVID-19 Resource Collection.

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CMS Issues Letter on the Importance of COVID-19 Staff Vaccinations

​Today, the Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure issued a letter to health care facility administrators on the importance of COVID-19 staff vaccinations and the current CMS requirements. CMS recommends that facilities review the vaccine rule guidance released on December 28, 2021; January 14, 2022​; and January 20, ​2022 for additional information.

https://www.cms.gov/files/document/health-care-facility-administrator-covid-19-vaccine-letter.pdf

Facing COVID With Creativity,  Connections, and Resilience

​After a devastating storm, the signs of life—children going to school, lights coming on after days of power outages, neighbors talking and laughing—are powerful reminders of people’s resilience and the importance of their connections to each other. Even though the pandemic isn’t completely over, it has led to some changes, innovations, and inspiring stories that should be embraced and remembered moving forward.

One impact of COVID-19 has been a bit of a double-edged sword. The pandemic has shown a spotlight on nursing homes and other long term care facilities. While this has brought some negative and often unfair media coverage, it also presents opportunities.

As James Wright, MD, CMD, a multifacility medical director in Virginia, says, “For a brief period of time, the public was more interested than ever in what goes on in nursing homes, especially with staffing. If we take this interest and harness it into legislative and regulatory changes, we can translate this into better funding and staffing.”

Read more at https://bit.ly/3IUH1RY

Booster Shots for Residents and Staff.

Making sure our residents and staff receive the booster dose against COVID-19 remains the best way to combat the continued spread of the Delta variant and protect one against the eventual spread of the Omicron variant. Each week, more scientific evidence becomes available showing vaccinated people experience waning immunity and we are see increasing breakthrough cases among our residents who have not received the booster. The vaccines and booster are shown to be safe and highly effective, as they dramatically decrease the risk of developing serious illness, hospitalization or death should you have a breakthrough case. ​​
Also, as reminder CMS QSO memo 21-19-NH requires that “all residents and staff be offered each resident and staff member is offered the COVID-19 vaccine unless the immunization is medically contraindicated or the resident or staff member has already been immunized” and before the end of the year will publicly post the rate of booster shots administered in each skilled nursing facility.
Resources to help with resident and staff boosters are available at AHCA/NCAL’s https://getvaccinated.us/

Long COVID: An Emerging Threat

Long COVID—symptoms that drag on long after someone gets ill with the coronavirus—has many in long term and post-acute care experiencing déjà vu. Diagnostic challenges, questions about treatments, and a limited body of research—these are the same issues they faced at the start of the pandemic over a year ago.

However, while there are still questions, providers have learned much from the pandemic that will help centers navigate the challenges of long COVID and implement and sustain standards, processes, protocols, and interventions that maximize outcomes and quality of life for residents with this condition.

Read more by going to https://bit.ly/3lRAwoq

Pandemic Takes its Toll on Sleep

During the pandemic, sleep was in short order for many people. In one survey, 56 percent of U.S. adults said they have experienced more sleep disturbances—ranging from problems falling or staying asleep to having disturbing dreams or nightmares—in the past year and a half. In fact, this has been so common, the phenomenon has been given a name—COVID-somnia.

Pandemic-related sleep issues haven’t discriminated. Young and old people alike report some sleep-related problem. Long term and post-acute care centers not only need to identify and address sleep disturbances in their residents but in their staff as well.

See the full article at https://bit.ly/3DWPXE1

Vaccinations, Visitation, and Vigilance During the Delta Surge

The Delta variant is now the most common variant in the US, making up over 85% of cases, and is two to three times as contagious as prior variants. This is causing a surge in cases in communities across the US, which puts long term care facilities at risk of outbreaks. The Centers for Disease Control and Prevention (CDC) urges healthcare workers to stay vigilant to prevent the spread of the virus and protect staff and residents in long term care facilities.
The CDC recommends staff and visitors take the following steps:
  • Get vaccinated as soon as possible
  • Wear a mask even if you are vaccinated
  • Stay home if you feel ill
  • Get tested if you have COVID-19 symptoms

To maintain compliance with CMS’ QSO memo on visitation 20-39-NH Revised, while ensuring the safety of residents and staff, AHCA/NCAL recommends that nursing homes enact policies that “strongly encourage” (but not require) all visitors to:

  • Be vaccinated;
  • Always wear a mask during the visit; and
  • Have a negative COVID-19 test if the community spread of COVID-19 is moderate to high OR obtain a negative Point of Care test the day of or day before visitation.
Providers may also consider asking residents if they want visitors given the surge in the Delta variant and if they want any unvaccinated visitors or visitors that have not been tested. Residents can put such a requirement in place under their resident rights.
Providers should also continue to strongly encourage vaccinations among staff, using the resources provided through the #GetVaccinated campaign. AHCA/NCAL also hosted a webinar on boosting staff vaccination rates, which is now available on demand.
The CDC also provides the following web resources to help inform and educate about COVID-19, the Delta variant, and vaccination: