COVID-19 UPDATE #94
October 29, 2020
IMPORTANT NHSN INFORMATION: TRAINING WEBINARS RESCHEDULED, NEW REQUIREMENTS TO REPORT POC ANTIGEN TESTS, AND SNFs MUST UPGRADE TO SAMS LEVEL-3 ACCESS
NHSN Training Webinars Rescheduled
We have just received updated information on the two rescheduled training opportunities for the new NHSN Long Term Care Facility COVID-19 Pathway laboratory data reporting option. Please note that advance registration is required. The webinar being offered on October 30 is full, but you can register for November 2.

The NHSN team will introduce and provide training for a new NHSN Long Term Care Facility COVID-19 Pathway laboratory data reporting option. The October 30 training will be live and allow for submission of audience questions. The November 2 training will be a rebroadcast of the recorded training followed by a live Q & A session. A recording of the original webinar will be posted for online viewing. 
 
  • October 30 | 11 AM PST | FULL
  • November 2 | 9:30 AM PST | Register Here

New Requirements to Report POC Antigen Tests to NHSN
As reported last week, HHS is now requiring facilities to report the point-of-care (POC) test results performed under their CLIA waiver to the NHSN system, which requires an upgrade to SAMS Level-3 access. We received clarity from CMS that this requirement only applies to skilled nursing facilities and not assisted living communities. Assisted living communities can still report to either the state or NHSN to meet the POC test reporting requirement. More information is available here. 

SNFs Must Upgrade to NHSN SAMS Level-3 Access to Meet CLIA Reporting Requirements
Skilled nursing facilities are now required to report point-of-care (POC) test results performed under their CLIA waiver to the National Healthcare Safety Network (NHSN) system. More information is available here. 

This requires an upgrade from SAMS Level-1 access to SAMS Level-3 access. Centers should take action immediately as this process can take up to four weeks. While this requirement is in effect now, we have been told that enforcement discretion will be utilized until November 20. Instructions on upgrading to SAMS Level-3 are available here. 

Assisted living communities can still report to either the state or NHSN to meet the POC test reporting requirement. However, if they choose to use NHSN, they must upgrade to SAMS Level-3. Read more.
PROCESS FOR EMERGENCY PPE PROCUREMENT
As Washington enters autumn, it is already apparent the “fall surge” has begun. COVID numbers are increasing across the state exponentially. It is crucial now more than ever to ensure that each facility has an adequate supply of PPE on hand whether or not they are experiencing an infectious disease outbreak. The State Department of Health released guidelines for PPE allocation. These guidelines elevate long term care facilities without a case to the Tier #1 category and define long term care facilities as including nursing facilities, assisted living facilities, adult family homes and supportive living providers.

To request PPE from the local emergency health jurisdiction, facilities should complete the 213 RR Emergency Supply Request form and submit the request. For those facilities in King County, complete this one and send your request via email.

To ensure your facility receives Tier 1 priority allocation, please include the following wording in the request, “for the protection and mitigation in confirmed or suspected COVID positive management in a long-term care facility.” Also, the following information will assist in disbursement of your PPE request:
  • Clearly communicate what usage status your facility is in: a. crisis, b. contingency, or c. conventional use
  • Number of days of PPE you have on hand per item
  • Burn rate. If a provider is using their N95 for days or weeks at a time, then clearly communicate that, otherwise it misrepresents the burn rate. Example: if the real burn rate is 1 mask every 3-4 days and you have 100 on hand, it looks like you have plenty of masks to cover your needs.
  • Please ask for specific brands/models of a mask if you have a preference, even if it is not available in inventory, the LJH will use the requestor's data to help drive future procurement. Without a demand signal, items can't be purchased beyond what is already in inventory.
  • If you want a specific brand, but will take an in-lieu of item please identify that in your request to your county.

DSHS also has limited supplies of PPE. You can order them through the online store; although, there is no guarantee that you will receive the items ordered and this should be used as a backstop if other channels of PPE procurement are not available. If you have questions, please contact Vicki McNealley or Elena Madrid.
WORK UNDERWAY TO UPDATE THE AL AND SNF SAFE START PLANS SPECIFIC TO VISITATION
WHCA is working closely with DSHS, DOH, the Ombuds office, LeadingAge Washington, and the local health jurisdictions to make necessary updates to the Safe Start for Long Term Care plan. The focus is updating visitation in order to accommodate the changing weather. This workgroup must come to consensus, with a deadline of mid-November to get recommendations to the Governor’s office.

For now, the current Safe Start for Long Term Care plan remains in effect. There are options specific to outdoor visits that you may find useful in promoting resident-family visits. DSHS is finalizing an outdoor structure guidance; once that document becomes available, we will share with members.
LTC VACCINATION PROGRAM DEADLINE EXTENDED TO NEXT FRIDAY | APPLIES TO ASSISTED LIVING AND SKILLED NURSING CENTERS
The deadline for long term care facilities to sign up to participate in the Pharmacy Partnership for Long-Term Care Program has been extended to Friday, November 6. Please don’t wait to register for the federal government’s national vaccine distribution program for long term care residents.

Long term care facilities must register with the CDC on how they want to receive and administer the COVID-19 vaccine when it becomes available. Nursing homes register via NHSN, while assisted living communities and other congregate settings sign up through an online survey. Read more.
WEBINAR NOW AVAILABLE: OVERVIEW OF SNF 3-DAY STAY AND BENEFIT PERIOD WAIVERS
In response to the declaration of the COVID-19 national public health emergency (PHE), the US Department of Health and Human Services (HHS) issued a nationwide blanket waiver of the 3-day prior hospitalization and 60-day break in benefit period requirements to qualify for skilled nursing Part A benefits effective March 1, 2020. The PHE was recently renewed and will apply until at least January 20, 2021.

The American Health Care Association (AHCA) hosted a webinar and accompanying fact sheet providing a brief overview of the background of these important waivers. They also provided specific details about when and how it would be appropriate for SNFs to apply the waivers to assure that Medicare beneficiaries are able to access skilled nursing Part A benefits in a manner that also minimizes risks for unnecessary exposure or transmission of the COVID-19 virus. Read more.
ADDITIONAL RESOURCES
WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.