COVID-19 UPDATE #96
November 5, 2020
URGENT | ASSISTED LIVING MEMBER CALL WITH HHS AT 1:30 PM TODAY
WHCA has just been informed that Nick Uehlecke, Advisor to HHS Secretary Azar, will be leading a call today with the goal of speaking directly to senior living providers who want to learn more about the CARES Act Provider Relief Fund application and distribution – both Phase 2 and Phase 3. His goal is to walk providers through the HHS application and distribution process and share how they are working through any complications. 

We strongly encourage you to join the call this afternoon, and please share this communication with your staff as needed. This is an exceptional opportunity to speak directly to HHS regarding this process. AHCA/NCAL will share with Mr. Uehlecke ahead of time frequently asked questions they have been receiving, but please bring your questions and concerns as well.

Topic: Provider Relief Fund Deadline Discussion
Time: Nov 5, 2020 04:30 PM Eastern Time (US and Canada)

Meeting ID: 972 5912 1145
Passcode: 845292

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FINAL REMINDER FOR ASSISTED LIVING AND SKILLED NURSING FACILITY COVID-19 VACCINATION PHARMACY PARTNERSHIP SIGN UP
Deadline to Sign Up for the Vaccine Program is Tomorrow! 
The deadline for long term care facilities to sign up for the Pharmacy Partnership for Long-Term Care Program is tomorrow, Friday, November 6. Please don’t wait to register for the federal government’s national vaccine distribution program for long term care residents.  

Nursing homes should register via NHSN. Assisted living communities and other congregate settings should sign up through this online survey. 

A list of those who have signed up was sent to states and chains earlier this week. We understand from the CDC that a few facilities were inadvertently left off that list. Providers are encouraged to verify their sign-up selections as follows: 
  • SNFs can review their data in NHSN by going in through the calendar view.
  • REDCap can be reviewed using the unique code that the facility would have received when initially filling out the form.

If you have any questions, you can email them to eocevent494@cdc.gov. Read more.
DSHS PROVIDES GUIDANCE ON SECURING PPE
All long term care facilities are instructed to purchase necessary personal protective equipment. In the event of an urgent shortage, facilities should notify their local emergency management agency (EMA). If these backup sources cannot fulfill the request, facilities may notify DSHS and request an emergency seven-day supply. Click here for information on contacting your EMA and notifying DSHS and requesting emergency supplies. 
NHSN POC TESTING RESULT CLIA ID NUMBER IMPORTANT FOR SNFs
The American Health Care Association has been notified that a vital component in ensuring that your Point-of-Care Testing Result information is submitted correctly lies within the accuracy of the CLIA identification number listed for the facility in the National Healthcare Safety Network (NHSN) system. Without an accurate CLIA ID number, your facility data cannot be submitted to your state health department.
 
The CLIA ID must fit this format:
  • The first two numbers identify the state the lab in which the lab is located.
  • The third number is the letter “D”.
  • Following are seven more unique numbers.
  • There should be a total of 10 characters/digits for the CLIA ID.

Detailed instructions on completing the Point-of-Care Testing Results tool can be found here. Read more.
NEW UNCERTAINTY ABOUT THE UNCERTAINTY CERTIFICATION: SBA's DRAFT QUESTIONNAIRES FOR PPP LOANS OVER $2 MILLION
*Note: This legal update's publication originates from Bloomberg Tax.
The Small Business Administration (SBA) has released draft questionnaires (one for for-profit businesses and one for non-profit businesses) for use in its review of paycheck protection program (PPP) loan forgiveness applications of PPP loans of $2 million or more. We applaud the SBA for sharing the draft forms because it allows the SBA to receive and consider comments from the public before finalizing. However, these drafts provide troubling insight into the SBA’s approach to its review. Learn more about the background and the Lane Powell analysis of the forms. Many thanks to Lane Powell, a WHCA Affinity Partner, for sharing this article and information. 
JOIN THE NATIONAL NURSING HOME COVID-19 ACTION NETWORK FOR BEST PRACTICES ON CORONAVIRUS CONTROL | COVID-19 ECHO PROJECT
The new National Nursing Home COVID-19 Action Network is recruiting nursing homes from across the country to participate in a virtual online peer community for improving COVID-19 infection control and better protecting residents and staff. In Washington, assisted living communities are also welcome to participate in the Seattle-based effort.
 
The Network is voluntary, and it puts a heavy emphasis on collaboration. Participating nursing homes receive hands-on technical assistance for preventing and reducing the spread of the novel coronavirus—which is even more important now, given that some federal provider relief payments will be tied to improved infection control through the end of the year.
 
Under the Network, training centers across the country will run a 16-week curriculum with cohorts of up to 35 nursing homes. Although each training center starts with a standardized curriculum developed by IHI, it will be updated weekly to reflect new evidence and best practices – and it will be adapted to meet the needs of the local nursing home community. 
 
Using Project ECHO’s “all teach, all learn” guided mentorship model as a foundation, expert teams at each training center will share best practices and use case-based learning to support the on-the-ground efforts of nursing home staff.
 
This program offers a distinctive opportunity for staff to gain access to up-to-the-minute expert guidance on how best to protect residents and themselves from the virus while taking part in a larger community of practice. Participants not only learn alongside their peers but also share their insights with them – and with the expert team.
 
Nursing homes that complete the 16-session training will receive a $6,000 honorarium through the Provider Relief Fund, and staff will earn continuing education units (CEUs) for completing the training. 
 
“Nursing home staff have been called on to bear a tremendous burden – and they need support,” said David Gifford, chief medical officer for AHCA/NCAL. “The Network offers that help, in a non-punitive, collaborative format, so that staff have the knowledge and expertise they need to fight COVID-19 successfully. We urge our nursing home community to take advantage of this unique program.”
 
KEY TAKEAWAYS FROM NURSING HOME QUALITY INCENTIVE PROGRAM METHOLDOLOGY
Under the $2 billion quality incentive payment (QIP) program, eligible facilities will have their performance measured on two outcomes. First, facilities will be judged on their performance on the COVID infection measure (80 percent of total incentive payment). Performance on the infection measure for each facility will be compared to a baseline rate of COVID infection in the county in which a facility is located.
 
Second, facilities with COVID infections will be further judged on their performance on COVID mortality. The mortality measure (remaining 20 percent of payment) will quantify how facilities with COVID infections perform relative to an expected level of mortality, given their number of infections and the demographic characteristics of their residents. Read more to learn about eligibility and exclusion criteria.
OSHA RELEASES COVID-19 RESPIRATORY PROTECTION GUIDANCE FOR LTC EMPLOYEES

In this resource, OSHA reviews requirements around PPE and includes the key elements of the respiratory protection program. The resource includes temporary enforcement discretion related to the respiratory protection standard during COVID-19. Guidance clearly states that for OSHA to exercise enforcement discretion, “employers must demonstrate and document good-faith efforts to comply with OSHA standards.” This includes documenting all attempts to procure required PPE. AHCA/NCAL’s consultants with Littler Mendelson have developed a template respiratory protection program that can be tailored to your organization’s needs. 
Additional OSHA guidance on reporting employee cases of COVID-19 and steps to take when PPE is critically low, including N-95 respirators, can be found on the AHCA/NCAL COVID-19 resource website. Providers can also find updated OSHA guidance on COVID-19 on OSHA’s COVID-19 website.
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.