COVID-19 UPDATE #77
September 7, 2020
CMS TO HOST COVID-19 NATIONAL NURSING HOME CALL SEPTEMBER 8
The Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma and Administration officials are hosting a National Nursing Home COVID-19 call on Tuesday, September 8 from 3:30 – 4:30 PM PST. The speakers will include:
  • Seema Verma, Administrator, CMS
  • Robert R. Redfield, MD, Director, CDC
  • Admiral Brett P. Giroir, MD, Assistant Secretary for Health, HHS
  • Lee Fleisher, MD, Chief Medical Officer, CMS
 
You can join the call via webcast as phone lines are limited. If you prefer trying to call in, you can dial (833) 614-0820 and use conference ID 6353368.
CMS POSITIVITY RATES IMPACT TESTING REQUIRMENTS IN SKILLED NURSING
Be sure to check positivity rates and begin testing as required.
As outlined in CMS QSO 20-38, skilled nursing facilities should begin testing all staff at the frequency prescribed in the Routine Testing table (below) based on the county positivity rate reported in the past week. Facilities should monitor their county positivity rate every other week (e.g., first and third Monday of every month) and adjust the frequency of performing staff testing according to the Routine Testing table.
  • If the county positivity rate increases to a higher level of activity, the facility should begin testing staff at the frequency shown in the table above as soon as the criteria for the higher activity are met.
  • If the county positivity rate decreases to a lower level of activity, the facility should continue testing staff at the higher frequency level until the county positivity rate has remained at the lower activity level for at least two weeks before reducing testing frequency.

The guidance above represents the minimum testing expected. Facilities may consider other factors, such as the positivity rate in an adjacent (i.e., neighboring) county to test at a frequency that is higher than required. For example, if a facility in a county with a low positivity rate has many staff that live in a county with a medium positivity rate, the facility should consider testing based on the higher positivity rate (in scenario described, weekly staff testing would be indicated).

In that today is the first Monday of the month, WHCA is urging providers to check county positivity rates and ensure you are testing according to the frequency outlined in the Routine Testing table.
AHCA DEVELOPS FAQs ON COVID-19 TESTING REQUIREMENTS IN SKILLED NURSING
The American Health Care Association (AHCA) has developed a document that includes frequently asked questions (FAQs) and quick links to resources available to help nursing home providers navigate the COVID-19 testing requirements in nursing homes. The document includes information on the following:
  • Types of Tests and Turnaround Times
  • Routine Testing Requirements
  • Outbreak Testing Requirements
  • Find a Vendor for Testing
  • Rapid Antigen POC Test Devices
  • Specimen Collection
  • How to Report Results
  • How to Document Results
  • Staff Refusals
  • Reimbursement for Testing
  • Clinical Considerations
  • Links to Additional Resources
DEAR ADMINISTRATOR LETTERS KEEP PROVIDERS INFORMED
In a Dear Administrator letter to assisted living providers dated September 2, 2020, the Department of Social and Health Services (DSHS) shares notification of a CR-101 filed to propose amending sections of Chapter 388-78A Washington Administrative Code (WAC) including -2524(1), -2525(1), and -2526(1) sections. The letter includes a link to the proposed rule language on the Aging and Long-Term Support Administration (ALTSA) website under “Assisted Living Facility Rule Filings.”
 
Another Dear Administrator letter to assisted living providers dated September 2, 2020, provides information on the filing of CR-103E to extend emergency rules in Chapter 388-78A WAC. The original emergency rules suspended administrator training requirements in WACs 388-78A-2524(1), 2525(1), and 2526(1). The current emergency rules extending the suspension of the administrator training requirements expire December 18, 2020. They are published in WSR 20-18-001.
 
In a Dear Administrator letter to skilled nursing providers amended September 2, 2020, an update on NHSN and the state reporting portal for COVID-19 data is provided. The amended section provides additional questions as of August 31, 2020, and provides a link to complete instructions for NHSN COVID-19 data reporting.
LABORATORIES WITH POTENTIAL FOR COVID-19 TESTING IN NURSING HOMES
We have heard from some providers that finding laboratory services with a 48-hour turnaround time is challenging. In collaboration with the Department of Social and Health Services (DSHS), we have obtained a list of laboratories that may be able to meet the 48-hour turnaround time. DSHS has asked us to share this information with providers to help provide options for meeting the new testing criteria.
DOH CONTINUES TO HOST WEEKLY CALL FOR LTC PROVIDERS
Leaders and experts from the Department of Health continue to host a weekly call specifically for long term care providers. You are invited to join the call each Thursday at 11:00 AM to learn more about the state and local health jurisdictions’ response to the COVID-19 pandemic as well as to ask questions you might have. The next call is this Thursday, September 10. Register in advance if you wish to attend.
WA-PALTC TO HOST WEBINAR ON COVID-19 AND INFLUENZA
The Washington Society for Post-Acute and Long-Term Care Medicine (WA-PALTC) invites you to join a webinar titled, COVID-19 and Influenza “Twindemic” – How do we prevent it? How do we deal with it? The webinar will be hosted on Wednesday, September 9, at 6:00 PM. Presenters will include Michael Myint, MD, Infectious Disease and Epidemiology, MultiCare Connected Care at MultiCare Health System, Jessica van Fleet-Green, MD, CMD, Board Member, WA-PALTC, and Sabine von Preyss-Friedman, MD, CMD, WA-PALTC. Click here to register.
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.