Coronavirus Update #164
Updates from AHCA/NCAL, CMS, HHS, and here in Maryland
Friends,

Please read through this email for additional updates from our partners at AHCA/NCAL. It has been a full day, both in DC and here in Maryland. 

Summary on the DC Front (see links & more info below)



  • AHCA released
  • Results of the survey on false positives among BD and Quidel suggest false positive are at the expected rate when testing lots of people
  • Clarification that Abbott invoices were an error and facilities do NOT need to pay

Here in Maryland

  • We continue to communicate with the state on updated guidelines
  • We are pushing for the last nine centers in Maryland to complete their MDH POC Surveys
  • I did an interview with Jayne Miller from WBAL and with the Sun on testing
  • We are reviewing the 600 page CMS Commission Report
  • And we are navigating other critical issues around government relations

You continue to save lives, and we are telling your story. Finally and as always in this critical time coming off of Labor Day:

  1. Our sector MUST double our efforts on infectious disease protocol, staffing, PPE, and testing. I am proud of all you are doing, we have to double down and prove we are on top of this.
  2. Train, train, and train teams again on infectious disease protocol.
  3. Recognize that COVID-19 fighting fatigue is an issue across the county, not just in our sector.
  4. Over-communicate with residents, patients, families, staff, and government partners; and work with your hospital partners, and coordinate with local and state regulatory partners.
  5. Know that MDH and the state of Maryland are working with HFAM and the other associations looking for member-helping-member models going forward, stay tuned.

We were fortunate to have recorded a video with Dr. Morgan Katz to talk about PPE, testing, and to offer reassurance to our teams providing care. Morgan Katz, M.D., MHS, is an Assistant Professor of infectious disease at Johns Hopkins Hospital. Her research has been devoted to making infection prevention practices feasible and effective in the long-term care setting. At the beginning of the pandemic, she was named the long-term care incident commander for the COVID-19 response in the Johns Hopkins Health System and served on the Maryland state strike team to provide testing, cohorting, and infection control guidance to facilities across Maryland. CLICK HERE for the Dr. Katz Video and please see the Donning and Doffing Checklist we first distributed a couple of months ago.

Be well,
Joe DeMattos
President and CEO
CMS Memo on Nursing Home Visitors

CMS today released a new QSO memo (20-39-NH) that greatly improves the ability for nursing home residents to receive visitors. In short, it allows for more outdoor and indoor visits, including parameters where indoor visits are required to be permitted. CMS also announced that they will allow for CMP funds to be used to help visitation through the purchase of tents and clear barriers (e.g., Plexiglas). Click here to read more.
CMS Clarification of Data Release Schedule

Data on county positivity will be release weekly by CMS, which will not always be on the same day. The will continue to modify and update the method to classify a county as green, yellow or red (facility need to use the color code) or they can also use data on test positivity rate from their state or local health department if its from a time period that is more recent than CMS data. Members need to have a plan and process to check the CMS data weekly. It does NOT need to be checked more often and changing the frequency of testing only needs to happen when they check not immediately after CMS updates the data. They just need to have a process to check at least every 7 days. A provider just needs to change testing the next time they have self-scheduled themselves to check, but doesn’t preclude them from checking sooner and changing based on that check.
Additional Details on Nursing Home Incentive Payment Program Released

Today, HHS released additional information on how $2 billion in incentive payments will be distributed to nursing homes under the CARES Act. Here is a summary of those details. Read More
An Update on Potential “False Positive” Tests – Differences Between Antigen and PCR Tests

Starting last week, we heard concerning reports of differences between the antigen tests and PCR confirmation test results (e.g. potential false positives) from the antigen testing machines HHS has sent to nursing homes. To better understand what’s going on across the country, AHCA and Leading Age collaborated on a survey to understand the use of the BD Veritor and Quidel Sofia-2 Antigen Point of Care analyzers in member communities.  Read More
Update to Paid Leave of the Families First Coronavirus Response Act

On Friday, September 11, the U.S. Department of Labor (DOL) issued an update to the temporary rule they issued in April regarding coronavirus leave. This update changes the definition of health care workers. Employees defined as health care workers are not required to have paid sick leave and extended family and medical leave under the Act. Other employees of providers are required to have paid sick leave and expanded family and medical leave. Read More 
Reminder: Great News on Testing for AL and SNFs
Abbot Webinar with Details Announced

Through our partners at AHCA/NCAL, we learned today that this week the Department of Health and Human Services (HHS) will be sending 1 million Abbott BinaxNOW™ test kits to skilled nursing facilities and 540,000 test kits to assisted living communities certified by the Centers for Medicare & Medicaid Services (CMS) with a Clinical Laboratory Improvement Amendment (CLIA) Certificate of Waiver.  

You are invited to a webinar on Friday, September 18 at 12:00 pm ET with HHS and Abbot to get more information on the tests themselves, including training, and use in assisted living facilities. During the webinar, Abbott will demonstrate the training tools available and representatives from the U.S. government will be online to speak about the program. 
Our understanding is that HHS will ship test kits to all ALs with CLIA Certificates of Waiver this week to be used for residents and staff. Kits will also be sent to some SNFs for use with staff. Replenishment of kits will be weekly thereafter with enough kits varying by the county the facility is located in, and based on the CMS ratings for COVID-19 test positivity in that county (red, yellow or green). HHS has also provided a training portal here. 

We have also heard that some providers have received an invoice from Abbott. AHCA/NCAL confirmed with Abbott yesterday that these were sent in error and you do NOT need to pay these invoices. Similarly, some members received information about “shipping specifications” that also include an error that they would be receiving large pallets of test kits. The amount of test kits will be based on estimates of the number of residents and staff you have in your facility and to last you for 1-2 weeks until the next shipment arrives
Did you miss HFAM's previous alerts?

Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
Thank you.

We cannot thank you enough for the dedication and diligence in doing all that you can for the residents in your communities. HFAM continues to monitor the COVID-19 pandemic with our state and national partners and will do all we can to support you during this time.