COVID-19 UPDATE #160
May 26, 2021
CMPs TO START JUNE 14 FOR SNF PROVIDERS
Earlier this month, the Centers for Medicare & Medicaid Services (CMS) published an Interim Final Rule on COVID-19 Vaccine Requirements. This rule applies to residents, clients, and staff of Skilled Nursing Facilities (SNF) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID). CMS also published a QSO memo to state survey agencies on how to operationalize this new requirement. The rule was scheduled to go into effect on May 21, 2021. However, CMS has publicly stated that it will not enforce compliance until June 14, 2021. 

The American Health Care Association and National Center for Assisted Living (AHCA/ NCAL) recommends that facilities implement several important steps before June 14 to ensure compliance with this new requirement. Read more.
INSLEE SIGNS SB 1236 IMPLEMENTING CHANGES TO WASHINGTON'S RESIDENTIAL LANDLORD TENANT ACT
On May 10, 2021, Governor Inslee signed SB 1236 into law. This new statute implements changes to Washington’s Residential Landlord Tenant Act in conjunction with other tenant protections that have been enacted in the wake of COVID-19. This law will affect only independent living residents – assisted living, memory care, and skilled nursing are not covered.

Most importantly, the new law prohibits a landlord from terminating a tenancy without cause. Whereas before, a residential landlord could end a month-to-month tenancy without cause with 20 days notice, SB 1236 limits landlords to certain enumerated reasons, including nonpayment, waste or nuisance, or habitual violation of lease or community rules. Communities seeking to terminate independent living residencies will need to make sure that their documentation and notices comply with the new provisions.

Remember, the COVID-19 eviction moratorium is still in effect until June 30, 2021, and the provisions of SB 1236 are in addition to the restrictions in the moratorium. We want to thank Abe Lorber of Lane Powell PC for this information. 
BUILDING VACCINE TRUST AND INCREASING RATES AMONG CNAs
Download the new, research-based guide and toolkit that speaks directly to the challenges nursing homes have expressed about the COVID-19 vaccine. Created by the Center for Public Interest Communications for the AHRQ ECHO National Nursing Home COVID-19 Action Network, it offers practical tools for building vaccine confidence in nursing homes. Read more.
MASKS ARE STILL MANDATORY IN NURSING HOMES AND OTHER CARE FACILITIES
The Centers for Disease Control and Prevention recently announced people who are vaccinated against COVID-19 no longer need to wear a mask indoors or outdoors. That does not include medical or long term care facilities, adult family homes, and other nursing and residential care facilities.

Here is a list of resources to help employers and workers make sure they’re wearing respirators the correct way and in the right situations.
DEAR PROVIDER LETTER SHARES INTERIM FINAL RULE FOR COVID-19 VACCINE IMMUNIZATION REQUIREMENTS FOR RESIDENTS AND STAFF IN SNFs AND ICF/IIDs
In a Dear Administrator letter dated May 20, 2021, skilled nursing and ICF/IID providers are informed on May 11, 2021, with QSO-21-19-NH, the Centers for Medicare and Medicaid Services (CMS) announced the update of nursing home and intermediate care facilities for individuals with intellectual disabilities (ICF/IID) regulations to establish facility requirements for COVID-19 immunization. The interim final rule, CMS-3414-IFC adds requirements for nursing homes at 42 CFR 483.80 and for ICF/IID at 42 CFR 483.460. A comment period about the rules is open for 60 days after the rule is published. The new requirements for both settings are related to:
  • Educating residents/clients or their representatives, and staff regarding the benefits and potential side effects associated with the COVID-19 vaccine in a manner they can understand;
  • Offering the vaccine; and
  • Documentation for staff and residents/clients about the education, the decision to accept or decline the vaccine, contraindications to the person receiving the vaccine, and administration of the vaccine, if applicable.
  • If a staff member is not eligible for COVID-19 vaccination because of previous immunization at another location or outside of the facility, the facility should request vaccination documentation from the staff member to confirm vaccination status.

Additionally, for nursing homes, there are new requirements to report COVID-19 vaccine and therapeutics treatment information to the National Healthcare Safety Network (NHSN), a division of the Centers for Disease Control and Prevention (CDC). 

Effective Dates and Enforcement
The rules are effective May 21, 2021. However, CMS has allowed nursing homes additional time to begin the immunization reporting requirements, and facilities have until June 13, 2021, to report their immunization data to NHSN. CMS will begin reviewing reporting data on June 14, 2021.

For nursing homes, noncompliance related to the new requirements for educating and offering COVID-19 vaccination to residents and staff will be cited at F-tag 887. CMS will update tools used by surveyors to assess compliance with these new requirements (Survey Resources), including CMS-20054, “Infection Prevention, Control & Immunizations” pathway.

Reporting Requirements for Nursing Homes
The QSO memo has more information about the reporting requirements, and lists NHSN resources. RCS will release additional information about available reporting methods in a Nursing Home Administrator letter shortly.

If providers have questions, they are encouraged to email Lisa Herke, Nursing Home Policy Manager, or call her at (509) 209-3088.
DEAR PROVIDER LETTER PROVIDES UPDATE ON PASRR RULES
In a Dear Administrator letter dated May 19, 2021, skilled nursing providers are informed that Residential Care Services (RCS) filed a new CR-103E (WSR 21-11-018) on May 10, 2021, that maintains the amendments for the PASRR rules and the rule related to participation in resident and family groups. This emergency rule expires September 7, 2021. The cancelation of the emergency rules in WSR 21-08-055 and the filing of emergency rules in WSR 21-11-018 modified the following WACs:
  • WAC 388-97-0120: Cancellation of WSR 21-08-055 reinstated the requirement to provide a bed-hold notice to a resident who leaves the facility.
  • WAC 388-97-1000: Cancellation of WSR 21-08-055 reinstated the timeline requirements in the required resident assessment.
  • WAC 388-97-1020: Cancellation of WSR 21-08-055 reinstated the requirement to develop a care plan within seven days of completion of the resident assessment.
  • WAC 388-97-1915 and 388-97-1975: With the filing of WSR 21-11-018, the amendments permitting the level I PASRR screening, and if needed, the level II evaluation to occur up to 30 days after admission remain in place.
  • WAC 388-97-0920: With the filing of WSR 21-11-018, this WAC, which is related to resident and family groups, remains repealed.

Providers are encouraged to email Lisa Herke, Nursing Home Policy Program Manager, or call her at (509) 209-3088. 
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.