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Virtual Spring Conference Live Session Schedule:
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May 14th @ 10 AM:
Results of Wisconsin Study on Light's Effect on the Elderly
May 14th @ 1 PM:
Common ICD-10 Coding Errors and the PDPM Impact
Don’t worry, if you are unable to attend a live session, it will be recorded and added as an on-demand session, that you may view in accordance with your own schedule.
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COVID-19 Updates: May 13, 2020
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This update includes:
- DHS Goes Live with Listing of Nursing Homes with Active Public Health Investigations
- Nation Favors More COVID-19 Support for Nursing Centers, Assisted Living
- CMS Issues Nursing Homes Best Practices Toolkit to Combat COVID-19
- Senators Call For $2 Billion In New Federal Funding To Help Health Care Providers Expand Telehealth Services During Pandemic
- DHS Memo: "Opportunity to Test Nursing Home Residents and Staff"
- Facility Location Determines COVID Outbreaks, Researchers Say
- Thursday Long-Term Care Webinars – COVID-19 Testing for All Residents and Staff in Wisconsin’s Nursing Homes
- COVID-19 Webinar for Health Care Providers: Friday, May 15, at 7 a.m.
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As of today, there are 10,902 confirmed cases of COVID-19 in the state of Wisconsin and 421 deaths caused by the virus. Click
HERE
to view the latest outbreak information from the Wisconsin Department of Health Services. Click
HERE
to view COVID-19 projections for Wisconsin and the United States.
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DHS Goes Live with Listing of Nursing Homes with Active Public Health Investigations
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Earlier today, the Wisconsin Department of Health Services released the names of skilled nursing facilities with active COVID-19 facility-wide public health investigations. As of May 13, 2020, there are 38 nursing homes with active public health investigations. Click
HERE
to view the listing.
“As we continue to see cases of COVID-19 in nursing homes, it is important to be transparent and list the locations where they are occurring,” said DHS Secretary-designee Andrea Palm. “We have opted to publish the names of nursing homes in order to provide peace of mind to families who cannot visit or check on their loved ones during these unprecedented times. We are grateful for all the important work that nursing homes are doing to prevent spread and the proactive steps they have taken to facilitate communication among families, loved ones and the residents in their care.”
WHCA/WiCAL has continued to raise concerns about the new public disclosure policy. In a
letter
sent on May 6, WHCA/WiCAL and LeadingAge Wisconsin expressed concerns to DHS Secretary-Designee Palm and Governor Evers.
Concerns raised in the letter included:
- A lack of provider input before the decision was made to create this new disclosure policy
- Resident privacy issues
- Unfairly targets nursing homes and does not include other health settings
- The public naming of COVID-positive facilities is a de facto public shaming of these facilities
- Facilities will be more reluctant to accept new admissions from hospitals for fear of a stigma associated with having COVID in the building
- There is a lack of a compelling public health interest for this proposed policy
The letter also discussed providers' ongoing request to have additional state funding to help nursing homes deal with the extra costs associated with preventing/minimizing COVID in a building. If the department is going to publicly name facilities with COVID, then the state should also be helping to reduce spread through adequate resources for facilities. The letter discussed the current financial insecurity of many facilities, and emphasized that the COVID crisis has made financial situations worse, requiring state assistance.
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Nation Favors More COVID-19 Support for Nursing Centers, Assisted Living
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A new national
survey shows that a vast majority of U.S. voters believe long term care facilities, including nursing centers and assisted living communities, need more support from the government to battle COVID-19, and the lack of funding thus far to purchase personal protective equipment (PPE) and boost testing has negatively impacted their ability to protect seniors.
Voters asked in the survey said by a three-to-one margin that nursing facilities and assisted living communities need more money for PPE, staff, and testing capabilities. The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) commissioned the national survey conducted on May 6-9 among 1,500 U.S. registered voters by GS Strategy Group.
“By an
overwhelming margin, U.S. voters want the government to provide long term care facilities with the same level of support as hospitals, including more than 80 percent of those over 65-years-old supporting an additional $10 billion in funding for long term care facilities to provide additional PPE, staff, and testing to residents,” according to the survey.
Mark Parkinson, president and chief executive officer, AHCA/NCAL, said the survey shows that Americans are deeply concerned about the impact of COVID-19 on long term care facilities and want their government leaders to rally around nursing facilities and assisted living communities.
“The American people want federal and state leaders to rally around nursing home and assisted living residents the same way we have around hospital patients and workers,” Parkinson said.
“They understand this is an unprecedented health crisis requiring significant funding to protect residents and caregivers. That’s why eight out of 10 voters support our
request for the federal government to provide $10 billion in emergency funding for expanded testing, PPE supplies, and additional staffing. Long term care providers can also be part of the solutions as the country recovers from the impacts of COVID-19, but we need the tools to do so.”
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CMS Issues Nursing Homes Best Practices Toolkit to Combat COVID-19
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Today, under the direction of President Trump, CMS released a new
toolkit developed to aid nursing homes, Governors, states, departments of health, and other agencies who provide oversight and assistance to these facilities, with additional resources to aid in the fight against the coronavirus disease 2019 (COVID-19) pandemic within nursing homes. The toolkit builds upon previous actions taken by the Centers for Medicare & Medicaid Services (CMS), which provide a wide range of tools and guidance to states, healthcare providers and others during the public health emergency. The toolkit is comprised of best practices from a variety of front line health care providers, Governors’ COVID-19 task forces, associations and other organizations, and experts, and is intended to serve as a catalogue of resources dedicated to addressing the specific challenges facing nursing homes as they combat COVID-19.
“The coronavirus presents a unique challenge for nursing homes. CMS is using every tool at our disposal to protect our nation’s most vulnerable citizens and aid the facilities that care for them. This toolkit will support state, local leaders and nursing homes in identifying best practices to protect our vulnerable elderly in nursing homes” said CMS Administrator Seema Verma.
The toolkit provides detailed resources and direction for quality improvement assistance and can help in the creation and implementation of strategies and interventions intended to manage and prevent the spread of COVID-19 within nursing homes. The toolkit outlines best practices for a variety of subjects ranging from infection control to workforce and staffing. It also provides contact information for organizations who stand ready to assist with the unique challenges posed by caring for individuals in long-term care settings. Each state was involved in the creation of this toolkit, resulting in a robust resource that may be leveraged by a variety of entities serving this vulnerable population.
Additionally, CMS has contracted with 12 Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) to work with providers, community partners, beneficiaries and caregivers on data-driven quality improvement initiatives designed to improve the quality of care for beneficiaries across the United States. The QIN-QIOs are reaching out to nursing homes across the country to provide virtual technical assistance for homes that have an opportunity for improvement based on an analysis of previous citations for infection control deficiencies using publicly available data found on Nursing Home Compare.
This effort augments CMS Administrator Seema Verma’s
five-part plan to ensure safety and quality in America’s nursing homes, which was announced in April 2019, and recent agency efforts to combat the spread of COVID-19 within these facilities. Since February, CMS has taken unprecedented action to address COVID-19 within nursing homes. On
February 6, CMS took action to prepare the United States for COVID-19 by reissuing longstanding infection control guidelines. CMS then moved quickly to address the rapid spread of infection by issuing guidance on new
screening processes for facilities, on the use of
personal protective equipment (PPE), and on
temporary restrictions on non-essential medical staff and visitors in March. CMS immediately followed these actions by
prioritizing inspections to conduct targeted surveys for infection control and complaints triaged at the Immediate Jeopardy level.
The Agency also issued a
call to action for nursing homes and state and local governments as a means of reinforcing infection control responsibilities and urging leaders to work closely with facilities to determine needs for testing and PPE. Recently, CMS announced
payment increases for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases. Finally, CMS will now require nursing homes to
report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC) and inform residents and their families and representatives of COVID-19 cases within their facilities in an effort to improve transparency.
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Senators Call For $2 Billion In New Federal Funding To Help Health Care Providers Expand Telehealth Services During Pandemic
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On May 11, U.S. Senator Brian Schatz (D-Hawai‘i) led a bipartisan group of senators to urge the leadership of both the Senate and House of Representatives to include $2 billion in the next coronavirus relief package to help health care providers expand telehealth services by improving their access to broadband. “The coronavirus pandemic has dramatically increased the need to expand telehealth,” the senators wrote in a letter to Senate Majority Leader Mitch McConnell (R-Ky.), House Speaker Nancy Pelosi (D-Calif.), Senate Minority Leader Chuck Schumer (D-N.Y.), and House Minority Leader Kevin McCarthy (R-Calif). “It is imperative that Congress act to ensure our front-line responders have the tools they need to combat this deadly virus.”
The Schatz press statement noted that, “Telehealth allows health care providers to treat patients safely without putting themselves or their patients at risk of contracting COVID-19 and has been recommended by the Centers for Disease Control and Prevention. However, many providers – especially in rural and hard-to-reach communities – lack the resources to handle this increase in demand for telehealth services. The senators are calling for $2 billion in additional funding to the Rural Health Care (RHC) Program, the only federal program that supports broadband deployment at urban and rural health care provider locations. These new funds would expand the RHC Program to support non-rural and mobile health care providers, eliminate administrative red tape slowing down the process of obtaining broadband connectivity, and provide more resources to help providers increase their broadband capacity.”
As noted in previous AHCA communication, AHCA supported H.R. 6474, the Healthcare Broadband Expansion During COVID-19 Act, which is a bipartisan bill to provide $2 billion to expand telehealth and high-quality internet connectivity at public and nonprofit healthcare facilities, including mobile clinics and temporary health facilities deployed to respond to the coronavirus pandemic. The House Health Subcommittee Chairwoman Anna G. Eshoo (D-CA) and Representative Don Young (R-AK) introduced this legislation.
Further information on this issue, including the Senate letter noted above, can be found
here.
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DHS Memo: "Opportunity to Test Nursing Home Residents and Staff"
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The DHS Division of Quality Assurance shared the below message to their listserv. Please note: WHCA/WiCAL is sharing this message now for informational purposes, but we have been in contact with DHS to provide additional clarification on what this testing program will look like both in the short-term and the long-term. We expect some additional clarity during tomorrow's 11 am webinar (see below for that information as well).
In appreciation and support of the challenging work you do every day to protect some of our most vulnerable individuals, Wisconsin is moving forward with a plan to test every nursing home resident and staff member in the state for COVID-19 by the end of May.
This testing is necessary because growing evidence suggests that persons with COVID-19 become infectious days prior to developing symptoms, and many develop only mild symptoms or no symptoms at all. This means that in congregate living settings like nursing homes where physical distancing is difficult to maintain, moving beyond only symptom-based screening is unlikely to detect all cases. To date, 40% of the individuals in Wisconsin who lost their lives due to COVID-19 lived in a nursing home.
The Wisconsin Department of Health Services (DHS) is calling local public health and every nursing home this week to work with you to make a plan for testing, reducing COVID-19 transmissions among residents and staff, managing COVID-19 infections, and identifying facilities that need special support. The goal is to provide support to maintain staffing levels, receive needed supplies, provide training, and maintain a safe living and work environment.
Free COVID-19 tests are available for all residents and staff in Wisconsin’s nursing homes. Testing will occur by May 31. DHS will prioritize more urgent testing in facilities that have expressed readiness or have higher infection rates in their communities.
You can prepare to make the most of these phone calls by identifying your facility’s strategies and needs before the call:
- How many testing collection supplies do you need to test the individuals who live and work in your facility?
When will you test your residents and staff?
- Do you need help?
- Do you have an ordering provider, i.e., Medical Director, attending physician, etc.?
- Do you have staff to collect the specimens for the test?
- Do you have staff to provide test results, education, and case management to residents and staff?
- Do you have staff to conduct contact tracing?
- Do you need help from local public health and/or the National Guard?
- Do you have an emergency management plan for isolating residents and for staffing?
COVID-19 testing is strongly recommended for all residents. People can have COVID-19 without any symptoms, so residents and staff should get tested even if they feel well. Every individual will receive information about COVID-19 and the test. However, testing is not mandatory.
Nursing Home providers and stakeholders are invited to attend this week’s webinar, hosted by the Division of Quality Assurance (DQA) and DHS, on Thursday, May 14 at 11am-12pm. During this time DHS will provide updates and answer questions related to COVID-19 and long-term care facilities.
Please do not reply directly to this email message. Submit any questions you would like addressed on the webinar to
DHSDQACOVID19@dhs.wisconsin.gov by 12 p.m. on the Wednesday before the webinar. Thank you again for the work you do.
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Facility Location Determines COVID Outbreaks, Researchers Say
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Where a nursing facility is located has a great deal to do with whether its residents have a case of COVID-19, said a panel of researchers in a May 7 webinar. According to preliminary research presented, larger facilities located in urban areas with large populations, particularly in counties with a higher prevalence of COVID-19 cases, were more likely to have reported cases.
Characteristics that were not associated with a facility having a COVID case included Five-Star Rating on Nursing Home Compare; whether or not a facility had a prior violation with infection; or whether it was for-profit, part of a chain, or having a high Medicaid census. These factors had no correlation with whether the facility had cases of COVID-19, said the researchers.
“It’s about where you are and not who you are,” said David Grabowski, PhD, professor of health care policy, Department of Health Care Policy, Harvard Medical School. “What we’re seeing in our data is it tends to be larger facilities—urban facilities in areas with more cases—that tend to be the facilities with COVID cases.”
The finding was supported by preliminary research presented by Vincent Mor, PhD, IMPACT principal investigator, professor, Florence Pierce Grant University, and professor of health services, policy and practice, Brown University School of Public Health.
In a partnership with Genesis HealthCare, Mor’s team used real-time electronic medical record data to track epidemiology of COVID-19 in nursing centers across 30 states. The preliminary analysis was consistent with Grabowski’s findings that larger facilities in urban communities with COVID cases are more likely to have outbreaks.
Both Grabowski, using data from 20 states, and Mor’s team data from Genesis investigated what differentiated facilities with COVID-19 from those without COVID-19. The Genesis facilities, in Mor’s preliminary analysis, found those that had a positive COVID case, compared with the facilities that did not have a positive case, have more total number of beds and were located in counties that had a higher number of positive COVID cases per hundred thousand. Both Grabowski and Mor indicated that these characteristics were strongly differentiating.
“So it’s a function of traffic; that is, if you’re in an environment where there are a lot of people in the community who have COVID, the patients in the building are more likely to have COVID: It’s as important,” Mor said. “If you are a larger facility versus a smaller facility, there is more traffic. Larger facilities simply have more staff, more people coming in and out of them. That’s more traffic and more likelihood that someone will be coming in from the outside with COVID.”
Grabowski added, “This is a system problem, not a bad apple problem.” He went on to say that the system has not adequately supported nursing homes during this pandemic.
Mor’s team also found a strong correlation between the number of skilled nursing facility (SNF) cases in the building that test positive and the number of positive cases in that county.
The researchers reported that even while nursing facilities are in lockdown, the COVID-19 virus is spreading and pointed to the asymptomatic presentation of the virus and the lack of testing as factors.
“As we know, it is spreading via asymptomatic and pre-symptomatic cases, and what we’ve learned is that in facilities that have been closed for weeks, we are seeing cases emerge,” said Grabowski. “Those cases are emerging because of staff who don’t know that they have the virus are coming in to work.”
The reality of the problem played out in a SNF in Massachusetts, said Grabwoski. The facility went into lockdown in mid-March. In early April, the facility was scheduled to become an all-COVID-19 facility—all the long-stay residents were to be moved out. Every resident in the building was tested for COVID-19, and over half tested positive with no symptoms, he said. About 60 percent of the staff were also tested, and of those, 40 percent tested positive.
“So this shows you it is coming into buildings,” said Grabowski. “It’s not about symptoms. It’s going to come into these buildings through asymptomatic staff, and like this [facility] in Massachusetts, the outcomes are often dire.”
Regarding the lack of testing, the researchers called for a system to test and monitor staff and residents. “We’re not going to get a handle on COVID-19 [facilities] until we get a systematic testing and surveillance system,” Grabowski said.
In addition to calling on federal leaders to implement testing all over the country for all residents and staff, the researchers called for adequate access to personal protective equipment, infection control personnel and infrastructure, hazard pay, practicing good cohorting, COVID-specialized post-acute care facilities, and investment in home- and community-based services to be included in policies to support nursing facility residents and staff.
The researchers highlighted the need for national data, including number of cases and fatalities for residents and staff. As previously
reported, the Centers for Medicare & Medicaid Services has released a
QSO memo addressing the interim final rule requiring SNFs to report to National Healthcare Safety Network (NHSN) on COVID-19, as well as to provide notifications to residents, their representatives, and families. The American Health Care Association/National Center for Assisted Living said these requirements were to go into effect with the publication in the Federal Register of the
interim final rule on May 8.
The research findings were presented during a webinar titled, “COVID-19 in Nursing Homes: Pragmatic Research Responses to the Crisis,” hosted by The National Institute on Aging (NIA) Imbedded Pragmatic AD/ADRD Clinical Trials (IMPACT) Collaboratory.
The NIA IMPACT Collaboratory works to build the nation’s capacity to conduct pragmatic clinical trials of interventions embedded within health care systems for people living with dementia and their care partners. To learn more, visit
https://impactcollaboratory.org.
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Thursday Long-Term Care Webinars – COVID-19 Testing for All Residents and Staff in Wisconsin’s Nursing Homes
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Nursing Home providers and stakeholders are invited to attend a weekly webinar hosted by the Division of Quality Assurance (DQA). During this time, the DQA will provide updates and answer questions related to COVID-19 testing for all Wisconsin’s nursing homes residents and staff.
The webinars will run from 11 a.m-12 p.m. every Thursday until further notice. Please join on Thursday, May 14, 2020.
To Join:
Join Zoom Meeting (click this link to go straight to the room without needing to enter the meeting ID and password)
- Meeting ID: 122-213-079
- Password: covid19
Or by Phone: (312) 626-6799
- Enter 122213079# when asked for the meeting ID
- Enter # if asked for participant ID
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COVID-19 Webinar for Health Care Providers: Friday, May 15, at 7 a.m.
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COVID-19 Webinar for Health Care Providers
"Remdesivir for COVID-19"
Friday, May 15, 7:00-8:00 a.m.
Join this Friday, May 15, at 7 a.m. for a webinar for health care providers on the current COVID-19 situation.
Or dial: 312 626 6799 or 646 558 8656
Webinar ID: 233 994 680
Presenters
Mary Beth Graham, MD, FIDSA, FACP
Professor of Medicine and Associate Chief, Division of Infectious Disease
Medical Director, Infection Prevention & Control Froedtert Hospital
Medical College of Wisconsin
Dr. Ryan Westergaard, Chief Medical Officer and State Epidemiologist, Division of Public Health, Wisconsin Department of Health Services
Traci DeSalvo, Communicable Diseases Epidemiology Section Chief, Division of Public Health, Wisconsin Department of Health Services
Send your questions ahead of time!
- Please note this mailbox is only for questions for this week's provider webinar.
- Questions sent ahead of time will be prioritized during the Q&A part of the webinar.
Webinar recordings
Access recordings of previous COVID-19 provider webinars
here.
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Pat Boyer, MSM, RN, NHA
| Director of Quality Advancement and Education |
pat@whcawical.org
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Business Partner Spotlight
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As experts in senior care, CE Solutions partners with you to meet compliance requirements while streamlining your staff education process through our online learning platform.
Why Should Your Organization Choose CE Solutions?
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CONTACT:
CE Solutions
Deb Martin
866-650-3400
For the complete listing of WHCA/WiCAL Gold Business Partners, click
HERE
!
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