Friends:
Thank you for all you are doing. You are containing the spread of the COVID-19 virus during this Delta surge. I know that you and your teams have been applying what you have learned over the last nineteen months to keep outbreaks relatively contained compared to previous surges. I am confident that you and your teams will remain diligent as you continue to provide quality care as new variants and surges present themselves.
We know of the workforce challenges you are facing, the agency staffing costs, and the potential regulatory pressure that comes with agency staff use – all of which is keeping all of us up at night. We have been sharing these messages with key government leaders, candidates, stakeholders, and partners, really anyone who will listen:
- We are experiencing a nationwide workforce shortage across all sectors.
- Even before the pandemic, healthcare generally and long-term care specifically faced dramatic workforce shortages.
- The pandemic has exacerbated these workforce shortages.
- The workforce shortage is more severe in rural settings; vaccination reluctance is typically higher in rural settings.
- The use of agency staff is dramatically up in our sector – a large unfunded marketplace dynamic not covered in Medicare or Medicaid rates.
The long-term and post-acute care sector has a tremendous success story to tell on employee vaccination – both before and after Governor Hogan’s mandate. Before the mandate, the Maryland average employee vaccination rate in our sector was 79 percent. Today that percentage is 86 percent at 218 out of 227 centers. That’s HUGE!
On Staff Vaccination:
- It is hard for smaller centers with smaller workforces to increase vaccination percentages dramatically. Getting one or two more team members vaccinated in a small setting is a significant win.
- Most skilled nursing and rehabilitation centers struggling to increase employee vaccination are located in rural communities. The workforce shortage is more severe in rural settings, and vaccination reluctance is high in rural settings.
- The Maryland Department of Health (MDH) is taking seriously those centers whose staff vaccination rates are in the 48-70 percent range, far below the 79 percent average even before the Maryland vaccination mandate – and may take action.
NOTE: I am confident that as a federal healthcare mandate is being finalized, it could also have punitive implications with hospitals, skilled nursing and rehabilitation centers, and other providers with low staff vaccination rates.
Last week nine (9) out of 227 skilled nursing and rehabilitation centers in Maryland did not fully report their staff vaccination numbers; twenty (20) centers reported vaccination rates in the 48-70 percent range. Even though we have explained workforce and census issues to state leaders, and the vast majority of the skilled nursing and rehabilitation centers have an average staff vaccination rates of 86 percent, I fully expect MDH to take some action against the centers that consistently do not report or that have staff vaccination numbers below 70 percent.
As I have shared: “I am proud of our work together and of our sector on vaccination. On average, 88 percent of nursing home residents and patients in Maryland are vaccinated, and 79 percent of the staff are vaccinated. In addition, several hospitals and nursing homes have already mandated staff vaccination. But still, there are far too many outlier centers at closer to 40 percent staff vaccination. In addition, while all employers have strongly encouraged and provided opportunities for vaccination, there are skilled nursing centers where employees have been extremely resistant to getting the vaccine. So, with these mandates, together, we will do better. And we will work to save the lives of Marylanders.”
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Monoclonal Antibody new EUA:
- Regeneron can be used for post-exposure prophylaxis for unvaccinated persons at high risk and for those who have been vaccinated but not expected to have mounted an adequate immune response, even with the vaccine.
- Regeneron may be administered subcutaneously when IV infusion is not available in a timely manner.
- Regeneron can be ordered directly through the supplier - AmerisourceBergen
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Here is a link to administration information https://www.regencov.com/hcp/dosing/dosing-administration
As Always:
- Focus on what is in your control and not what is out of your control.
- Overcommunicate – with residents, patients, families, staff, and government partners.
- Adapt and innovate.
- Rely on your partnerships.
- Speak up when you need help.
- Double efforts on infectious disease protocols, training, and operations.
- Take and document your action; keep a timeline.
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CLICK HERE for the Dr. Katz Video, and please see the Donning and Doffing Checklist we have been sharing.
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Joe DeMattos
President and CEO
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New PRF Phase 4 & Rural Distribution Application Information Released
Today, the Health Resources and Services Administration (HRSA) released additional information on the $17 Billion Phase 4 and the $8.5 Billion Rural Distribution application. Applicants will be able to apply for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments during the application process. PRF Phase 4 is open to a broad range of providers with changes in operating revenues and expenses. ARP Rural is open to providers who serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP). See a detailed list of eligible provider types here.
HRSA released information on:
- Required documentation for application
- Creating an Application Account
- An updated explanation of “rural” awards
- How to apply for the Upcoming HRSA Phase 4 and Rural Distributions
No additional application information nor Phase 3 Reconsideration detail is available at this point. However, please watch for a link to an AHCA/NCAL pre-recorded webex on “how to apply” which will become available on October 5 and, regarding Phase 3 Reconsideration, members may email HRSA, now, at prfreconsideration@hrsa.gov to be added to a listserv for when HRSA begins processing requests.
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Other COVID-19 Updates
FDA Authorizes Pfizer/BioNTech COVID-19 Vaccine Booster: Last week, the FDA amended the Emergency Use Authorization (EUA) for the Pfizer vaccination to allow the use of a single booster dose only to those who received the Pfizer vaccine and be administered at least six months after completion of the primary series. Read more.
Vaccination Rates Now on Care Compare: Last week, CMS unveiled functionality on Care Compare to enable users to compare staff and resident vaccination rates across different SNFs. Read More
Tell Us About Your COVID-19 Honors Program Ceremonies!: Since the March launch of the AHCA/NCAL COVID-19 Honors Program, nearly 300 facilities have participated in the program to recognize their incredible staff. Read More
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Updated Booster Guidance from CDC
CDC has published updated guidance for the use of booster doses of Pfizer's Comirnaty vaccine. This follows the FDA's Emergency Use authorization for booster doses that was published on Wednesday.
MDh has also published this Update on Maryland's COVID-19 vaccination plan.
Please read this guidance carefully. The summary main points are as follows.
Booster doses should not distract from our most important focus of primary vaccination in the United States and around the world.
The following groups SHOULD be offered a 3rd dose of Pfizer vaccine at least 6 months after the original series:
- Individuals who originally got the Pfizer vaccine and
- are over 65 OR
- who live in long term care settings OR
- are 50-64 years old with underlying medical conditions
The following individuals MAY be offered a booster dose of Pfizer vaccine at least 6 months after the original series, based upon their individual risk/ benefit assessment:
- Individuals who originally got the Pfizer vaccine and
- are aged 18-49 with underlying medical conditions OR
- are 18-64 with increased risk for occupational exposure to COVID-19
Things that have not yet been addressed include:
- Booster does for Moderna and Janssen recipients.
- "Mix and match" booster doses/ providing Pfizer boosters to recipients of other vaccine series.
- Booster doses for more general populations.
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Maryland Department of Health:
Resource Guide for SNFs
Additional Resources for the Third Dose COVID-19 Vaccine
The Maryland Department of Health (MDH) created resource guides for SNFs that are looking for additional resources for the third dose COVID-19 shots. The resource guides are broken down by region, so please review carefully to find resources for your center.
Carroll, Howard, Baltimore, Baltimore City, Anne Arundel, and Harford Counties
Cecil, Kent, Queen Anne's, Caroline, Talbot, Dorchester, Wicomico, Somerset, and Worcester Counties
Charles, St. Mary's, and Calvert Counties
Garrett, Allegany, and Washington Counties
Frederick, Montgomery, Prince George's Counties
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Exploring Sepsis Strategies - Part 2: Care Coordination & Preventing Sepsis-Related Readmissions
Please see this flyer for an upcoming webinar on September 30. If you would like to review the recording of Part 1, watch the recording here.
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Free Online or In-Person Infection Control Training Now Available!
The Maryland Department of Health Project Firstline learning management system (NextThought) is now available as a free service for all Maryland healthcare workers, including Environmental Services staff.
A total of seven CDC-prepared courses are available as self-guided modules. Materials for the introductory infection control course are also provided in a format for group training sessions with a facilitator. Additional content for group training sessions will be released in October 2021.
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Health Care Cybersecurity Symposium
November 8, 2021
3PM – 5PM ET
Virtual
Managing Risk Within the Health Care Supply Chain
Registration is free.
Join us as we reflect on the past and plan for the future! Hear from industry leaders locally and nationally as they share perspectives on the changing cybersecurity landscape, supply chain vulnerabilities, and strategic matters, technical and cultural, including best practices for securing the health care supply chain.
Presentations will highlight the need to secure protected health information more than ever with the increasing use of telehealth, web-connected medical devices, and other third-parties, including impacts and lessons learned from the COVID-19 public health emergency.
Questions
Contact Eva Lenoir
410-764-337
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We are thrilled to announce that you can now attend the 2021 HFAM conference in person OR virtually. The 2021 HFAM Conference “Together We Re-Imagine” will be held in person AND online from October 4 – 7, 2021 at the Maryland Live Hotel and Casino in Hanover, Maryland.
Hundreds of long-term care leaders will connect, share best practices and discuss actionable insights on how we can reflect, reform, rebuild, and revolutionize quality care. You and your teams will not want to miss this opportunity as we come together again.
No matter how you attend, you will gain valuable knowledge and insight through exclusive, dynamic presentations and an innovative Solutions Lounge.
CEs awarded for in person and virtual attendance.
for more information and to register.
HFAM's safety protocol requires proof of vaccination
or a negative PCR test within 72 hours of attendance.
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Thank you to our current sponsors! |
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Plus, Visit our Sponsors and Supporters in the
Brand New "Solutions Lounge"
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Did you miss an update?
Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
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