COVID-19 UPDATE #88
October 7, 2020
NEW GUIDANCE FROM CDC ON DISCORDANT TEST RESULTS IN ASSISTED LIVING AND SKILLED NURSING
The Centers for Disease Control and Prevention (CDC) released new information on testing in nursing homes through the frequently asked questions website that addresses discordant test results (i.e., false positives and false negatives) and how long term care facilities should handle these situations.

Among other information, the CDC addresses:
  • Optimal frequency for testing residents and staff in response to an outbreak
  • How to determine a false positive test result on an antigen device
  • What action should be taken while waiting to confirm a false positive or negative
  • What action should be taken once a false positive is confirmed

Providers are encouraged to review the new guidance as it applies to their testing program.
HHS UPDATES PROVIDER RELIEF FUND FAQs
The Department of Health and Human Services (HHS) recently updated the Provider Relief Fund (PRF) FAQs with Phase 3 information. Several of the FAQs also provide helpful insights into other PRF requirements. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) has developed a summary of these updates. Read more.
CORRECTION: PUBLIC HEALTH EMERGENCY EXTENSION AND IMPLICATIONS FOR SKILLED NURSING CENTERS
The public health emergency (PHE) is issued by the Department of Health and Human Services Secretary in 90-day increments. Effective October 23, Secretary Azar extended the PHE for another 90 days through January 23, 2021.

The PHE extension means:
  • Section 1135 National, Blanket Waiver remains in place. This waiver includes the telehealth and staffing waivers;
  • Section 1812(f) Waiver also remains in place. This covers the waiver of the 3-day stay requirement and the waiver of the Spell of Illness; and
  • Because of the CARES Act statutory link to the PHE, the Medicaid increased FMAP continues until the end of the quarter in which the PHE ends. Therefore, the increased FMAP will flow to the states until March 2021. More information is available here.

The PHE issued on October 2 is available to view here.
UPDATED TESTING GUIDANCE
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) updated the FAQs on Testing in Nursing Homes and Assisted Living Communities. The updates include information on the Abbott BinaxNOW shipments, further clarity on CMS testing requirements, as well as a new section on discordant results. It is important for providers to be aware that some of the answers contained in the AHCA FAQ guidance may differ from Washington State’s interpretation and current direction. If you have questions, please reach out to Vicki McNealley or Elena Madrid.
PPE SHORTAGES CONTINUE TO CREATE CHALLENGES FOR LONG TERM CARE PROVIDERS
Assisted living and skilled nursing facilities continue to experience shortages of personal protective equipment, namely N95 masks. The recently updated guidance from the CDC on how COVID-19 spreads through airborne transmission has compounded this problem.

The CDC recommends that health care personnel who enter a room of a patient with known or suspected COVID-19 should wear a NIOSH-approved N95 or equivalent or higher-level respirator (or facemask if a respirator is not available) along with adherence to standard precautions. For skilled nursing facilities, according to the National Healthcare Safety Network (NHSN), you are to document for N95 respirators. You are not to include KN95s into the NHSN pathway. 

With updated CDC guidance, providers should review OSHA and CDC Guidance on PPE shortages, including N95 masks. AHCA/NCAL has resources on guidance in consideration of OSHA obligations when PPE is critically low or unavailable. This resource provides steps to take when PPE is low, including N95 respirators. Read more.
HHS COVID-19 TESTING IN NURSING HOMES WEBINAR FOLLOW-UP
On September 3, 2020, the Department of Health and Human Services (HHS), in conjunction with Quidel Corporation and Becton, Dickinson and Company (BD), hosted a webinar to provide additional information regarding antigen testing in skilled nursing facilities.

The COVID‐19 Testing in Nursing Homes State Webinar was open to skilled nursing facilities and state public health laboratories. The webinar was recorded and can be watched here. The Q&A from the webinar is provided here.
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.