COVID-19 UPDATE #167
July 2, 2021
GOVERNOR'S LATEST PROCLAMATION RELAXES VISITATION REQUIREMENTS FOR ALFs AND SNFs
Last night WHCA was provided a copy of Governor Inslee’s latest proclamation addressing visitation in long term care. These most recent changes to the visitation requirements are the result of heavy pressure from WHCA and other stakeholders who have spent the last several months urging the Governor’s Office to bring visitation requirements in line with CDC/CMS guidance and to move away from the more restrictive model that the Governor imposed. Within the Governor’s new Proclamation are links to revised versions of the Safe Start Guidance for Assisted Living Facilities and the Safe Start Guidance for Skilled Nursing Facilities that explain the new visitation revisions. The overall impact of the new Proclamation is to relieve providers from having to inquire about the vaccination status of visitors and to allow unvaccinated and not fully vaccinated residents access to visitors, except when community positivity rates are high and the facility’s resident vaccination rate is low.

Under the new requirements, facilities should allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission. These scenarios for limiting indoor visitation include:
  1. Unvaccinated residents, if the home’s COVID-19 county positivity rate is greater than 10% and less than 70% of residents in the facility are fully vaccinated;
  2. Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated until they have met the criteria to discontinue Transmission-Based Precautions; or
  3. Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.

Page ten of both documents contains a helpful and detailed step-by-step explanation of how assisted living and skilled nursing providers can determine and comply with the greater than 10% county positivity ratio and the less than 70% facility vaccination ratio.

In addition to easing up on visitation criteria, the Governor’s latest proclamation also extends the waivers and suspension of certain resident rights statutes and regulation governing visitation and socialization in order to allow the Department greater flexibility.

If you have questions please contact Robin Dale, Vicki McNealley or Elena Madrid. 
PRF REPORTING PORTAL NOW OPEN
The Provider Relief Fund (PRF) Reporting Portal is now open for providers to report fund use for April 10, 2020, through June 30, 2020. Providers who received one or more PRF payments exceeding $10,000, in the aggregate, during this time have until September 30, 2021 to submit the initial report.

Last month, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), released updated PRF reporting requirements. The updates provided more reporting time, reducing burdens on smaller providers and extending key deadlines for expending PRF payments received after June 30, 2020.  

HRSA has released several new resources to support efforts as you begin the reporting process, including a Data Entry Workbook, Reporting-specific FAQs, and Submitting Reporting Information user guide. Additionally, HRSA will host a recorded webcast on Thursday, July 8, at 3 PM Eastern to provide technical assistance on reporting requirements for PRF recipients and stakeholders. Be sure to register. 

You are encouraged to register in the reporting portal in advance of your relevant Reporting Time Period dates; registration is required before reporting. This takes approximately 20 minutes and must be completed in one session. HRSA has developed a Registration User Guide to assist. 

As a reminder, the reporting timelines are as follows:
The HRSA Provider Support Line is available at (866) 569-3522 (TTY dial 711) for questions. Hours of operation are 8 AM to 10 PM Central, Monday through Friday. Additional updates and resources from AHCA/NCAL will be shared as they become available.
NHSN TO UPDATE REPORTING MODULES ON JULY 8
Beginning​ July 8, the National Healthcare Safety Network (NHSN) will make multiple updates and modifications to reporting modules. NHSN users should have received an email notification from NHSN outlining the changes to the system.  

Modules included in the updates are: 
  • Point of Care (POC) Test Reporting Tool – adding POC devices to dropdown list 
  • Resident Impact and Facility Capacity Pathway – Enhancements to “Vaccination Status of Resident with a Newly Confirmed COVID-19 Viral Test Result” section 
  • Ventilator Capacity and Supplies Pathway – removing this module 
  • Therapeutics Pathway – adding new therapeutic and removing outdated therapeutic 
  • COVID-19 Vaccination Data Modules – including user data quality alert screen 

The CDC will host a webinar to provide information about these modifications on Thursday, July 8, and Monday, July 12, 2021, from 10:00 – 11:00 AM PST. Register for either date in advance.
EXPEDITED APPLICATIONS AND USE OF 70.15 PROCESS FOR NURSES
The Nursing Care Quality Assurance Commission (NCQAC) completes the licensing for all nurses in our state, including RNs, LPNs, ARNPs and Nursing Technicians. Over the last several months, the NCQAC worked with the Governor’s office to give top priority to temporary practice permit applications for nurses to assist with the urgent and critical care needs during the COVID-19 response. This included processing expedited application requests from qualifying healthcare facilities.

Beginning July 1, 2021, the NCQAC is legislatively required to complete licensure of complete applications within seven days and has staffed accordingly to meet this requirement. In accordance with this new expectation, the NCQAC will no longer be processing expedited application requests from individual facilities.

The NCQAC would also like to remind any nurses who came to Washington under the Emergency Volunteer Healthcare Provider (chapter 70.15 RCW) program to apply for a permanent license in Washington State. This will avoid a lapse in licensure in the event the Governor-declared state of emergency ends. To apply for a Washington State Nursing License, please visit our licensing webpage. 
CMS UPDATES EMERGENCY PREPAREDNESS EXERCISE EXEMPTION FOR SNFs
CMS issued an updated memo (QSO-20-41-ALL) this week that provides new guidance around when an inpatient provider may be exempted from its next required full-scale exercise. The memo indicates that inpatient providers that are still operating under “disaster/emergency conditions during the Public Health Emergency” are exempt from their next full-scale exercise in the facility’s 12-month exercise cycle.  
 
This exemption assumes the facility is still operating under its “activated emergency plan.” If the facility has resumed normal operations, the exemption does not apply. Where the exemption is applicable, the guidance clarifies that a second exercise of choice is still required annually. 
NEW CENTRAL DOH WEBPAGE FOR COVID-19 HEALTHCARE INFECTION PREVENTION GUIDANCE INCLUDES FIT TESTING RESOURCES
The Department of Health (DOH) has moved all COVID-19 healthcare infection prevention materials to one location on the DOH website. Regardless of healthcare setting, click here for all COVID-19 infection prevention guidance. The DOH has also included a new N95 fit testing page with free fit testing and resources available to all healthcare settings.
CMS SENDING COVID-19 VACCINE STICKERS AND POSTERS TO SNFs
The Centers for Medicare and Medicaid (CMS) will be mailing COVID-19 vaccine stickers and posters to all nursing homes and requesting they share photos of themselves using the materials. These photos will be shared on CMS' social media channels as part of their long term care vaccine outreach efforts. We wanted to share this opportunity and encourage you to participate as you see fit. The materials will be accompanied by a release form facilities will be required to complete before they can use any of the materials. If you have questions after receiving the materials, please email Kelly Dinicolo of CMS.
COMAGINE WEBINAR FOCUSES ON INFECTION PREVENTION SUSTAINABILITY
Comagine hosted the first webinar in a two-part series entitled Infection Prevention Sustainability - Clinical. The slides from the webinar are being shared with you as well as a link to the recording. Comagine invites you to join them for the second part of this two-part series - Infection Prevention Sustainability for Non-Clinical Areas - on Wednesday, July 14, 2021, at 11:30 AM. Click here to register for this webinar.
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.