COVID-19 UPDATE #180
August 19, 2021
BIDEN ADMINISTRATION ANNOUNCES NATIONAL VACCINATION MANDATE FOR SNFs
Yesterday, President Biden announced that HHS will develop new regulations requiring nursing homes to require that all of their workers be fully vaccinated against COVID-19 as a condition of participating in the Medicare and Medicaid programs. Washington State took a similar but broader action last week. The President’s action was reportedly taken to ensure consistent and equitable standards across the country. These new federal regulations would apply to nearly 15,000 nursing home facilities, which employ approximately 1.6 million workers and serve approximately 1.3 million nursing home residents. A message from AHCA President Mark Parkinson can be found here and AHCA’s media statement can be found here. 

Yesterday afternoon, President Biden made the announcement during public remarks, CMS issued a press release, and the White House shared a fact sheet. Here is what we know:
  • Washington State’s Mandate is broader, as it applies to all health care providers and settings; President Biden’s announcement does not change the scope of the state mandate.
  • For now, the federal mandate applies only to skilled nursing facilities and no other health care providers, but Washington’s mandate continues to apply to all health care providers and settings.
  • The federal mandate would not include private pay assisted living and probably will not include assisted living providers that participate in the Medicaid program; but Washington’s mandate clearly applies to assisted living and other settings.
  • CMS intends to issue a rule in “late September” but as we’ve learned, timelines can change. Washington’s mandate requires full vaccination status effective October 18, 2021.
  • CMS has also indicated that it is working on a booster plan for residents using facility long term care pharmacy providers or immunization partners.
  • The federal regulation has not yet been issued and is currently being written; the state mandate is currently in effect with an implementation date of October 18, 2021.

In the meantime, we encourage you to attend a special webinar that AHCA was already planning and scheduled for 12:00 noon today (see next article for webinar details) about best practices for implementing vaccine mandates. While the AHCA webinar will be focused on a more national approach, it will provide helpful information on the reasonable accommodation process for medical conditions and religious beliefs. 
AHCA/NCAL WEBINAR TODAY TO DISCUSS VACCINE MANDATES IN LONG TERM CARE
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) invites you to a webinar being held TODAY, August 19, 2021, at 12:00 noon PST. Randy Bury from the Good Samaritan Society, Jim Tabek from Genesis Healthcare, and Dr. Priti Jindal from Five Star Senior Living join AHCA/NCAL's CEO Mark Parkinson and CMO David Gifford to talk about their experiences with implementing staff vaccine mandates. This discussion will include insight from the announcement by President Biden yesterday. This webinar is available to members only.

Registration Information
  • To avoid technical problems, use Google Chrome. 
  • Members will need to log in using their existing email and password first. 
  • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
  • If you have forgotten your password click here. 
  • If you are new to the site, you can create an account here. Answer all fields on the create an account page, especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register for the webinar. 

If you need additional assistance registering for this webinar, please email AHCA/NCAL staff at educate@ahca.org.
STATEWIDE UPDATED MASK ORDER GOES INTO EFFECT MONDAY, AUGUST 23
The Department of Health (DOH) released information that Washington State Secretary of Health Umair A. Shah, M.D., MPH, amended Order 20-03 requiring face masks for everyone over five years of age in most public indoor settings regardless of vaccination status. These include places like grocery stores, malls, gyms, and community centers. Masks are strongly recommended in crowded outdoor settings like sporting events, fairs, and concerts where physical distancing is not possible. The updated order goes into effect on Monday, August 23.

There are some exceptions to the indoor mask requirement, including:
  • Children under five years of age. However, children age two to four years old can wear a mask under close adult supervision.
  • People with a medical or mental health condition or disability that prevents them from wearing a mask
  • Fully vaccinated workers who are working alone or in an area not accessible to the public
  • Athletes who play indoor sports and who are actively engaged in competition or practice (masks are still required on sidelines and in team meetings)
  • Small indoor private gatherings when everyone is vaccinated
  • Children under two years of age should not wear a face covering due to the risk of suffocation

You can find more information about mask requirements on the Department of Health (DOH) website.
VACCINATIONS, VISITATION, AND VIGILANCE DURING THE DELTA SURGE
The Delta variant is now the most common variant in the US, making up over 85% of cases, and is two to three times as contagious as prior variants. This is causing a surge in cases in communities across the US, which puts long term care facilities at risk of outbreaks. The Centers for Disease Control and Prevention (CDC) urges healthcare workers to stay vigilant to prevent the spread of the virus and protect staff and residents in long term care facilities.  

The CDC recommends staff and visitors take the following steps: 
  • Get vaccinated as soon as possible 
  • Wear a mask even if you are vaccinated 
  • Stay home if you feel ill 
  • Get tested if you have COVID-19 symptoms 

To maintain compliance with CMS’ QSO memo on visitation 20-39-NH Revised, while ensuring the safety of residents and staff, AHCA/NCAL recommends that nursing homes enact policies that “strongly encourage” (but not require) all visitors to: 
  • Be vaccinated; 
  • Always wear a mask during the visit; and 
  • Have a negative COVID-19 test if the community spread of COVID-19 is moderate to high OR obtain a negative Point of Care test the day of or day before visitation.   

Providers may also consider asking residents if they want visitors given the surge in the Delta variant and if they want any unvaccinated visitors or visitors that have not been tested. Residents can put such a requirement in place under their resident rights. 
 
Providers should also continue to strongly encourage vaccinations among staff, using the resources provided through the #GetVaccinated campaign. AHCA/NCAL also hosted a webinar on boosting staff vaccination rates, which is now available on demand.  

The CDC also provides the following web resources to help inform and educate about COVID-19, the Delta variant, and vaccination: 
ADDITIONAL RESOURCES
The CDC now officially recommends COVID-19 vaccination for people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. Previously, the CDC had recommended it be left up to the individual to discuss with their physician. The CDC has collected enough data about the safety and effectiveness of the COVID-19 vaccination during pregnancy to suggest that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks. Pregnant and recently pregnant people are more likely to get severely ill with COVID-19 compared with non-pregnant people. Getting a COVID-19 vaccine can protect you from severe illness from COVID-19. To learn more, visit the CDC website on COVID-19 Vaccines While Pregnant or Breastfeeding​. 
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.