COVID-19 UPDATE #225
January 28, 2022
PPE SUPPLY PROBLEMS IN LTC | DOH SURVEY
The recent surge in COVID-19 cases has resulted in difficulty obtaining needed supplies such as PPE in long term care (LTC) settings. The Washington State Department of Health (DOH) created a survey to learn what is happening for LTC providers. Please complete the survey with as much detail as possible to help DOH understand the extent of the PPE supply problem. This information will help DOH plan and deploy PPE resources to help combat COVID-19. Thank you for all of the work that you do every day under difficult circumstances.
CMS RELEASES UPDATED GUIDANCE AND RESOURCES TO SKILLED NURSING FACILITY SURVEYORS
CMS made updates to the Long-Term Care Survey Process Procedure Guide effective January 27, 2022. These updates include:
  • Mandatory facility task assignment and review of NHSN data related to the QSO Memo-QSO-22-07-ALL 
  • Entrance Conference Worksheet updates to include COVID-19 Vaccine review and COVID-19 Staff Vaccination Matrix located under Survey Resources January 2022 (1/25/22) (ZIP).
  • Closed record review may select a resident with confirmed case of COVID-19 in last four weeks who was hospitalized or died to add to closed record review.
  • Infection Control surveyor will review the infection prevention and control program, policy and procedures for staff COVID-19 vaccination, antibiotic stewardship program, and the influenza, pneumococcal, and COVID-19 for residents and staff. 
  • Details around whether to enforce §483.80(i). If enforced, the facility will have 4 hours to complete the COVID-19 Staff Vaccination Matrix.
  • Once the matrix is received, the assigned surveyor selects eight staff to review for COVID-19 vaccinations according to the guidelines below: 
  • 2 vaccinated staff (at least one CNA and one contractor who provides services, such as hospice and dialysis staff, occupational therapists, mental health professionals, licensed practitioners).
  • 6 unvaccinated staff, if available (3 unvaccinated staff - 2 CNAs, if available) without exemption or reason for temporary delay, 1 non-medical exemption, 1 medical exemption (note: If there are 2 or more staff with medical exemptions, select 50% of the staff from this category), 1 whose primary vaccine series has been temporarily delayed.
  • If there are no staff who meet one of the above unvaccinated criteria, no increase to the sample size is needed for another category. 
  • If they identify any staff that weren’t vaccinated and weren’t granted an exemption or temporary delay (and weren’t listed on the staff matrix), that individual(s) should be added to the staff sample.
  • F888 will be cited according to Attachment A in the QSO-22-07-ALL memo. 
  • Dining task: Temporarily allowing the dining task to be discretionary and completed only if a resident is investigated for nutrition, weight loss, or facility incidents related to dialysis. 
  • Med Storage: CMS is temporarily allowing the med storage task to be discretionary and only completed if there is an outstanding complaint, or concerns from the ombudsman or concerns identified when completing the med admin observation task.
  • Resident Council: CMS is temporarily allowing the resident council task to be discretionary and only completed if there’s an outstanding complaint, or concerns from the ombudsman or during the initial pool (e.g., with visitation or grievances).

For more information on updates, please visit CMS’s Nursing Home website.
SENIOR ACT MARKS FIRST CONGRESSIONAL LEGISLATION TARGETED AT SAVING NATION'S SENIOR LIVING COMMUNITIES
Bold bipartisan legislation made necessary by the COVID pandemic would save America’s assisted living and senior living communities from financial ruin and stem a workforce shortage crisis. Introduced by Rep. Lori Trahan (D-Mass.) and Rep. Brian Fitzpatrick (R-Pa.), the SENIOR (Safeguarding Elderly Needs for Infrastructure and Occupational Resources) Act is the first bill targeting senior living for assistance related to the pandemic.

Argentum, the leading advocacy group for professionally managed senior living communities, said the SENIOR Act would address two issues through new federal appropriations by creating a caregiver sustainability fund and expanding the senior caregiving workforce. The sustainability fund appropriates $10 billion in new federal funding to assisted living caregivers that demonstrate significant and uncompensated COVID-19 related losses due to direct senior care, similar to the Provider Relief Fund (PRF).

With media reports out this week reporting that the PRF has no remaining balance due to the Biden Administration tapping the funds for pharmaceutical expenditures, this new legislation is made even more relevant to protecting the nation’s senior living communities. Read full article here.
NATIONAL NURSING HOME STAKEHOLDER CALL
Join the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) for a National Stakeholder Call on Wednesday, February 2, 2022, from 12:00 to 12:45 PM PST providing updates on COVID-19, revisions to nursing home guidance, and best practices. Additionally, subject matter experts from CDC and CMS will address frequently asked questions. Register in advance for this call, and the Zoom link will be provided following registration.

Panelists:
  • Dr. Lee Fleisher, CMS Chief Medical Officer and Director, Center for Clinical Standards and Quality (CMS)
  • Jean Moody Williams, Deputy Director, Center for Clinical Standards and Quality (CMS)
  • Dr. Kara Jacobs-Slifka, Long Term Care Lead, Prevention and Response Branch (CDC)
  • Evan Shulman, Director, Division of Nursing Homes (CMS)
PANDEMIC BURNOUT: STAYING SANE IN UNPREDICTABLE TIMES WEBINAR
These are unprecedented times! The National Association of the Directors of Nursing (NADONA) is hosting a webinar to address burnout and stress in long term care. Let’s talk about what it takes to keep it together when you feel like everything is falling apart. The presentation will share real life experiences and self-care strategies. Presenters are Lisa Stubenrauch, RN-BC, BSN, CDONA/LTC, RAC-CT NHA, President of Washington State Chapter of NADONA, and Misty Reid, AGACNP-BC, MSN, Chief Nursing Officer at EmpRes Healthcare Management. Every nurse leader will benefit from this webinar, being held February 9, 2022, at 11 AM PST. Click here to register.
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.