COVID-19 UPDATE #161
June 3, 2021
ARGENTUM SHARES INSIGHT ON WASHINGTON ASSISTED LIVING PROVIDERS FACING $885 MILLION IN PANDEMIC-RELATED LOSSES
In a report from Argentum, a leading national association representing professionally managed assisted living communities, assisted living providers are informed that new data released underscores the dire predicament facing Washington seniors and caregivers in the wake of the COVID-19 pandemic. Through the second quarter of 2021, it is estimated that Washington assisted living providers will have incurred $866 million in uncompensated financial losses due to the financial burdens imposed by the pandemic. While the federal government allocated money for provider relief in last year’s CARES Act, less than 1 percent of that funding has been allocated toward helping the nation’s assisted living communities.

“During the pandemic, the communities in Washington went above and beyond to protect their seniors and caregivers and ensure they had access to the PPE, staffing, care, and services needed to keep people safe,” said James Balda, Argentum president and CEO. “Now, without federal intervention, many of Washington’s communities could be at-risk of closing due to the steep and uncompensated costs stemming from the pandemic.”

Washington has more than 53,000 older adults living in 512 assisted living facilities. Many of these facilities are now operating at a loss, with some facing potential closure if relief funding is not provided soon. To date, $145 billion in CARES’ provider relief funding has been provided to health care providers around the country, but Washington senior living facilities have received only $18.2 million despite spending $884 million to protect seniors and caregivers.

Argentum is asking leaders on Capitol Hill to share additional relief from the unallocated resources in the Provider Relief Fund with these struggling communities. Without financial aid, some of these communities may not be able to sustain operations, resulting in the loss of homes and caregivers for millions of older Americans. Argentum also shared an Executive Summary completed by the National Investment Center (NIC) providing an overview of the impacts of COVID-19 on senior housing. As well, Argentum provided a press release about the study completed by NORC at the University of Chicago. Argentum has also created a new webpage with 50 state-specific infographics for COVID-19 losses.
DEAR PROVIDER LETTER REGARDING SOURCE CONTROL REGARDLESS OF VACCINATION STATUS
A Dear Administrator letter dated May 26, 2021, informs all providers that the new CDC guidance regarding vaccinated persons not needing to wear a mask does not apply in LTC settings, except in those specific cases outlined in the LTC Safe Start plans. Click here to view the updated Safe Start for Long-Term Care Recommendations and Requirements document in its entirety.

Guidance regarding source control, including source control for visitors, is provided by the Department of Health (DOH) in the Interim Guidance for SARS-CoV-2 Source Control in Healthcare Settings here. This link also has a graph outlining the types of acceptable source control for each group (visitors, residents, staff). Providers are encouraged to email the RCS Policy Unit if they have questions.
DEAR PROVIDER LETTER INFORMS SNFs OF INTERIM FINAL RULE FOR COVID-19 VACCINE IMMUNIZATION REPORTING REQUIREMENTS FOR RESIDENTS AND STAFF
In a Dear Administrator letter dated May 26, 2021, skilled nursing providers are notified on May 11, 2021, with QSO-21-19-NH, CMS announced the update of nursing home regulations to establish facility requirements for COVID-19 immunization. The interim final rule, CMS-3414-IFC adds requirements at 42 CFR 483.80. The new regulations require facilities to offer education to residents and staff about the vaccine, to offer the vaccine, and to report information about vaccination rates to NHSN. RCS provided information about education and offering the vaccine in Dear Administrator letter 021-040.

42 CFR 483.80(g)(1)(viii)-(ix) requires nursing homes report, on a weekly basis, the COVID-19 vaccination status of residents and staff, and therapeutics administered to residents for treatment of COVID-19 through NHSN's Long Term Care Facilities (LTCF) COVID-19 Module. The last date to begin reporting is June 13, 2021.

CMS will begin reviewing for compliance with the reporting requirement on June 14, 2021. Facilities identified as not meeting reporting requirements will be cited at a scope and severity of F. Civil monetary penalties starting at $1000 for the first occurrence will be imposed and amounts are progressive based on the provider history of non-compliance with reporting requirements

More information about the reporting requirement is available at the CDC/NHSN website. The QSO memo also has a list of additional resources. CMS will post the new information reported to the NHSN for viewing by facilities, stakeholders, and the public on CMS’s COVID-19 Nursing Home Data website. If providers have questions, they can email Lisa Herke, Nursing Home Policy Program Manager, or call her at (509) 209-3088.
EEOC SAYS EMPLOYERS CAN MANDATE COVID-19 VACCINES, BUT TREAD CAREFULLY
Approximately 50 percent of Americans age 12 and older have received one dose of the COVID-19 vaccine, and 40 percent are fully vaccinated now. Most recently, the CDC issued guidance that people who are fully vaccinated do not need to wear face coverings in most settings. Still, many employers (rightfully) are grappling with whether to mandate employee vaccination as a condition of employment. The Equal Employment Opportunity Commission’s (EEOC) May 28, 2021 guidance on mandatory employer COVID-19 vaccination programs should make employers feel more comfortable with mandatory vaccination programs for their employees. Read more. Many thanks to Lane Powell for providing this information.
NEW NIOSH GUIDANCE ON N-95 RESPIRATORS
The National Institute for Occupational Safety and Health (NIOSH) issued new ​​guidance that health care providers should only use N-95 respirators and should not be using crisis standards as availability of N-95 respirators is now sufficient. According to a situational update as of May 2021:  
“T​he supply and availability of NIOSH-approved respirators have increased significantly over the last several months. Health care facilities should not be using crisis capacity strategies at this time and should promptly resume conventional practices. Check the NIOSH Certified Equipment List to identify all NIOSH-approved respirators.  
​​Health care facilities should stop purchasing non-NIOSH-approved respirators for use as respiratory protection and consider using any that have been stored for source control where respiratory protection is not needed. Respirators that were previously used and decontaminated should not be stored. We do not know the long-term stability of non-NIOSH-approved respirators and respirators that have been decontaminated, and whether these will be recommended for use in the future. Health care facilities should return to using only NIOSH-approved respirators where needed.” 
In addition, the FDA posted a letter about transitioning from non-NIOSH-approved and decontaminated disposable respirators. 

This update applies to the following guidance: 
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.