Coronavirus Update #200

HFAM Update, MDH Staff Contingency Plan, PPE Resources,
POC Test Distribution and Reporting, Antibody Treatment Capability
Friends:
 
As we head into a traditional holiday week, we are thankful for you. You and your frontline heroes are, in fact, saving lives and providing quality care during the worst pandemic in over 100 years. During times such as the current surge, it is easy to forget that, please don’t forget that! CLICK HERE for an AHCA/NCAL Video.
 
Today, and every day of this year, you join with me as we remain thankful for our healthcare heroes working to provide quality care and saving lives across all healthcare settings, including hospitals and skilled nursing and rehabilitation centers. COVID-19 is dramatically surging in 47 states, including Maryland.  Now, even more than before, it will take all of us fighting together to protect ourselves, our loved ones, and those most at-risk.
 
As we celebrate the upcoming holidays, I know you are urging your teams to follow guidance from the Centers for Disease Control and Prevention about hosting or attending holiday gatherings. Wear a mask and practice social distancing — not only for yourself but for your loved ones, for vulnerable friends and family members. I know in talking with some of you on the phone that some employers are giving masks to employees to take home and share with their family members. Thank you.
 
Yesterday we had a very productive conversation in our continuing work with MDH on testing. As of yesterday, most of the skilled nursing and rehabilitation centers in Maryland have received two weeks of POC testing supplies. All-in-all, 162 HFAM members received those supplies.  We continue to share our expertise with MDH on the workforce demands on frontline care staff with POC testing, especially in larger centers. And we continue to push back against talk of daily testing, as the physicians tell us given the incubation period of the virus, that would be of very little help. As a reminder, if the facilities have any test questions, especially the shipments of rapid antigen tests, please have them contact MDH.RapidPOCtest@Maryland.gov.
 
NOTE: As you may have seen on the news, the Baltimore Convention Center is being turned into an infusion center. The State is receiving weekly shipments of monoclonal antibody treatment, which is mostly being sent to hospitals, for outpatient infusion and observation.
 
Question: The state would like to gain an understanding of how we could most effectively use this treatment for confirmed positive nursing home residents. 
 
We need to have an understanding of your capability to administer monoclonal antibody treatment. Keep in the mind the treatment needs to be combined (mixed), infused, the patient needs be observed for an hour in case of adverse reaction, and the setting needs to be able to medically respond to any adverse reaction. Dr. Gifford in our calls with AHCA/NCAL indicates that a small number of patients could have an anaphylactic reaction, similar to a food allergy.
 
ACTION: Please send pdegrasse@hfam.org an email ASAP if you have the capacity to administer this treatment—or to outline suggestions for a transportation/protocol plan to get clinically appropriate patients to the treatment.
 
REMINDERS, AS ALWAYS:
 
  • People first, quality counts.
  • Our sector MUST double our efforts on infectious disease protocol, staffing, PPE, observation, and testing.
  • Train, train, and train teams again on infectious disease protocol.
  • Recognize that COVID-19 fighting fatigue is an issue across the country, not just in our sector.
  • Overcommunicate with residents, patients, families, staff, and government partners.
  • Work with your hospital partners, and coordinate with local and state regulatory partners.
  • Take and document your action; keep a timeline (including staff needed to administer POC testing)
  • CLICK HERE for the Dr. Katz Video, and please see the Donning and Doffing Checklist we first distributed a couple of months ago.

Be well,
Joe DeMattos
President and CEO
Maryland Department of Health Issues Healthcare Worker Exemptions and Contingency Capacity Standards to Mitigate Healthcare Staffing Shortages

See the attached guidance allowing asymptomatic healthcare workers who have been exposed to COVID-19 to work, at the discretion of the employer.  Note that this guidance applies to both skilled nursing and assisted living facilities.
MDH LTC Redetermination Extension

On November 24, MDH announced that the Department has extended Medicaid redeterminations to March 31, 2021. Attached Memorandum. The Maryland Department of Health (MDI-I) requested and received additional approvals from the Centers for Medicare and Medicaid Services (CMS) and the Maryland Department of Budget and Management (DBM) to extend the deadline for renewal of Medicaid cases in Maryland, including Long-Term Care (L TC) Medicaid cases.

Redetermination and renewal deadlines set for March 31, 2020, April 30, 2020, May 31, 2020, June 30, 2020, July 31, 2020, August 31, 2020, September 30, 2020, October 31, 2020, November 30, 2020, December 31, 2020, January 31, 2021 and February 28, 2021 have been extended to March 31, 2021. Cases that are due to close on those dates have been extended to March 31, 2021.
MDH Update POC Distribution

MDH has notified us that they will be shipping two weeks worth of supplies at a time. The first shipment to support the Governor's order is expected to arrive this week and the next shipment by the end of next week (11/30) or the beginning of following week (12/7). If you have any test questions, especially the shipments of rapid antigen tests, please contact MDH.RapidPOCtest@Maryland.gov.
CRISP Reports Delay in Implementation of Bulk Reporting of POC Test Results
 
While credentialing of Direct Accounts is still occurring, the bulk reporting of POC test results is being delayed. There is a 2 Account limit per facility and Direct Accounts are only for use if you will be submitting more than 20 test results per day.

CRISP is running further testing on the new workflow and pilot sites to ensure that the full rollout goes as smooth as possible. CRISP understands how important this feature will be and they are working hard to ensure it goes live at the earliest time with an excess of security.
Reminder: MDH Orders Requiring PPE Stockpile

Per the most recent nursing home order, all nursing homes are required to stock and maintain a 30 day private stockpile of PPE by November 30, 2020 and increase that amount to a 60 day private stockpile of PPE by January 31, 2021. All nursing homes must report their PPE inventory to MDH weekly.
PPE Resource - Caton Health Services

Caton Health was instrumental in sourcing the multiple PPE requests for the HFAM / Horizon Foundation Grant. Contact Sherri at Caton Health Health Services for your immediate and future PPE need.

Sherri P. Gamerman, MPA
Caton Health Services, Inc.
3407 Wilkens Avenue
Suite 230
Baltimore, Maryland 21229
410-644-1111
Need PPE? 

Thanks to a partnership with our colleagues at LifeSpan Network and LeadingAge Maryland, we can help with that! Gloves, masks, gowns, shields, shoe coverings and more are available. Please contact APBeacon@Lifespan-network.org to let us know your PPE needs so we can provide you with the best pricing options.  
Medline: Spot Buys mitigate shortages on COVID-19 core products

To meet the demand for medical supplies during this time of supply chain strain, Medline has sourced and procured several new products through "spot buys" in order to alleviate the pain due to shortages on some of their traditional products.
 
In this catalog you will find:

  • An overview of the spot buy program
  • Products currently available
  • Details on availability, pricing, and other purchase specifics
 
Keep in mind that what is included and available may change from week to week.
Did you miss HFAM's previous alerts?

Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
Thank you.

We cannot thank you enough for the dedication and diligence in doing all that you can for the residents in your communities. HFAM continues to monitor the COVID-19 pandemic with our state and national partners and will do all we can to support you during this time.