COVID-19 UPDATE #234
March 17, 2022
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PPE, TESTING SUPPLIES, AND SUPPLY CHAINS - FACILITIES NEED TO ENSURE ADEQUATE STOCKPILES |
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As COVID rates continue to decline in our state and facilities, that is not the case elsewhere in the world. The international effects of continued COVID activity are having, and are predicted to have, significant impact on the supply chains coming into the United States. It is important now and moving forward for skilled nursing and assisted living facilities to maintain the maximum possible stockpile of PPE, testing supplies, and other needed supplies. Now is not the time to think that this pandemic is over. If we have learned anything over the last two years, it is to expect the unexpected and to prepare for the worst.
WHCA was informed yesterday in a meeting with the DOH and DSHS that DOH will begin “phasing out” their supplies of testing materials available to facilities as FEMA monies are being eliminated. What materials/supplies they have will be allocated to the local health jurisdictions throughout the state. The DOH will not be filling any direct orders to facilities/entities moving forward. Please contact your local LHJ for emergency testing resources.
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LATE FEES FOR RENEWALS AND REACTIVATIONS WILL BEGIN APRIL 4, 2022 |
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On April 4, 2022, NCQAC is reinstating late fees for all late license renewals and reactivations. We requested the waiver of late fees for renewals and reactivations on March 31, 2020, under WSR 20-08-125. We did this to help nurses return to active status in response to the COVID-19 public health emergency. Starting Monday April 4, 2022, all late renewals must include the $50 late fee. All reactivation applications must include both the $50 late fee and the $70 expired license reissuance fee.
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RESEARCH REVIEW SHOWS COMMUNITY SPREAD IS THE PRIMARY DRIVER OF COVID OUTBREAKS IN SNFs |
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A review of scientific research by leading academic experts in the field found that community spread was the primary driver of COVID-19 outbreaks in long term care facilities. The review examined 36 different studies, and the final analysis was published in the Journal of the American Geriatrics Society. The paper supports prior findings that showed that the size and location of a facility were the strongest and most consistent predictors of COVID-19 outcomes, especially if the facility was located in an area with high COVID-19 rates.
The study concluded that if communities had been better able to control the spread of the virus, nursing homes would have had a better chance at mitigating outbreaks and safeguarding residents. Additionally, the scientific review found that ownership type and quality performance were not strong indicators of how prepared a nursing home was for the pandemic. This means a facility’s rating within the Five-Star Quality Rating System and any previous infection control citations were not associated with COVID cases and deaths. The conclusion of the research stated:
“Given the importance of community COVID-19 prevalence and facility size, studies that failed to control for these factors were likely confounded. Better control of community COVID-19 spread would have been critical for mitigating much of the morbidity and mortality long-term care residents and staff experienced during the pandemic. Traditional quality measures such as Nursing Home Compare 5-Star ratings and past deficiencies were not consistent indicators of pandemic preparedness, likely because COVID-19 presented a novel problem requiring extensive adaptation by both long-term care providers and policymakers.”
Long term care residents are more susceptible to the virus because of their age and underlying medical conditions. And while heroic caregivers did everything they could to help prevent cases, they often lacked support from the public health sector for much-needed resources such as personal protective equipment (PPE), testing, and staff support. Read more.
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CONGRESS EXTENDS TELEHEALTH WAIVERS |
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The recent enactment of the Consolidated Appropriations Act (CAA) includes provisions to extend beneficial telehealth waiver policies advocated by AHCA/NCAL. Under the current COVID-19 telehealth waiver policy, Medicare beneficiaries in all geographic locations can access telehealth services. Without legislative relief, beneficiaries in their homes, including assisted living residences or in nursing facilities in urban locations, would lose this access once the COVID-19 public health emergency (PHE) ends. Title III, Subtitle A, Section 301 of the CAA legislation extends access nationwide for 151 days after the end of the PHE. AHCA/NCAL and a large coalition of provider groups requested a two-year extension.
Section 302 also addresses a request by AHCA/NCAL and a coalition of therapy advocacy organizations to assure continued beneficiary access to rehabilitation therapy services via telehealth once the PHE ends. Specifically, the legislation explicitly lists physical therapists, occupational therapists, and speech-language pathologists as eligible telehealth practitioners for 151 days following the end of the COVID-19 PHE.
The following telehealth waiver provisions are also extended for 151 days after the end of the COVID-19 PHE:
- Section 303 extends telehealth services access in federally qualified health centers and rural health clinics.
- Section 304 delays the in-person requirements for mental health services furnished via telehealth.
- Section 305 extends the ability for beneficiaries without broadband internet access or difficulty using telehealth technology to still access audio-only telehealth services.
- Section 306 extends flexibilities for beneficiaries to access hospice recertification via telehealth.
While temporary, these welcome extensions of telehealth waiver provisions permit more time for policymakers to evaluate the effectiveness of the waivers to determine which should become permanent. Section 308 includes two provisions to achieve this:
- It requires a report on telehealth utilization and policy recommendations to be submitted to Congress by the Medicare Payment Advisory Commission no later than June 15, 2023.
- The legislation directs the Secretary of Health and Human Services to publish telehealth utilization data on a quarterly basis and to submit a report to Congress by June 15, 2023, regarding program integrity risks and policy recommendations associated with telehealth services.
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ORAL ANTIVIRALS NOW AVAILABLE TO LTC FACILITIES TO TREAT COVID-19 |
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The federal government has launched two new initiatives, “Test to Treat” and “Long-Term Care Pharmacy Program,” to create an allocation of oral antiviral medications for utilization in vulnerable populations. Via the Long-Term Care Pharmacy Program, as of March 7, long term care (LTC) pharmacies can direct order from the federal allocation, which has significantly increased the access to these lifesaving therapies for LTC residents who are at increased risk for developing severe COVID-19. While vaccination continues to provide the best protection against COVID-19, the “Test to Treat” and “Long-Term Care Pharmacy Program” are part of a broader strategy to quickly connect eligible individuals who are at high risk of getting very sick from COVID-19 to treatments.
LTC facilities who have need for these therapeutics should reach out to their pharmacies for consultation and request the oral antivirals Paxlovid (by Pfizer) and Molnupiravir (by Merck). It is important to note that certain medications may have drug-to-drug interactions when using oral antivirals. Pharmacists should review the resident’s medication list prior to filling the prescription.
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SEATTLE & KING COUNTY PUBLIC HEALTH UPDATES TESTING RECOMMENDATIONS AND HAS TESTING RESOURCES AVAILABLE |
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Seattle & King County Public Health has updated their long term care facility testing recommendation to twice weekly testing of all staff, regardless of vaccination, rather than three times per week. A prepared letter provides detailed information on this recommendation. Seattle & King County Public Health continues to provide Ag tests to facilities who order them. Facilities may reach out to an investigator with whom they currently work or with whom they have previously worked or email LTCF COVID Support to request an order be placed for them. |
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COMAGINE OFFERS WEEKLY WEBINARS TO SUPPORT SNFs WITH COVID-19 VACCINATION RESOURCES |
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Comagine is offering two weekly webinar series for skilled nursing centers to support ongoing COVID-19 vaccination efforts. Below are the two weekly webinars available.
Weekly Webinar Series for LTPAC Facilities to Support COVID-19 Vaccine and Booster Rates
Join us for a 30-minute webinar series focused on improving vaccine and booster rates in your facilities. Each week we will present best practices and resources that are actionable for your facility leaders and staff.
Weekly Open Office Hours for LTPAC Facilities to Support Vaccinations
Join Comagine Health for 30 minutes every Friday for an open conversation about raising your COVID-19 primary vaccine series and booster rates for residents and staff. Join us to learn about new resources and best practices, to ask questions, and to hear and learn from a small group of your peers.
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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.
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