COVID-19 UPDATE #173
August 6, 2021
JOIN THE FIGHT: MONOCLONAL ANTIBODY THERAPEUTICS FOR HIGH-RISK COVID-19 POSITIVE RESIDENTS
COVID-19 and its variants are plaguing the country as we see case counts rise once again. The COVID-19 vaccine is critical in slowing the spread. In addition to the vaccine, once a person is infected with COVID-19 and are considered high-risk, the focus should turn to treatment using monoclonal antibodies (mAbs) and therapeutics.  

The Health and Human Services Office of the Assistant Secretary for Preparedness and Response (HHS ASPR) has updated the CombatCOVID website with new resources to support providers in the fight against COVID-19.  

Included in the updates are: 
  • ​New testimonials from healthcare providers. 
  • Promising practice briefs that describe how health care leaders have improved access to mAb treatment for high-risk patients with COVID-19. 
  • View a Facebook Live event held on August 5 featuring experts with ASPR and CDC discussing COVID-19 variants.
CDC UPDATES GUIDANCE FOR FULLY VACCINATED INDIVIDUALS
The Centers for Disease Prevention and Control (CDC) announced updated guidance for fully vaccinated individuals. This policy is aimed at preventing transmission levels of the highly communicable and now predominant Delta variant. The CDC has released additional information in its Mortality and Morbidity Weekly Report.  

As of now, CDC guidance for long term care has not changed. However, this new guidance does impact staff outside of work, and we​ encourage you to educate your staff on this new guidance, the impact of the Delta variant, and the importance of getting vaccinated to prevent further spread.​  

As the Delta variant continues to spread, it will impact testing frequency and other infection control practices. Please double down on your efforts to follow CDC infection control guidance. AHCA/NCAL recommends reviewing the following CDC documents:  

If community rates continue to increase and vaccination rates remain the same, we anticipate seeing changes to our infection control and other guidance from the CDC. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) will continue to work closely with the CDC and keep us informed of changes that impact you.
AHCA/NCAL WEBINAR: HOW TO BOOST YOUR STAFF VACCINATION RATES | AUGUST 11
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) will host a webinar on August 11 at 12 noon PST focused on the recent report, Invest in Trust: A Guide for Building COVID-19 Vaccine Trust Among Certified Nursing Assistants (CNAs). The report’s lead researcher will share key findings from the report that was commissioned by the AHRQ ECHO National Nursing Home COVID-19 Action Network. You will also hear from two long term care (LTC) providers who have worked hard to improve vaccination rates among their staff. 

This webinar will also involve a Q&A session to allow attendees to share their challenges and seek insight from the speakers. Through both evidence-based research and real-world stories of success, this webinar will provide you with helpful tools and knowledge to improve your staff vaccination rates.

LTC communities have been working tirelessly to build COVID-19 vaccine confidence among their staff, but data from the CDC show that only approximately 59% are fully vaccinated. With the new delta variant quickly spreading in the United States, it is more important than ever to increase staff vaccination rates.​
WHAT DOES RENEWAL OF THE PUBLIC HEALTH EMERGENCY MEAN FOR SKILLED NURSING PROVIDERS?
The Department of Health and Human Services (HHS) renewed the Public Health Emergency (PHE) on July 20. The PHE renewal also extends all Section 1135 waivers, irrespective of a state’s PHE status – the federal waivers remain in place. Recently, several providers across the nation have reported hospitals indicating the SNF 3-Day Stay Waiver no longer is in effect and other incorrect information. 
 
Based upon the PHE renewal:
  • 3-Day Stay Waiver Remains in Effect: The waiver language is unchanged: “3-Day Prior Hospitalization. Using the authority under Section 1812(f) of the Act, CMS is waiving the requirement for a 3-day prior hospitalization for coverage of a SNF stay, which provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who experience dislocations, or are otherwise affected by COVID-19. In addition, for certain beneficiaries who recently exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period (this waiver will apply only for those beneficiaries who have been delayed or prevented by the emergency itself from commencing or completing the process of ending their current benefit period and renewing their SNF benefits that would have occurred under normal circumstances).” SOURCE: CMS Waiver Document
  •  SNF Providers Do Not Need Hospital Documentation: The 3-Day Stay Waiver is intended to free up as many hospital beds as possible by allowing beneficiaries who meet the Skilled Care Criteria to be directly admitted to a SNF. In regard to documentation, SNFs need only document that the beneficiary meets the SNF Criteria for Skilled Care and code claims associated with waiver stays using the disaster billing codes. Billing instructions are here.
  •  AHCA 3-Day Stay Guidance: AHCA also developed 3-Day Stay guidance for the membership. This guidance is located here. You will note this document indicates the waiver guidance is “until April 21, 2021.” This is an anachronism which we will correct. 
NHSN ANNOUNCES CHANGES TO COVID-19 VACCINATION SUMMARY | SNF
The National Healthcare Safety Network (NHSN) has announced new changes coming this fall to NHSN reporting for skilled nursing facilities. Changes will be made to the Health Care Personnel COVID-19 Vaccination Cumulative Summary.  

Changes include: 
  • Current health care personnel categories will no longer be collected. New categories include: 
  • ​Employees on facility payroll 
  • ​​Licensed independent practitioners (physicians, nurse practitioners, etc.) 
  • Adult students/trainees and volunteers (non-employees aged 18+) 
  • Other contract personnel (contracted staff who do not fall into any other category) 
  • Question #3.2 (offered but declined) and question #3.3 (unknown COVID-19 vaccination status) will be required 
  • Question #4 COVID-19 Vaccine supply is now optional 

What you need to do now: 
  • ​Watch for the monthly reporting plan form and a table of instructions document which will be available this fall 
  • Develop or update data tracking mechanisms to collect weekly COVID-19 vaccination data on the new categories of health care personnel 

The CDC will be conducting training webinars this fall. In the meantime, email questions to NHSN@cdc.gov​ with the subject line “COVID-19 Vaccination Data Reporting.”
WA-PALTC OFFERS UPDATE ON COVID IN POST-ACUTE LTC VIA WEBINAR
The Washington Society for Post-Acute Long Term Care (WA-PALTC) invites you to an update on COVID in post-acute long term care to be held on Wednesday, August 11, at 6 PM. The presenters will address vaccination, breakthrough cases, and the Delta variant, what has changed and what best practices now. 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.