Nursing Home Commission Releases Recommendations

On September 16, 2020 the Coronavirus Commission on Safety and Quality in Nursing Homes released it's report and formal recommendations to the Centers for Medicare & Medicaid Services (CMS). 

 

The report was compiled by MITRE Corporation, the independent research firm charged with administering the commission, and submitted to CMS on September 1, 2020.  CMS has utilized the time since to review findings and recommendations before releasing publicly. 

 

The report identifies seven main areas to focus on, stating "To reduce suffering and to save the lives of residents and staff, CMS can implement or initiate the Commission's actionable recommendations in relatively short order," the commission concluded.

 

The commission met numerous times over the summer months and emerged with 27 recommendations, which were paired with action steps for CMS to engage in.  From CMS's perspective, the Commission's findings align with the actions the Trump Administration and CMS have taken to contain the spread of the virus and to safeguard nursing home residents from the ongoing threat of the COVID-19 pandemic.

 

Further broken down, the guidance has 10 themes, which address responses to:

• Ongoing supply and affordability dilemmas related to testing, screening, and personal protective equipment (PPE)
• Tension between rigorous infection control measures and quality of life issues that exist in cohorting and visitation policies
• A call for transparent and accessible communications with residents, their representatives and loved ones, and the public
• Urgent need to train, support, protect, and respect direct-care providers
  Commission Final Report
• Outdated infrastructure of many nursing-home facilities
• Opportunities to create and organize guidance to owners and administrators that is more actionable and to obtain data from nursing homes that is more meaningful for action and research
• Insufficient funding for quality nursing home operations, workforce performance, and resident safety.

"The intent is that CMS would implement each principal recommendation in conjunction with its associated action steps to understand and realize the Commission's vision," the report summary states.

 

Several members of the commission, including former American Health Care Association Board Chairman and CEO of PruittHealth Neil Pruitt Jr., as well as Jeannee Parker Martin, president and CEO of LeadingAge California, took part in a discussion of the final report and recommendations at the White House today along with CMS Administrator Seema Verma, Vice President Mike Pence, CMS chief Robert Redfield and AHCA President and CEO Mark Parkinson.

 

Testing for AL and SNFs -Abbot Webinar with Details Announced

Beginning this week, the US Department of Health and Human Services (HHS) will begin sending 1 million Abbott BinaxNOW test kits to skilled nursing facilities and 540,000 test kits to assisted living (AL) communities certified by the Centers for Medicare & Medicaid Services (CMS) with a Clinical Laboratory Improvement Amendment (CLIA) Certificate of Waiver.   We have heard from ALs in Michigan that the test kits have begun arriving on-site.

 

Abbott & HHS will be sharing a webinar on Friday, September 18 at 12:00 pm EST to provide more information on the tests themselves, including training, and use in assisted living facilities. During the webinar, Abbott will demonstrate the training tools available and representatives from HHS will be online to speak about the program. Register now for the webinar.

 

AHCA's understanding is that HHS will ship test kits to all ALs with CLIA Certificates of Waiver this week to be used for residents and staff. Kits will also be sent to some SNFs for use with staff. Replenishment of kits will be weekly thereafter with enough kits varying by the county the facility is located in, and based on the CMS ratings for COVID-19 test positivity in that county (red, yellow or green). HHS has also provided a training portal HERE. 

 

We have also heard that some providers have received an invoice from Abbott. AHCA confirmed with Abbott yesterday that these were sent in error and you do NOT need to pay these invoices. Similarly, some members received information about "shipping specifications" that also include an error that they would be receiving large pallets of test kits. The amount of test kits will be based on estimates of the number of residents and staff you have in your facility and to last you for 1-2 weeks until the next shipment arrives.  

 

Please contact Linda Lawther at LindaLawther@michcal.com if you have questions or concerns regarding the Abbot test kits.

 

Testing Guidance for CMS QSO Memo 20-38-NH

This afternoon, Michelle Roepke, Director Director-Federal Survey and Certification Division, Bureau of Community and Health Systems (BCHS) shared an update regarding notification and documentation of COVID testing challenges as below:

 

The Federal Survey and Certification Division (FSCD) within the Bureau of Community and Health Systems (BCHS) in the Department of Licensing and Regulatory Affairs (LARA) provides the following guidance based on the CMS Memo QSO 20-38-NH, dated August 26, 2020.

 

In the memo, CMS has listed a target Turn Around Time (TAT) of 48 hours for COVID laboratory test results. 

 

In the CMS QSO 20-38-NH memo (page 5, 1st paragraph) it states the following:

 

"If the 48-hour turn-around time cannot be met due to community testing supply shortages, limited access or inability of laboratories to process tests within 48 hours, the facility should have documentation of its efforts to obtain quick turnaround test results with the identified laboratory or laboratories and contact with the local and state health departments."

 

BCHS shares the following guidance in response to the inability to meet the 48 hour turnaround time as required by CMS:

• The provider should contact MDHHS at MDHHS-LTCRequests@michigan.gov, to inform them of the delay in receiving the testing results, and request assistance with timely testing.  
• The provider does not notify the LARA survey team managers regarding the delayed testing results.
• The provider is to retain copies of the e-mail communication with the department is an example of the type of documentation the surveyor would be looking for.  The same would apply when contacting the local health departments. 
• Examples of documentation when contacting the laboratory would be e-mail communication or phone logs documenting the date, time and the contact person at the laboratory. 
• The provider should document continued efforts to obtain quick TAT after notification to MDHHS.

The association has worked to clarify with CMS the 48-hour window of time.  The window should begin at the time of specimen collection and end with receipt of test results.

 

Aerial Treatment Continues Tonight; Additional Cases Of EEE In Horses Expands Treatment Areas And Adds Livingston County

With the confirmation of six additional horse cases of Eastern Equine Encephalitis (EEE), aerial treatment is slated to continue tonight with additional treatment blocks added to the overall plan, the Michigan Department of Health and Human Services (MDHHS) announced today.

The new cases of EEE in horses added Livingston County to the list bringing the total to 28 cases in 11 counties. Impacted counties are now Barry, Clare, Ionia, Isabella, Jackson, Kent, Livingston, Mecosta, Montcalm, Newaygo and Oakland. In addition, there is one suspect case of EEE in a Barry County resident.

 

The newly discovered EEE cases expand or add treatment blocks in Ionia, Jackson, Kent, Livingston and Montcalm counties. Aerial treatment conducted on Sept. 16, covered more than 157,000 acres in Blocks 4-1, 4-2, 8-1, 9-1, 9-2, 9-3 and 9-4.

 

Areas slated for treatment tonight are identified in the Aerial Treatment Zones Map:

• Block 5-1 in Kent County.
• Block 6-1 in Newaygo, Oceana and Muskegon counties and 6-2 in Newaygo County.
• Block 7-1 in Mecosta County.
• Block 10-1 in Ionia County.
  

If time and weather permit, the following areas will also be treated:

• Blocks 1-1 and 1-2 in Barry County.
• Block 2-1 in Jackson County. 
  

To reduce the potential to be bitten by mosquitoes, consider postponing, rescheduling or cancelling outdoor activities occurring at or after dusk until the first hard frost of the year.

 

For more information about EEE, visit Michigan.gov/EEE.

2021 AHCA/NCAL Quality Award Applications Available: Submit Your Intent to Apply Today!

The 2021 AHCA/NCAL National Quality Award Program year has started and applications are available on the Quality Award website. We hope you will consider applying for this prestigious award and submit your Intent to Apply today!

 

Participating in the Quality Award Program has many benefits, including:

• A proven framework that organizations can use to make improvements in any clinical, quality or other operational issue (i.e. staff engagement, customer satisfaction, hospital readmissions).
• It prepares organizations to meet regulatory requirements and navigate a changing market.
• It serves as a team building activity to engage staff across all levels of the organization.
• Organizations gain recognition, serving as a marketing resource for consumers, referral partners and hospitals.
• Participants receive customized feedback with their top strengths and improvement areas.

2021 Deadlines

• Intent to Apply (ITA) Deadline - November 12, 2020
• Application Deadline - January 28, 2021

If you're interested in other ways to get involved, consider becoming an Examiner for the 2021 program year. Examiners play a significant role in reviewing Quality Award applications and impacting quality improvement in organizations across the country.

 

It's never too early to start preparing. For additional information, visit the Quality Award website at ahcancal.org/qualityaward or email qualityaward@ahca.org.

 

 

For questions or concerns please contact Cathy Sunlin at CathySunlin@HCAM.org.

 

 Sept. 17, 2020