• COVID-19: CMS QSO Memo Details Nursing Home Reopening Recommendations for State and Local Officials (5/20)

    Tuesday, May 19, 2020 | CMS

    • Recommendations for State and Local Officials: CMS is providing recommendations to help determine the level of mitigation needed to prevent the transmission of COVID19 in nursing homes. The recommendations cover the following items:

    o Criteria for relaxing certain restrictions and mitigating the risk of resurgence: Factors to inform decisions for relaxing nursing home restrictions through a phased approach.

    o Visitation and Service Considerations: Considerations allowing visitation and services in each phase.

    o Restoration of Survey Activities: Recommendations for restarting certain surveys in each phase.

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  • OIG Targets Monitoring Psychotropic Drug Use in Nursing Homes (5/20)

    Monday, May 18, 2020 | OIG
    Previous OIG work found that elderly nursing home residents who were prescribed antipsychotics, a type of psychotropic drug, were at risk for harm. In response, the Centers for Medicare & Medicaid Services (CMS) took steps to address the risk of harm to nursing home residents. One such step was introducing a quality measure to track the rates of antipsychotic drug use in residents without an appropriate diagnosis. Recently, CMS and researchers expressed concerns that some nursing homes underreport antipsychotic drug use and may inaccurately report certain patient diagnoses in order to avoid CMS monitoring. Additionally, research on antipsychotic drug use has highlighted the need to closely monitor all psychotropic drug use to accurately oversee drug use in nursing homes. We will determine the extent to which there are inconsistencies, if any, between (1) Medicare claims data for residents prescribed psychotropic drugs compared to nursing home self-reported data on residents who received psychotropic drugs, and (2) Medicare claims data as it relates to the diagnoses that exclude residents from monitoring in the antipsychotic quality measure compared to nursing home self-reported data on resident diagnoses.
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  • CMS COVID-19 Stakeholder Engagement Calls – Week of 5/18/20

    Monday, May 18, 2020 | CMS

    CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

    Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. 

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  • OSHA Alert: COVID-19 Guidance for Nursing Home and LTC Facility Workers (5/20)

    Monday, May 18, 2020 | MX

    The Occupational Safety and Health Administration (OSHA) is committed to protecting the health and safety of America’s workers and workplaces during these unprecedented times. The agency will be issuing a series of alerts designed to keep workers safe. In a nursing home or long-term care facility, the following tips can help reduce the risk of exposure to the coronavirus.

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  • LTCSP Survey Resources: Surveyor Tools Updated to Include COVID-19 (5/20)

    Monday, May 18, 2020 | CMS

    This ZIP file contains resources for surveyors conducting initial surveys under the Long-term Care Survey Process (LTCSP).

     

     05/14/2020 COVID-19 Focused Survey folder Updated the following:

    • F-Tag Job Aid- changed font color of F761 to black. Removed asterisks from F885.

    • Added updated F-Tag job aide to survey resources zip file.

     

    05/08/2020 COVID-19 Focused Survey folder Updated the following:

    • Summary of the COVID-19 Focused Survey for Nursing Homes Added to offsite survey activities-telephonic interviews of residents, representatives and families. Added review communication with residents, representatives and families. In the onsite survey activity section added in the interview section-information provided to residents concerning COVID-19. In the Facility Self-Assessment added Reporting to residents, families and representatives to priority areas. Added Reporting to CDC to priority areas.

    • COVID-19 Focused Survey Protocol Added information about the review of F884 by CMS Federal Surveyors. Added ACO coding information to off-site prep. Expanded information under offsite and onsite activities.

    • Entrance Conference Worksheet Clarified language under #9. Added #13 requesting information on facility’s mechanism for reporting COVID-19 to residents, representatives, and families.

    • COVID-19 Focused Survey for Nursing Homes Added two critical elements (CE) and adjusted the CE order. #7 CE Reporting to Residents, Representatives & Families, #8 Reporting to CDC, and #9 Emergency Preparedness.

    • F-Tag Job Aid- Added tags F884 and F885

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  • LTCSP Survey F-Tag List by Regulatory Grouping UPDATED and Additional Resources (5/20)

    Sunday, May 17, 2020 | CMS
    These resources from CMS include a list of F-tags by regulatory grouping used in the Long-term Care Survey Process (LTCSP) effective Nov. 28, 2017, and a crosswalk between old and new F-tags. CMS updated the tag list in May 2020.
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  • CDC Long-term Care COVID-19 Resources Updated (5/20)

    Thursday, May 14, 2020 | CDC

    Interim Additional Guidance for Infection Prevention and Control for Patients with Suspected or Confirmed COVID-19 in Nursing Homes

     

    Summary of Changes to the Guidance:

    Updated guidance to recommend that nursing homes:

    • Act now to implement ALL COVID-19 preparedness recommendations, even before cases are identified in their community
    • Address asymptomatic and pre-symptomatic transmission, implement source control for everyone entering a healthcare facility (e.g., healthcare personnel, patients, visitors), regardless of symptoms.
    • Dedicate an area of the facility to care for residents with suspected or confirmed COVID-19; consider creating a staffing plan for that specific location


    COVID-19 Preparedness Checklist for Nursing Homes and other Long-Term Care Settings

    Nursing homes and other long-term care facilities can take steps to assess and improve their preparedness for responding to coronavirus disease 2019 (COVID-19). This checklist should be used as one tool to develop a comprehensive COVID-19 response plan, including plans for:

    • Rapid identification and management of ill residents
    • Considerations for visitors
    • Supplies and resources
    • Sick leave policies and other occupational health considerations
    • Education and training
    • Surge capacity for staffing, equipment and supplies, and postmortem care

    The checklist identifies key areas that long-term care facilities should consider in their COVID-19 planning. Long-term care facilities can use this tool to self-assess the strengths and weaknesses of current preparedness efforts. This checklist does not describe mandatory requirements or standards; rather, it highlights important areas to review to prepare for the possibility of residents with COVID-19.

     

    Additional pages: 


     


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  • CMS COVID-19 Nursing Homes Best Practices Toolkit and New QIN-QIO Virtual Assistance (5/20)

    Wednesday, May 13, 2020 | CMS

    New tool provides innovative solutions for states and facilities to protect our nation’s vulnerable nursing home residents during emergency

    CMS has released a new toolkit developed to aid nursing homes, Governors, states, departments of health, and other agencies who provide oversight and assistance to these facilities, with additional resources to aid in the fight against the coronavirus disease 2019 (COVID-19) pandemic within nursing homes. The toolkit builds upon previous actions taken by the Centers for Medicare & Medicaid Services (CMS), which provide a wide range of tools and guidance to states, healthcare providers and others during the public health emergency. The toolkit is comprised of best practices from a variety of front line health care providers, Governors’ COVID-19 task forces, associations and other organizations, and experts, and is intended to serve as a catalogue of resources dedicated to addressing the specific challenges facing nursing homes as they combat COVID-19.

    “The coronavirus presents a unique challenge for nursing homes. CMS is using every tool at our disposal to protect our nation’s most vulnerable citizens and aid the facilities that care for them. This toolkit will support state, local leaders and nursing homes in identifying best practices to protect our vulnerable elderly in nursing homes” said CMS Administrator Seema Verma.  

    The toolkit provides detailed resources and direction for quality improvement assistance and can help in the creation and implementation of strategies and interventions intended to manage and prevent the spread of COVID-19 within nursing homes. The toolkit outlines best practices for a variety of subjects ranging from infection control to workforce and staffing. It also provides contact information for organizations who stand ready to assist with the unique challenges posed by caring for individuals in long-term care settings. Each state was involved in the creation of this toolkit, resulting in a robust resource that may be leveraged by a variety of entities serving this vulnerable population.

    Additionally, CMS has contracted with 12 Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) to work with providers, community partners, beneficiaries and caregivers on data-driven quality improvement initiatives designed to improve the quality of care for beneficiaries across the United States. The QIN-QIOs are reaching out to nursing homes across the country to provide virtual technical assistance for homes that have an opportunity for improvement based on an analysis of previous citations for infection control deficiencies using publicly available data found on Nursing Home Compare.

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  • CMS QSO Memo updates F-tags and COVID-19 Focused Survey Tools to Include Reporting Requirements (5/20)

    Thursday, May 7, 2020 | CMS
    Interim Final Rule Updating Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes

    Memo # QSO-20-29-NH

    Posting Date 2020-05-06

    Fiscal Year 2020

     

    Summary

    • CMS is committed to taking critical steps to ensure America’s healthcare facilities are prepared to respond to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE).

    • On May 8, 2020, CMS will publish an interim final rule with comment period. • COVID-19 Reporting Requirements: CMS is requiring nursing homes to report COVID-19 facility data to the Centers for Disease Control and Prevention (CDC) and to residents, their representatives, and families of residents in facilities.

    • Enforcement: Failure to report in accordance with 42 CFR §483.80(g) can result in an enforcement action.

    • Updated Survey Tools: CMS has updated the COVID-19 Focused Survey for Nursing Homes, Entrance Conference Worksheet, COVID-19 Focused Survey Protocol, and Summary of the COVID-19 Focused Survey for Nursing Homes to reflect COVID-19 reporting requirements.

    • COVID-19 Tags: F884 and F885.

    • Transparency: CMS will begin posting data from the CDC National Healthcare Safety Network (NHSN) for viewing by facilities, stakeholders, or the general public. The COVID-19 public use file will be available on https://data.cms.gov/.

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  • National Healthcare Safety Network Long-term Care Facility COVID-19 Reporting Module Website (5/20)

    Tuesday, May 5, 2020 | CDC

    CDC’s NHSN provides healthcare facilities, such as long term care facilities (LTCF) with a customized system to track infections and prevention process measures in a systematic way.

    Tracking this information allows facilities to identify problems, improve care, and determine progress toward facility and national healthcare-associated infection goals.

    The NHSN Long-term Care Facility Component is supporting the nation’s COVID-19 response by introducing a new COVID-19 Module for Long Term Care Facilities. Facilities eligible to report into the COVID-19 Module include nursing homes/skilled nursing, long-term care for the developmentally disabled, and assisted living facilities.

    The COVID-19 Module for LTCFs consists of four pathways within NHSN’s Long-term Care Facility Component:

    • Resident Impact and Facility Capacity
    • Staff and Personnel Impact
    • Supplies and Personal Protective Equipment
    • Ventilator Capacity and Supplies

    The Module enables an assessment of the impact of COVID-19 in LTCFs through facility reported information, including: 1) counts of residents and facility personnel with suspected and laboratory positive COVID-19; 2) counts of suspected and laboratory positive COVID-19 related deaths among residents and facility personnel; 3) staffing shortages; 3) status of personal protective equipment (PPE) supplies; and 4) ventilator capacity and supplies for facilities with ventilator dependent units.  The Module does not collect staff or resident-level information.

    Participation in the COVID-19 Module for LTCFs requires facilities to be actively enrolled in NHSN. LTCFs that are currently enrolled in NHSN’s LTCF Component have immediate access to the new module and may begin reporting. If your facility previously enrolled, but is no longer able to gain access, contact NHSN user support at nhsn@cdc.gov for assistance. Please do not re-enroll a previously enrolled facility.

    LTCFs that are not enrolled in NHSN may gain access to the COVID-19 Module by completing the enrollment process outlined in the Enrollment section of this page. Upon completion, the facility will gain same-day access to NHSN.

    While daily reporting will provide the timeliest data for response purposes, retrospective reporting of prior day(s) is encouraged if daily reporting is not feasible. LTCF data submission options include manual entry, CSV file submitted by individual facilities or bulk CSV file upload for multiple facilities.  NHSN, in turn, will enable state and local health departments and the Centers for Medicare and Medicaid Services (CMS) to gain immediate access to the COVID-19 data for LTCFs in their jurisdictions. COVID-19 data submitted to NHSN also will be used by CDC’s emergency COVID-19 response and by the U.S. Department of Health and Human Services’ (HHS’) COVID-19 tracking system maintained in the Office of the Assistant Secretary of Preparedness and Response.

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