Issue: March 23, 2020

Published on March 23, 2020

Articles in this issue:

DOH: Nursing Home Advisory Recommendations to Protect Nursing Home Residents

Author: Jackie Pappalardi and Lisa Volk* Published in Clinical & Quality

Attached is an Advisory with recommendations to Support Resident Physical Health and Support Resident Mental and Emotional Health.

NYSHFA/NYSCAL CONTACTS:

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

Suspension of Preauthorization Requirements

Author: Carl J. Pucci* Published in Clinical & Quality, Finance & Reimbursement

A temporary requirement for hospitals to suspend preauthorization review for scheduled surgeries or admissions for the next 90 days, subject to further evaluation, has been enacted. Here is the link to the guidance from NYS Department of Financial Services.

Questions should be directed to Colleen Rumsey at colleen.rumsey@dfs.ny.gov.

NYSHFA/NYSCAL CONTACTS:

Carl J. Pucci
Chief Financial Officer
518-462-4800 x36

CMS: Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19

Author: Lisa Volk and Jackie Pappalardi* Published in Clinical & Quality

CMS announced it is granting exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs with respect to upcoming measure reporting and data submission for those programs. The action comes as part of the Trump Administration’s response to 2019 Novel Coronavirus (COVID-19).

CMS is implementing additional extreme and uncontrollable circumstances policy exceptions and extensions for upcoming measure reporting and data submission deadlines for several CMS programs. For those programs with data submission deadlines in April and May 2020, submission of those data will be optional, based on the facility’s choice to report.

CMS recognizes that quality measure data collection and reporting for services furnished during this time period may not be reflective of their true level of performance on measures such as cost, readmissions and patient experience during this time of emergency and seeks to hold organizations harmless for not submitting data during this period.

You can find a copy of the press release here:  https://www.cms.gov/newsroom/press-releases/cms-announces-relief-clinicians-providers-hospitals-and-facilities-participating-quality-reporting

CMS will continue monitoring the developing COVID-19 situation and assess options to additional relief to clinicians, facilities, and their staff so they can focus on caring for pat

This action, and earlier CMS actions in response to COVID-19, are part of the ongoing House Task Force efforts. To keep up with the important work the Task Force is doing i response to COVID-19, please visit Coronavirus.gov. For a complete and updated l CMS actions, and other information specific to CMS, please visit the Current Emergencies Webpage on CMS.Gov.

NYSHFA/NYSCAL CONTACTS:

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16

Weekly Town Hall Calls – in Support of COVID-19 Topics of Concern

Author: Jackie Pappalardi* Published in Clinical & Quality

We are listening to your requests to receive information as quickly as possible.  To meet that request, NYSHFA-NYSCAL has set up weekly Town Hall Calls to provide you information on key topics as well as, to offer you an opportunity to get questions answered and/or receive clarification. The weekly Town Hall Calls will start on Thursday March 26, 2020 at 11:00am and will continue every Thursday at 11:00 am until further notice. Agendas listing topics will be sent at the beginning of each week. 

For future topics most important to your needs, please send us the top 2-3 topics and/or concerns you want information on at this time.  Please send your ideas to Jackie Pappalardi (jpappalardi@NYSHFA-NYSCAL.org)

AHCA: COVID-19 Update #17 - Call on the Public for Supplies

Author: Stephen Hanse* Published in Clinical & Quality

In This COVID-19 Update:

Public Call for Supplies 

PPE supplies are running dangerously low in most long term care facilities. Many facilities and states are issuing calls for public donations. AHCA/NCAL has developed a template to serve as a call for donations. 

Preparing for States’ Use of Increased FMAP Funds  

Due to significant increases in unemployment from business closures and related furloughs, states may choose to use any portion of last week’s 6.2% increase in federal Medicaid payments to provide Medicaid coverage for the newly unemployed and, very likely, uninsured. Such decisions will result in less Medicaid funding for provider rate increases to cover COVID-related costs.  

However, on March 21, the federal government announced that it is considering a special enrollment period for Affordable Care Act Health Insurance Exchange (HIX) coverage. Individuals purchase health care coverage through the HIX. The special enrollment period would be aimed at offering lower cost coverage to the individuals with reduced incomes if made available. Such a special enrollment period might influence state decision making on how much of the 6.2% federal Medicaid funding should be used on coverage versus COVID-related provider expenses.  

Suggested Action Step: State Affiliates should take steps to assess state decision on how to divide funds between Medicaid coverage for the uninsured and provider rate increased to address new COVID-related costs. See a more detailed discussion.   

Conversations Revisiting End-of-Life Wishes and Advance Directives 

In light of the high mortality rate (20-30%) for nursing home and assisted living community residents who become infected with COVID-19, we urge you to: 

In the coming weeks, we expect to have hospital surges across the country that will exceed the capacity to transfer nursing homes and assisted living communities' residents with suspected or confirmed COVID-19. Discussing with residents and families now as to how they want to be cared for in place in the nursing home or assisted living community will be helpful to inform how to best meet their wishes, in advance of the anticipated continued spread of COVID-19, and its increased strain on the health care system.

CMS Announces SNF QRP and VBP Relief in Response to COVID-19 

On March 22, the Centers for Medicare & Medicaid Services (CMS) announced administrative burden relief for providers participating in various quality programs during the COVID-19 outbreak. CMS recognizes that quality measure data collection and reporting for services furnished during this time of emergency may not be reflective of their true level of performance on measures such as cost and readmissions and seeks to hold organizations harmless for not submitting data during this period. Specific to SNFs, CMS is implementing exceptions and extensions for upcoming measure reporting and data submission deadlines for: 

Skilled Nursing Facility Quality Reporting Program 

Skilled Nursing Facility Value-Based Purchasing (VBP) Program  

CMS will continue monitoring the developing COVID-19 situation and assess options to bring additional relief to providers so they can focus on caring for patients. 

For additional questions, please email COVID19@ahca.org and visit www.ahcancal.org/coronavirus for more information and resources. 

COVID-19 Update #16 - Guidance on Essential Staff Entering Your Building / Communicating After a Confirmed Case

Author: * Published in Clinical & Quality

Communicating After a Confirmed Case

It’s important to keep families and staff informed once you have confirmed a case of COVID-19 in your building. To help with communication to all stakeholders, AHCA/NCAL has developed a sample letter for families and staff and talking points for the media and broader public. 

Making Decisions on Essential Staff Entering Your Building 

When deciding if a person needs to enter your building (including employees or outside contractors such as therapy, pharmacy, lab, portable x-ray, mental health provider, repair technicians, and others), all long term care facilities should consider the intent of the federal and state guidance on visitation and building entry restrictions.

The intent is to restrict entry of as many people as possible to reduce the risk of COVID-19 entering and/or spreading in the building.  Anybody entering the building must comply with the most current federal and state COVID-19 guidelines. Entering multiple buildings during the day should be discouraged, or increased attention to infection control processes should be applied in cases when it is essential.
  
This decision needs to be balanced with meeting the needs of the resident. The risk-benefit trade off needs to be made on a case-by-case basis and should be informed by the high mortality associated with contracting this virus in the elderly. This decision process should also be evaluated and adjusted as necessary as the COVID-19 situation evolves in your local community and building. 

Utilizing Non-Direct Care Staff to Support Needs 

COVID-19 has interrupted usual daily operations in all long term care facilities. This means some direct or non-direct care staff usual duties are on hold or not urgent during this pandemic. Thus, there is opportunity to engage those staff in supporting activities that must continue despite the pandemic disruptions.  Below are some ideas to consider.

Typical Nurse Aide Duties to be Stopped and Shifted to Other Non-Direct Care Staff: 

Nurse and Nurse Aide duties that could be supported by physical and occupational therapy and speech-language pathology staff: 

Typical Nurse (or some medication aide) duties to be shifted, stopped, or requests to reduce/discontinue: 

Please email COVID19@ahca.org for additional questions, and visit
www.ahcancal.org/coronavirus for additional information and resources. 

NYSHFA/NYSCAL CONTACTS:

Stephen B. Hanse, Esq.
President & CEO
518-462-4800 x11

Infection Control Session

Author: Nancy Knapp

Infection Control and Prevention is critical knowledge for all health care workers during this COVID-19 pandemic.  Our skilled nursing and assisted living workforce needs the most up to date information and guidance as they care for those at the greatest risk for COVID-19 infection. This is a free Infection Control and Prevention session (this is the same session as offered on Monday March 23, 2020) available for NYSHFA/NYSCAL members as listed below: 

Wednesday March 25, 2020 at 11:00 am
Don’t Forget the Basics During the CoVID-19 Pandemic!

Review of the basic and fundamental approaches to Infection Prevention and Control Program (IPCP) compliance such taking the time to stop, take a step back and look around to evaluate the common day-to-day infection control practices within our facilities.

Amy Lee, RN, MSN, CRRN, QCP
President/CEO Core-tactics

Call-in Number:  1-800-220-9875; Passcode:  14227658#


NYSHFA/NYSCAL CONTACT:

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16

REMINDER: COVID-19 HERDS survey for Nursing Homes and Adult Care Facilities

Author: Lisa Volk and Jackie Pappalardi* Published in Clinical & Quality

ATTENTION: Completion of survey is required 7 days a week

Please be sure to have staff available to complete and to respond to DOH questions

Read and confirm all information before submitting

Please be reminded that data entry for the COVID-19 HERDS survey on the Health Commerce System must be updated as soon as possible but no later than 1 PM today.

Please note that the form has an additional question related to census reduction due to COVID deaths in the hospital.

Please remind staff that roles on the Health Commerce System need to be up to date and all fields should be completed in order for the survey to be submitted.

For Nursing Homes we have opened the survey to the following roles:

Administrators, Director of Nursing, Director of Patient and Family Services, Emergency Response Coordinator, HPN Coordinator and NH Data Reporter

For Adult Care Facilities we have opened the survey to the following roles:

Administrators, Data Reporter, Director of Resident Services, Emergency Response Coordinator, and HPN Coordinator.

NYSHFA/NYSCAL CONTACTS:

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16

 

Please note that the form has an additional question related to census reduction due to COVID deaths in the hospital.

Please remind staff that roles on the Health Commerce System need to be up to date and all fields should be completed in order for the survey to be submitted.

For Nursing Homes we have opened the survey to the following roles:

Administrators, Director of Nursing, Director of Patient and Family Services, Emergency Response Coordinator, HPN Coordinator and NH Data Reporter

For Adult Care Facilities we have opened the survey to the following roles:

Administrators, Data Reporter, Director of Resident Services, Emergency Response Coordinator, and HPN Coordinator.

NYSHFA/NYSCAL CONTACTS:

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16

 

 

New York Workforce Reduction Guidance

Author: Stephen Hanse

Attached below, for your information, is a link to the State’s guidance for determining whether a business is subject to the workforce reduction requirements under the Governor Cuomo’s Executive Orders. Pursuant to this guidance, nursing homes, residential health care facilities and congregate care facilities and their employees, regardless of the nature of the service or the function they perform, are not subject to the Governor’s workforce reduction requirements. 

https://esd.ny.gov/guidance-executive-order-2026

NYSHFA/NYSCAL CONTACT:

Stephen B. Hanse, Esq.
President & CEO
518-462-4800 x11

DOH: Respiratory Illness in Nursing Homes and Adult Care Facilities in Areas of Sustained Community Transmission of COVID-19

Author: Lisa Volk and Amy Kennedy* Published in Clinical & Quality

Please see the attached Advisory regarding Respiratory Illness in Nursing Homes and Adult Care Facilities in areas of sustained community transmission of COVID-19.

NYSHFA/NYSCAL CONTACTS:

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

Amy Kennedy
Executive Director, NYSCAL
518-462-4800 x17

2020 Nursing Scholarship Program Accepting Applications

Author:

Once again we are pleased to announce the Foundation for Quality Care Nursing Scholarship Program. The Foundation for Quality Care, the research and education affiliate of the New York State Health Facilities Association/New York State Center for Assisted Living (NYSHFA/NYSCAL), will administer the Ruth E. Stafford and James D. Durante Nursing Scholarship Program for 2020. This Scholarship Fund Program has been established to provide financial support to incumbent employees of NYSHFA/NYSCAL member facilities who are also nursing students pursuing careers in long term care. The Durante/Stafford Scholarships will now be awarded to students/nurses in three categories:

Skilled Nursing

Category I:  Students pursuing licenses as a practical nurse or registered nurse.  Two scholarships for $2,000 each are available for the Category I Scholarship.

Category II:  Registered nurses pursuing advanced degrees in nursing (Bachelors, Masters, Doctorate, Nurse Practitioner, Clinical Specialist).  Two scholarships for $2,000 each are available for the Category II Scholarship.

Assisted Living

Students pursuing licenses as a practical nurse or registered nurse.  One scholarship for $2,000 is available.

The winners will be selected by NYSHFA’s Nurse Leadership Advisory Committee and awarded their Scholarship at the Annual Nurse Leadership Conference on Thursday, September 17, 2020 in Verona, New York.

Scholarship Criteria and Submission Information:
Attached are the Scholarship Brochure and Application and Recommendation Forms. At the time of application, and when the scholarships are awarded, applicants must be employed by a long term care facility that is a member in good standing of the New York State Health Facilities Association/New York State Center for Assisted Living. Applicants must be applying to or enrolled in / accepted to an accredited school of nursing program for the 2020-2021 academic year.

Applications are due by April 30, 2020.

If you have questions regarding this program, please contact Joanne O'Connor at the Foundation.

NYSHFA/NYSCAL CONTACTS:

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16

Joanne O'Connor
Communications & Business Development Coordinator
518-462-4800 ext. 23

NYSHFA/NYSCAL Website: Your Source for COVID-19 Daily Updates

Author: Joanne O'Connor

In response to the outbreak of COVID-19, we are committed to supporting you in providing up-to-date prevention strategies with information provided from the CDC, NYSDOH and American Health Care Association (AHCA) for Skilled Nursing and Assisted Living Facilities. For the most up to date information, visit www.nyshfa-nyscal.org and click on COVID-19 Daily Updates on the Home page or click here:  https://www.nyshfa-nyscal.org/operations/emergency-preparedness/.