HQI/ASCP Webinar Invite

January 31, 2023: Clearing the Path for a Healthy New Year: Improving Bivalent Booster Rates in Long-Term Care

Join a FREE interactive panel discussion with frontline pharmacists and nursing home staff who will discuss effective strategies for improving bivalent COVID-19 vaccine rates in skilled nursing homes. You will have the opportunity to pose questions to these national and frontline leaders.

This session will be led by American Society of Consultant Pharmacists (ASCP) Chief Executive Chad Worz, PharmD, BCGP, FASCP and Health Quality Innovators (HQI) Vice President and Senior Consulting Manager Sheila McLean, MBA, LNHA, CPHQ.

We invite nursing home administrators, directors of nursing, infection preventionists and pharmacists to join this session to learn new tactics and workflows that reduce staff stress, and how to improve vaccination rates by building and expanding on already established pharmacy partnerships.

 

COVID-19 Article

New virus variants are causing significant change in symptoms, and WHO list of COVID symptoms is becoming less relevant. There is a shift to “cold” like presentation without loss of smell/taste, etc. Unfortunately, for older citizens, delirium and psychiatric effects are longer lasting now.

The Division of Community and Public Health shared the attached article from the British Medical Journal for long term care providers to review.  

New CMS Audio Series Delves into Health Care Quality

Thank you for your continued partnership in improving the health and well-being of one of our most vulnerable populations.

In line with our efforts to promote COVID vaccinations to nursing home teams and residents, the Centers for Medicare & Medicaid Services (CMS) has released a new audio series. Conversations with the Centers for Medicare & Medicaid Services Chief Medical Officer provides nursing homes with the facts on COVID-19 vaccines and therapeutics that support better resident outcomes. In these conversations with Dr. Lee Fleisher, the CMS CMO, nursing home leaders will hear from Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) experts.

As part of this audio series, titled Quality Improvement (QI) Voices: Improving COVID-19 Outcomes in Nursing Homes Across America, each episode gives listeners a closer look at the projects and the people who are improving health care quality and outcomes. These brief conversations include detailed show notes for even more insights into the process behind health care quality improvement – and how listeners might adapt these to their own organizations.

Three episodes, each under 15 minutes long, have been released: The Facts Behind the Updated COVID-19 Vaccine: Safety and Efficacy, Long-term Care Treatment Options for COVID-19 and CDC Programs for COVID-19 Infection Prevention and Vaccination in Nursing Homes. I encourage you to take full advantage of this cadre of information and resources.

COVID and Flu A/B Test Kits

  • ALERT: DHSS 30-Day Pause of PPE and Test Kit Shipping Operations on January 31, 2023

DHSS will pause shipping operations on January 31, 2023 for up to 30 days to complete inventory and transition warehouse operations to a new platform. Orders for PPE and Flow Flex Antigen Test Kits will need to be placed prior to January 27, 2023 for shipment on January 30, 2023. Please ensure your last order will cover PPE and Antigen Test Kit needs through March 1, 2023. During the pause, orders will not be processed or shipped. However, once shipping resumes March 1, 2023, PPE and Antigen Test Kits will be shipped daily upon approval and order processing.

 

  • FREE COVID-19/Flu A&B TEST KITS

DHSS is now offering free lifeSign Status COVID-19/Flu A&B Test kits to long-term care facilities.  These testing supplies are currently in limited supply, therefore, LTC facilities should continue to use COVID-19 antigen testing supplies as indicated. Orders may be placed now. Shipping will begin on Tuesday, January 17, 2023.

Application for Status COVID-19/Flu A&B Test Kits

When to use Flow Flex COVID-19 antigen test kit VS Status COVID-19/Flu A&B Test kit:

  1. Use Flow Flex for residents with known COVID-19 exposure
  2. Use Flow Flex for residents during the facility COVID-19 outbreak, or high COVID community level
  3. Use Status test kit if COVID exposure is unknown or unlikely
  4. Use Status test during the facility influenza outbreak, or high influenza activity in the community
  5. Do not use Status test for COVID detection if patient symptomatic for more than 5 days

Long Term Care Facilities must add to the facility’s CLIA certificate:

Adding lifeSign Status COVID-19/Flu A&B Test kits to Your CLIA Test Menu

The CLIA program has developed an email template that you can copy and paste, fill in the blanks, and email to CLIA@health.mo.gov to update your test menu to include lifeSign Status COVID-19/Flu A&B.

Email Subject line: Add COVID-19 Testing to existing CLIA Certificate for [FACILITY NAME]

Lab/Facility Name:

 

Existing CLIA Waived Lab #:

 

Lab Director Name:

 

Which COVID-19/ SARS-CoV-2 Waived Test system added?
Check [X] all that may apply.

[    ] Abbott BinaxNOW COVID-19 Ag Card
[    ] Acon FlowFlex
[    ] Quidel Sofia 2 SARS-CoV-2 Antigen assay
[    ] Becton Dickinson Veritor™ Plus Antigen test kit
[    ] Abbott ID Now
[ X ] OTHER Waived test(s) approved by FDA EUA (specify below): lifeSign Status COVID-19/Flu A&B Test kits

As the Laboratory Director or administrator/owner’s agent of record for the CLIA facility holding a Waived Certificate identified above, I wish to append my facility’s existing CLIA# to include additional testing for COVID-19. I attest that my facility will provide reasonable assurances that:

  1. All testing personnel for COVID-19 will be provided adequate and documented training
  2. All Manufacturer’s Instructions for Use (IFU) will be strictly adhered to

All tests results (both positive and negative) will be reported to the proper public health entities under federal and state requirements. See MO DHSS link regarding reporting: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/how-to-report-lab-results.php

 

 

Reporting Positive Influenza Results

As a reminder, all influenza results must be reported on a weekly basis, in aggregate, to your LPHA using the Laboratory-Confirmed Influenza Weekly Worksheet for Reporters.

For additional information about influenza, including Missouri’s reporting rules, please see https://health.mo.gov/living/healthcondiseases/communicable/communicabledisease/cdmanual/pdf/Influenza.pdf or contact MO DHSS, Bureau of Communicable Disease and prevention at (573) 751 -6113.

 

Reporting Positive COVID-19 Tests

Facilities performing their own COVID-19 testing (antigen testing) must report positive results through one of the following portals:

  1. Missouri Disease Reporting Online Portal (MODROP)
  2. In bulk via HL7 or CSV file using the DHSS- Electronic Lab Reporting process
  3. National Healthcare Safety Network (NHSN) or the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) Platform.

Facilities using an external laboratory (PCR testing) must enter positive case information into MODROP.

The Missouri Disease Reporting Online Portal (MODROP). MODROP can be accessed directly from https://modrop.health.mo.gov/ or by using the existing ECD-1 link at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/case-reporting.php and selecting the MODROP button.

NOTE: The recommended browser for use of MODROP is Google Chrome. Other browsers may cause issues with MODROP.

Facilities will need to register for a MODROP account the first time they use the new portal. MODROP allows reporting of only COVID-19 cases. Reports of other reportable conditions may be faxed to 573-751-6417.

If you have any questions or encounter any issues utilizing MODROP or for questions about HL7 or CSV reporting, please reach out to the EpiTrax Help Desk via e-mail at epitrax@health.mo.gov.

Please see the FAQ and thank you for your efforts to provide complete and accurate COVID-19 data to public health.

Take Aim at a Healthy New Year Stakeholder Packets

According to the CDC, older adults are more likely to get very sick from COVID-19. This could mean hospitalization, intensive care, a ventilator to help them breathe, or possibly death. The risk increases as we age and those 85 years and older are the most likely to get very sick.

Our best defense against COVID-19 is vaccination. Vaccines reduce hospitalizations and deaths for those 65 and older. The Health Quality Innovation Network (HQIN) recently launched a campaign to improve vaccination rates among our most vulnerable populations. As part of our Take Aim at a Healthy New Year initiative, we have developed an electronic informational package (below) to help you spread the word about vaccinations and how they can help keep us all healthier.

If you have any questions about this initiative, please contact the HQIN team at 1-877-731-4746 or email LTC@hqi.solutions.

Thank you for your commitment to our shared goals. We wish you a healthy new year!

7 Questions About the COVID Bivalent Vaccine
COVID Vaccine Encouragement Signature and Instructions
COVID Vaccine Social Media Messaging

Infection Control and Assessment and Response (ICAR)

QIPMO has formed an Infection Control and Assessment and Response (ICAR) team with a primary goal to assist Missouri Long-Term Care Facilities navigate the challenges of the COVID-19 pandemic and other infectious diseases.

Members of the ICAR Team are available for voluntary, no cost visits (virtual and/or in-person) to any residential care, assisted living, and skilled nursing facility in Missouri. These visits are intended to consultative and collaborative in nature with a non-regulatory focus to evaluate inflection control practices. Visits will consist of:

  • completion of a standardized assessment of infection control processes, focusing on highly-transmittable infectious diseases
  • observations of infection control practices
  • preliminary feedback with supplemental educational resources

See flyer for full details.

Reporting Positive COVID-19 Tests

Facilities performing their own COVID-19 testing (antigen testing) must report positive results through one of the following portals:

  1. Missouri Disease Reporting Online Portal (MODROP)
  2. In bulk via HL7 or CSV file using the DHSS- Electronic Lab Reporting process
  3. National Healthcare Safety Network (NHSN) or the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) Platform.

Facilities using an external laboratory (PCR testing) must enter positive case information into MODROP.

The Missouri Disease Reporting Online Portal (MODROP). MODROP can be accessed directly from https://modrop.health.mo.gov/ or by using the existing ECD-1 link at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/case-reporting.php and selecting the MODROP button.

NOTE: The recommended browser for use of MODROP is Google Chrome. Other browsers may cause issues with MODROP.

Facilities will need to register for a MODROP account the first time they use the new portal. MODROP allows reporting of only COVID-19 cases. Reports of other reportable conditions may be faxed to 573-751-6417.

If you have any questions or encounter any issues utilizing MODROP or for questions about HL7 or CSV reporting, please reach out to the EpiTrax Help Desk via e-mail at epitrax@health.mo.gov.

Please see the FAQ and thank you for your efforts to provide complete and accurate COVID-19 data to public health.

Personal Protective Equipment

Missouri has limited PPE reserves to assist in filling critical needs and prioritize healthcare providers providing direct care to confirmed or suspected COVID patients. Note requests should only be submitted after all normal supply chains, including the Missouri COVID Supply Solution, have been exhausted and you have a supply of twenty-one days or less on hand as the quantities and types of PPE available through the state are limited.

https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/ppe.php

Free COVID-19 Antigen Test Kits

DHSS offers TWO different types of rapid antigen test kits. DHSS offers ACON Flow Flex antigen test kits under the state CLIA waiver for testing in congregate care settings (In-Office) by testing personnel. DHSS also offers iHealth antigen test kits for At-Home testing.

Rapid Antigen Test Kit Application Portal (arcgis.com)

Long Term Care Facilities must make sure the ACON Flow Flex are added to the facility’s CLIA certificate:

Adding ACON Flow Flex to Your CLIA Test Menu

The CLIA program has developed an email template that you can copy and paste, fill in the blanks, and email to CLIA@health.mo.gov to update your test menu to include ACON Flow Flex.

Email Subject line: Add COVID-19 Testing to existing CLIA Certificate for [FACILITY NAME]

Lab/Facility Name:

 

Existing CLIA Waived Lab #:

 

Lab Director Name:

 

Which COVID-19/ SARS-CoV-2 Waived Test system added?
Check [X] all that may apply.

[    ] Abbott BinaxNOW COVID-19 Ag Card
[    ] Acon FlowFlex
[    ] Quidel Sofia 2 SARS-CoV-2 Antigen assay
[    ] Becton Dickinson Veritor™ Plus Antigen test kit
[    ] Abbott ID Now
[    ] OTHER Waived test(s) approved by FDA EUA (specify below):

As the Laboratory Director or administrator/owner’s agent of record for the CLIA facility holding a Waived Certificate identified above, I wish to append my facility’s existing CLIA# to include additional testing for COVID-19. I attest that my facility will provide reasonable assurances that:

  1. All testing personnel for COVID-19 will be provided adequate and documented training
  2. All Manufacturer’s Instructions for Use (IFU) will be strictly adhered to

All tests results (both positive and negative) will be reported to the proper public health entities under federal and state requirements. See MO DHSS link regarding reporting: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/how-to-report-lab-results.php

 

CMS Memo: QSO-23-01-ALL: The Importance of Timely Use of COVID-19 Therapeutics

Memorandum Summary

  • Providers and suppliers, especially those delivering care in congregate care settings, should ensure their patients and residents are protected against transmission of COVID-19 within their facilities, as well as receiving appropriate treatment when tested positive for the virus.
  • Further, all providers and suppliers should continue to implement appropriate infection control protocols for COVID-19 (https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control.html) and Influenza (https://www.cdc.gov/flu/professionals/infectioncontrol/index.htm).
  • This memo discusses the importance of the timely use of available COVID-19 therapeutics, particularly for high-risk patients who test positive for the virus.

Please see the full memo for complete details at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/importance-timely-use-covid-19-therapeutics.

NHSN Long-Term Care Post-Release October 2022

Below is important information regarding modifications to the Point of Care Test Reporting Tool, the Long-term Care Facility COVID-19 Module, and the COVID-19 Vaccination Module. The changes described below took effect with the October 2022, NHSN release. Resources on the NHSN LTCF COVID-19 Module webpage and the COVID-19 Vaccination Modules webpage have been updated, where indicated, with revised forms, instructions, FAQs and CSV templates.

Point of Care (POC) Test Reporting Tool:
The following enhancements were made.

Additional POC devices were added to the NHSN system.
Although some are titled, “At-Home,” the devices below have been provided POC Emergency Use Authorization by the U.S. Food and Drug Administration. If you are using any of these devices, please check the model’s name and ensure you choose the correct device from the drop-down menu.

  • DxLab COVID-19 Test_ DxLab Inc.
  • MicroGEM Sal6830 SARS-CoV-2 Saliva Test_ MicroGEM U.S., Inc.
  • OHC COVID-19 Antigen Self Test_ OSANG LLC
  • QuickVue At-Home OTC COVID-19 Test_ Quidel Corporation
  • Rapid SARS-CoV-2 Antigen Test Card_ Xiamen Boson Biotech Co., Ltd.

COVID-19 Pathway Data Reporting:
Please refer to the data reporting pathways below to learn about enhancements that were made within each pathway.

Resident Impact and Facility Capacity Pathway:
No enhancements

Staff and Personnel Impact Pathway:
No enhancements

Supplies and Personal Protective Equipment (PPE) Pathway:
No enhancements

Therapeutics Pathway:
An issue regarding csv upload for group and facility users was recently identified and a resolution has been implemented. Facility and group users are now able to successfully upload csv files.

State Veterans Homes COVID-19 Event Reporting Tool:
No enhancements

Weekly NHSN COVID-19 Vaccination Data Modules

Person-Level COVID-19 Vaccination Forms
If you use the optional Person-Level COVID-19 Vaccination Forms to submit your weekly COVID-19 vaccination data, demographic variables are now required for individuals currently in the facility (i.e., those without an end date or discharge date) to save and submit data. Please keep in mind that if you are unable to obtain this information, you can select ‘Unknown.’

Analysis Reports
The Long-Term Care COVID-19 Vaccination Coverage bar chart reports are once again available for use. These reports are called “Bar Chart – LTC HCP COVID-19 Vaccination Coverage” and “Bar Chart – LTC Resident COVID-19 Vaccination Coverage”.

CMS Reporting Deadline
The deadline for quarterly reporting of COVID-19 vaccination coverage data for long-term care facilities to fulfill CMS Quality Reporting Program requirements covering Quarter 2 of 2022 (April 1, 2022-June 30, 2022) is November 15, 2022.

For questions about any of these updates, please send an e-mail to the NHSN Helpdesk at NHSN@cdc.gov with the subject line identifying the topic of the message.

CMS Memo: QSO-23-02-ALL: Revised Guidance for Staff Vaccination Requirements

Memorandum Summary

  • CMS is committed to taking critical steps to protect vulnerable individuals to ensure America’s health care facilities are prepared to respond to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE).
  • On November 5, 2021, CMS published an interim final rule with comment period (IFC). This rule establishes requirements regarding COVID-19 vaccine immunization of staff among Medicare- and Medicaid-certified providers and suppliers.
  • CMS is revising its guidance and survey procedures for all provider types related to assessing and maintaining compliance with the staff vaccination regulatory requirements.
  • This memorandum replaces memoranda QSO 22-07-ALL Revised, and QSO 22-09-ALL Revised, and QSO 22-11-ALL Revised to consolidate the information into a single memorandum. The guidance in this memorandum applies to all states.

Please view the latest CMS memo regarding revisions to SSF program at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/revised-guidance-staff-vaccination-requirements.

Revised Update: NHSN Person-Level Vaccination Forms: Requiring Demographics Fields

Please be aware that the upcoming NHSN application update has been pushed back, so the demographics fields (gender, race, and ethnicity) in the Person-Level (Event-Level) COVID-19 Vaccination Forms will not become required for existing records to save and submit data until after the application release, the evening of October 27, 2022.

As a reminder, the demographics fields will only be required for all individuals without an end date or discharge date. These fields will not be required for individuals who are no longer in the facility (i.e., those with an end date or discharge date). Please keep in mind that you may select ‘Unknown’ if you are unable to obtain this information.

Please note that the use of the Person-Level Vaccination Forms remains optional, and facilities are welcome to continue using the aggregate weekly summary forms to submit COVID-19 vaccination data.

New Person-Level Vaccination Form Resources

We are also excited to let you know that two new resources are being posted to the NHSN Long-Term Care Vaccination website by the end of this week:

  • Person-Level (Event-Level) Vaccination Form Table of Instructions: Healthcare Personnel
  • Person-Level (Event-Level) Vaccination Form Table of Instructions: Residents

These new Table of Instructions (TOI) documents can be used to help users enter and manage their person-level vaccination data and contain instructions for each column you see on the Person-Level Vaccination Forms.

Additional NHSN Resources: Person-Level Vaccination Forms

Training:

CSV Materials:

If you have any questions, please reach out to nhsn@cdc.gov and include the subject line “Person-Level Vaccination Forms”. Thank you for your continued efforts to report vaccination data in NHSN.

Reminder – Data for CMS Quality Reporting Programs Due Soon!

This message contains reporting deadline reminders for the CMS Quality Reporting Programs. The National Healthcare Safety Network (NHSN) encourages facilities to enter data in timely manner ahead of the deadlines in order to ensure data completion and accuracy. Make sure to allow ample time before the deadline to review, and if necessary, correct your HAI data. Data entered in NHSN after the submission deadline are not sent to CMS and will not be used in CMS pay-for-reporting or pay-for-performance programs. Data can be reviewed by using the Analysis reports within NHSN.

If you are unable to enter data into NHSN, it is possible that your Facility Administrator or Patient Safety Primary Contact has not accepted the updated NHSN Agreement to Participate and Consent. For questions or assistance with the updated Consent form and/or reassignment of the Facility Administrator or Primary Contact, please contact nhsn@cdc.gov as soon as possible.

The following data must be entered into NHSN by November 15, 2022, for facilities that participate in certain CMS quality reporting programs.

Long-Term Acute Care Facilities (LTACs/LTCHs) that participate in the Long-Term Care Hospital Quality Reporting Program:
2022 Quarter 2 (April 1 – June 30) CLABSI and CAUTI data (all bedded inpatient locations)
2022 Quarter 2 (April 1 – June 30) C. difficile LabID Events (FacWideIN, all healthcare-onset, and community-onset)
2022 Quarter 2 (April 1 – June 30) COVID-19 Vaccination Coverage Among Healthcare Personnel

Skilled Nursing Facilities (SNFs) that participate in the Skilled Nursing Facility Quality Reporting Program:
2022 Quarter 2 (April 1 – June 30) COVID-19 Vaccination Coverage Among Healthcare Personnel

Please ensure that at least one individual at your facility can access NHSN via their Secure Access Management Services (SAMS) account and has been assigned appropriate user rights in NHSN to enter and view your facility’s data. To guarantee that your data is accurately entered into NHSN, verify that; 1) your monthly reporting plans are complete; 2) you’ve entered appropriate summary and event data or checked the appropriate no events boxes; and 3) you’ve cleared all alerts from your NHSN facility homepage. For additional guidance on ensuring your data are accurately sent to CMS for Quality Reporting purposes, please visit our website and navigate to the appropriate section(s) for your facility type: https://www.cdc.gov/nhsn/cms/index.html.

If you have any questions, please contact the NHSN Helpdesk: NHSN@cdc.gov. The NHSN Helpdesk is staffed Mondays thru Fridays, 7 am-5 pm ET, excluding Federal Holidays.

Up to Date COVID-19 Vaccination Status: NHSN Surveillance definition change for facilities reporting data

CDC hosted a webinar on the NHSN surveillance definition of up to date COVID-19 vaccination status on October 13, 2022. We would like to provide some important reminders on how to apply these definitions for the purpose of NHSN surveillance.

NHSN’s surveillance definition of up to date COVID-19 vaccination status is based on CDC’s clinical considerations and up to date definition for the first day of the reporting quarter. Please be sure to report up to date vaccination status in NHSN according to the definition for the reporting period associated with the reporting weeks you are submitting data for. Please refer to the definitions of key terms related to COVID-19 vaccination for the purpose of NHSN public health surveillance: https://www.cdc.gov/nhsn/pdfs/hps/covidvax/UpToDateGuidance-May2022-508.pdf.

New Up to Date Definition for Quarter 4

Individuals are considered up to date with their COVID-19 vaccines during the NHSN surveillance period of September 26, 2022-December 25, 2022 if they have received an updated (bivalent) booster dose OR if they received their last monovalent booster dose less than 2 months ago, OR if they completed their primary series less than 2 months ago. See table below. Changes for Quarter 4 of 2022 are highlighted in yellow.

Reporting deadline for Quarter 2 of 2022

As a reminder, for facilities participating in a CMS quality reporting program, the reporting deadline for COVID-19 Vaccination Coverage among Healthcare Personnel for Quarter 2 2022 (April 1, 2022-June 30, 2022) is on November 15, 2022. Highlighted in yellow below.

Data Tracking Worksheet

We are currently working to update the Data Tracking Worksheet. Stay tuned to CDC NHSN emails and check the CDC NHSN webpage often for updates.

Frequency of Reporting COVID-19 Vaccination Data:

The frequency of reporting COVID-19 vaccination data has not changed. NHSN allows for, and encourages, weekly submission of COVID-19 vaccination data via the Weekly COVID-19 Vaccination Module.

Beginning on October 1, 2021, facility types that are part of the CMS Inpatient Quality Reporting Program, Inpatient Psychiatric Facility Quality Reporting Program, Inpatient Rehabilitation Facility Quality Reporting Program, or Long-term Acute Care Quality Reporting Program will need to submit COVID-19 vaccination data via the Weekly COVID-19 Vaccination Module for at least one week per month to fulfill CMS reporting requirements. Beginning on January 1, 2022, ambulatory surgery centers are also required to submit COVID-19 vaccination data via the Weekly COVID-19 Vaccination Module for at least one week per month to fulfill CMS reporting requirements.

Facilities can select any week within the month to report data. A week is designated as belonging to the month of the week-end date. For example, reporting data for the week of September 27-October 3 is considered as submitting data for a week in October.

COVID-19 vaccination data should be submitted by the end of the quarter as defined by CMS.

NHSN COVID-19 Vaccination Resources:

Please visit the Weekly HCP COVID-19 Vaccination Resource page for additional information: https://www.cdc.gov/nhsn/hps/weekly-covid-vac/index.html#anchor_93402.

Please pay particular attention to the COVID-19 Vaccination Modules Key Terms: https://www.cdc.gov/nhsn/pdfs/hps/covidvax/UpToDateGuidance-May2022-508.pdf.

During the webinar we received some questions about COVID-19 Hospital Data. Please send any questions related to the upcoming transition of COVID-19 hospital data to NHSN@cdc.gov using the subject line “COVID-19 Hospital.” Resources and information can be found on the transition webpage: https://www.cdc.gov/nhsn/covid19/transition.html.

NHSN Person-Level Vaccination Forms: Requiring Demographics Fields

Reminder that the demographics fields (gender, race, and ethnicity) in the Person-Level (Event-Level) Vaccination Forms will become required in order to save and submit data as of Monday, October 24, 2022.

 These fields will be required for all individuals without an end date or discharge date. These fields will not be required for individuals who are no longer in the facility (i.e., those with an end date or discharge date). Please keep in mind that you may select ‘Unknown’ if you are unable to obtain this information. 

NHSN Resources: Person-Level Vaccination Forms

Training:

CSV Materials:

If you have any questions, please reach out to nhsn@cdc.gov and include the subject line “Person-Level Vaccination Forms”. 

Show-Me ECHO

Show-Me ECHO (Extension for Community Healthcare Outcomes) uses videoconferencing to connect interdisciplinary teams of experts with clinicians and other healthcare professionals. Together participants and teams collaborate in interactive, individualized, case-based learning environments to develop skills and discuss best practices. Some ECHOs meet every week, some twice a month, and some have a completely different timeline. We know how challenging it can be to commit time away from your other responsibilities, but by building and supporting a strong community of learners, the ECHO model improves care access, quality, and efficiency. Show-Me ECHO learning sessions offer free continuing education and are provided at no cost to participating sites and individuals. Check out the ECHO schedule to see when you can attend the next session!

PAC/LTC: Post-Acute & Long-Term Care
2nd & 4th Thursdays: 9:30 am – 10:30 am

Topics or Learning and Discussion:

  • Post-Vaccination Practices: Including Visitation Policies and PPE practices
  • Ongoing COVID-19 Identification and Treatment: Plans for Recognizing Patients with COVID, Post-COVID Syndromes, Testing, Treatment and Cohorting
  • Emotional and Organizational Support for Staff
  • Vaccinations: Vaccine Confidence, Testing, Logistics, Ongoing Compliance and Complications
  • Addressing and Supporting Needs of Residents, Families or Care Partners: Isolation and Family Communication
  • Stopping the Spread (Infection Control): Building Sustainable Infection Control Practices
  • Leadership Communication for COVID-19: Huddles, Rounding, Etc.
  • Leadership Behaviors to Support Teams During COVID-19: Teamwork, Roles and Psychological Safety

Resolution of Issues: NHSN Person-Level (Event-Level) COVID-19 Vaccination Forms

We want to provide an update on the issues related to the Person-Level (Event-Level) COVID-19 Vaccination Forms that occurred following the recent NHSN application update. These issues are now resolved, and users can do all of the following:

  • Users can search and filter their data
  • Users can import .CSV files that contain more than one row per individual (for example, if an individual was discharged and later re-admitted)
  • Users can modify all fields, including ID and name
  • Users can no longer delete staff IDs from the other event-level forms (e.g., from the POC tool) if the staff ID is linked to a staff vaccination record

As a reminder, users cannot delete rows. If you have incorrect data that needs to be removed, please do one of the following:

  1. Edit the row/ repurpose the row with someone else’s data, or
  2. Change the discharge/end date to a date that is before the person-level forms could be used to submit date (i.e., before 3/28/2022). This way, the incorrect row won’t contribute to any data that can be submitted. In addition, you should change the ID so that it is not linked to a real ID. Also, add a note to the Comments column on the far right to document that this entry is incorrect.

In addition, updated CSV materials for the Person-Level (Event-Level) COVID-19 Vaccination Forms are now posted to the website, and links are provided below. Please note that is it optional to use the CSV materials, as users can manage all data within the application without using the CSV files.

Resources:

All resources: https://www.cdc.gov/nhsn/ltc/weekly-covid-vac/index.html

Trainings:

Guidance:

.CSV variable description and file layout:

.CSV template and example – HCP:

.CSV template and example – Residents:

Please contact NHSN@cdc.gov with “COVID-19 Person-level Vaccination Forms” in the subject line with any additional questions or concerns. Thank you for your efforts with submitting data to the Weekly COVID-19 Vaccination Modules.

NHSN Long-term Care Release September 2022

Below is important information regarding modifications to the Long-term Care Facility COVID-19 Module, and COVID-19 Vaccination Module. The changes described below will take effect after the September 2022 NHSN release. Resources on the NHSN LTCF COVID-19 Module webpage and the COVID-19 Vaccination Module webpage will be updated, where indicated, with revised forms, instructions, FAQs, and .CSV templates.

Point of Care (POC) Test Reporting Tool:

No enhancements

COVID-19 Pathway Data Reporting:

Please refer to the below data reporting pathways to learn about enhancements that will be made within each pathway.

Resident Impact and Facility Capacity Pathway:

The Primary Series Vaccination Status section of the Resident Impact and Facility Capacity Pathway has been revised with simplified language to account for the recent approval of the Novavax Vaccine. The reporting process for this pathway has not changed and users will not need to go back and make any revisions to their data. Please continue using the Table of Instructions, found on the LTCF COVID-19 Webpage, as a guide while reporting data for this pathway.

Staff and Personnel Impact Pathway:

No enhancements

Therapeutics Pathway:

For those that upload data via CSV files, please be sure to use the templates that are posted on the LTCF COVID-19 Module Webpage. The following therapeutics must be listed for each submission date within the CSV file.

Each Therapeutic should have a line within the CSV file:

  • Casirivimab plus Imdevimab (Regeneron)
  • Bamlanivimab plus etesevimab (Lilly)
  • Sotrovimab (GlaxoSmithKline)
  • Evusheld (AstraZeneca)
  • Bebtelovimab (Lilly)
  • Paxlovid (Pfizer)
  • Molnupiravir (Merck)

State Veterans Homes COVID-19 Event Reporting Tool

No enhancements

Weekly NHSN COVID-19 Vaccination Data

Optional NHSN Person-Level (Event-Level) Vaccination Forms

  • Enhanced security for Staff-Person-level (event-level) vaccination data.
  • Action item for users: If a user is not a NHSN facility administrator (FA) and submits person-level vaccination data for healthcare personnel, the user must have the ‘Staff/Visitor- Add, Edit, Delete’ and ‘Staff/Visitor- view’ boxes checked under user rights. A user with administrative rights can grant these additional rights to users. Facility administrators will continue to have access to these person-level vaccination data.

For questions about any of these updates, please send an e-mail to the NHSN Helpdesk at NHSN@cdc.gov with the subject line identifying the topic of the message.

COVID-19 Study – University of Missouri Sinclair School of Nursing

Drs. Amy Vogelsmeier and Lori Popejoy from the University of Missouri Sinclair School of Nursing are conducting a statewide study to understand how nursing homes prepared for and responded to COVID-19 so that they can describe how COVID-19 impacted nursing home staff, residents, and families.

We would like to conduct interviews with leadership (the Administrator/Director of Nursing), the infection preventionist, a group of 6 to 8 staff members and two residents and/or family members. Each of these five interviews should last no more than one hour. A member of our study team will come to your nursing home to conduct the interviews; we complete the interviews all in one day. The information provided will be kept confidential and only the research team will have access. As part of participation in the project, we will compensate your nursing home with a $500 payment.

If you are interested in participating, please contact Steve Miller at 314-322-9510 or via email at millerst@umsystem.edu.

News Release: $10 million in ARPA funding for Missouri RCFs and ALFs

Missouri residential care and assisted living facilities licensed with the Missouri Department of Health and Senior Services (DHSS) are now eligible for reimbursement for COVID-19-related expenses through the American Rescue Plan Act (ARPA). $10 million of this federal funding has been allocated for reimbursement.

Providers may seek reimbursement for expenses incurred and/or business interruption costs directly related to preparing, preventing and responding to the COVID-19 pandemic. The funds will compensate expenses incurred between April 1, 2021 and March 31, 2022. Expenses eligible for reimbursement include:

  • Payroll costs.
  • Training and orientation.
  • Operational supplies.

“Missouri’s residential care and assisted living facilities had some of the most challenging situations to navigate throughout the pandemic, from infection control management to workforce and equipment shortages,” said Paula Nickelson, DHSS acting director. “This reimbursement opportunity will allow facilities to recover from the unprecedented challenges the past two and a half years have presented so they can focus on providing care to some of Missouri’s most vulnerable.”

DHSS created two portal guidance documents to assist operators with registering online and navigating the portal. Operators will need to register on the MO ARPA portal before they can apply. An application checklist and FAQs can be found on moarpa.mo.gov.

A link has also been posted under the Information for Long-Term Care Facilities/COVID webpage at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php#collapseSix.

New COVID-19 boosters targeting currently circulating strains becoming available in Missouri

Bivalent COVID-19 boosters are becoming available among some providers in Missouri beginning as early as today with additional providers adding these boosters to their inventory next week. A list of providers who pre-ordered these booster doses is available at MOStopsCovid.com.

On Sept. 1, CDC Director Rochelle P. Walensky, MD, MPH, endorsed the CDC Advisory Committee on Immunization Practices’ (ACIP) recommendations for use of updated COVID-19 boosters from Pfizer-BioNTech for people ages 12 years and older and from Moderna for people ages 18 years and older.

The Moderna and Pfizer bivalent boosters both target two strains of SARS-CoV-2, the virus that causes COVID-19 – the original strain of the virus and two of the Omicron subvariants (BA.4 and BA.5), which are currently the most widespread variants globally. Only individuals who have completed their primary vaccination series (two doses of Pfizer or Moderna or one dose of Johnson & Johnson) are eligible to receive the bivalent booster. Those who have recently received Novavax are not yet eligible for any booster at this time.

“We encourage those who are eligible to receive this new booster dose as it will greatly help protect individuals from the variant most commonly detected today and for the past several months,” said State Epidemiologist Dr. George Turabelidze with the Missouri Department of Health and Senior Services (DHSS). “As we head into the fall and winter months, this added protection becomes even more important since viruses generally tend to circulate at a more rapid pace during this time.”

In the coming weeks, CDC also expects to recommend updated COVID-19 boosters for other pediatric groups, per yesterday’s discussion and evaluation of the data by ACIP. When data is available and FDA authorizes these other types of COVID-19 boosters and CDC provides use recommendations, the CDC and DHSS will work to quickly make them available in Missouri with the help of COVID-19 vaccinators throughout the state.

If you have not been vaccinated or have not completed your primary series, visit MOStopsCovid.com to find a location offering vaccines. The original formulations of Pfizer, Moderna, J&J and Novovax will continue to be used. Booster doses use reduced amounts of the original vaccines.

Individuals are eligible for the bivalent booster two months since their last primary or booster dose of Pfizer, Moderna or Johnson & Johnson. The previous monovalent booster will no longer be available to persons 12 and older; the FDA is removing authorization for those boosters to reduce provider confusion for staff administering vaccines.

The Pfizer bivalent booster is currently authorized for ages 12 and older while Moderna’s is currently authorized for 18 years of age and older. Individuals may choose to receive either the Pfizer or Moderna bivalent booster, regardless of which primary series vaccine or original booster dose they had previously.

For the latest information on bivalent boosters, visit MOStopsCovid.com.

Funding Opportunity for Residential Care and Assisted Living Facilities

The Missouri Department of Health and Senior Services (DHSS) is excited to announce a reimbursement opportunity available to Residential Care Facilities (RCF) and Assisted Living Facilities (ALF). Beginning, September 1, 2022, operators may apply for reimbursement for expenses incurred between April 1, 2021 and March 31, 2022, directly related to preparing, preventing, and responding to the COVID-19 pandemic.

If you operated a residential care facility or assisted living facility licensed with DHSS between April 1, 2021 and March 31, 2022, you are eligible for reimbursement for allowable expenses.

Before operators can complete an application for reimbursement:

  1. Operators must be registered as a vendor with the State of Missouri and must have provided their Federal Employer ID Number (FEIN) to DHSS.
  2.    If not already registered, complete the Vendor Input Form located here. Completed forms must be sent to the Office of Administration by fax at 573-526-9813 or by mail to PO Box 809, Jefferson City, MO 65102.
  3. The address used in registering as a vendor must be the same address used on the reimbursement application. Be sure to register only the operating entity and not all individual facilities owned by the same company.
  4. Email registered name and FEIN to LTCARPAReimbursements@health.mo.gov.

For your convenience, you will find a Frequently Asked Questions and an Application Checklist attached to this communication. These documents can also be found online at https://moarpa.mo.gov/required-forms-program-application-instructions/ under Operators of Residential Care / Assisted Living Facilities.

Funding for this initiative has been made available through the American Rescue Plan Act (ARPA). Missouri’s ARPA funding opportunities are located here: https://moarpa.mo.gov/available-funding-opportunities/.

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ARPA Funds Checklist 2022 0829 final

Free Resources Can Help Boost Vaccine Confidence

Health Quality Innovation Network (HQIN), the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Missouri, recently released three new tools in the fight against COVID-19.

The Why Wait? Vaccines Can Keep Us Healthy video and the Is It Time to Get Your Booster? video are both under two minutes long. They can be shown in reception areas, common spaces and through electronic communications with staff, residents and families.

Additionally, the Direct Exposure Infographic poster displays the differences in COVID-19 illness and death among those unvaccinated, vaccinated and fully vaccinated. It can be shared electronically or printed and displayed in high-traffic areas.

Check out and share these free tools to help spread education, rather than the virus.