Category: COVID

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

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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

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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

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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

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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!

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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/.

ARPA Funds FAQ 2022 0829 final
ARPA Funds Checklist 2022 0829 final

Free Resources Can Help Boost Vaccine Confidence

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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.

COVID-19 Boosters – Customizable Package Encourages Staff, Residents, Families and Visitors to Share Their “Why”

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

The Vaccine Champion Social Media Package can help your facility boost vaccine confidence by encouraging staff, residents, families and visitors to share their “why” for getting the COVID-19 vaccine. The customizable package includes pages you can print and display for staff, residents, families and visitors to add their reason for getting vaccinated. It includes instructions and suggestions to promote their positive messages on social media channels.

Download the package and customize it for your team to help spread the word, rather than the virus.

DHSS Supply Chain Assessment Survey

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Missouri DHSS is conducting a survey to assess healthcare supply chain integrity and is requesting your input. The survey is designed to assess the current status of the healthcare supply chain while also capturing lessons learned from the COVID-19 pandemic. As part of the Hospital Preparedness Program, we are required to complete a supply chain assessment to examine supply chain vulnerabilities to guide future planning efforts. The information collected will also help statewide assets and stockpile realignment with respect to location, number and contents of caches, as well as to identify gaps for future investments.

This survey is 52 questions and divided into 5 sections: facility information, background information, preparedness, purchasing/operations, and future planning. It is recommended that facilities have emergency preparedness staff and procurement staff work together to complete the survey. Thank you in advance for participating in this collaborative effort regarding the healthcare supply chain.

https://survey123.arcgis.com/share/e9b6ec9e7bcd4aaeb3ee1755aecb8075

The survey will close COB August 5, 2022.

Webinar Registration & Recap: Up to Date Vaccination Status: Surveillance Definition Change for COVID-19 Vaccination Modules

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Information for NHSN users

The NHSN Vaccination Team hosted a webinar on Thursday, June 23rd to review changes to the definition for individuals considered Up to Date with COVID-19 vaccines for data reporting through the NHSN COVID-19 Vaccination Modules. We learned that some users were unable to join the webinar due to the number of participants exceeding capacity. We apologize for this inconvenience. To address this, NHSN is hosting a second webinar on the same topic (Up to Data Vaccination Status Surveillance Definition Change) on Tuesday June 28th from 12:00-1:00 PM Eastern Time.

Please click the link below to register for the webinar on Tuesday June 28th from 12:00-1:00 PM Eastern:

https://cdc.zoomgov.com/j/1619745620?pwd=ODE3QTNGb1FzNlRvMFB1bHQvd3NGUT09

After registering, you will receive a confirmation e-mail containing information about joining the webinar.

We also wanted to provide answers to a few frequently asked questions that came up during the webinar:

  • The guidance we provided on how to report Up to Date COVID-19 vaccination applies to all facilities that report vaccination data through the NHSN COVID-19 Vaccination Modules including long-term care facilities (LTCF), dialysis facilities, acute care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, long-term acute care hospitals, and ambulatory surgery centers. The information provided regarding case reporting through the Resident Impact and Facility Capacity (RIFC) Pathways applies only to LTCFs.
  • NHSN’s surveillance definition of Up to Date with COVID-19 vaccines is based on CDC’s clinical considerations and Up to Date definition for the first day of the reporting quarter. CDC recently updated the definition of Up to Date vaccination, so the NHSN surveillance definition will change for Quarter 3, 2022, which begins during the reporting week of June 27, 2022 – July 3, 2022.
  • For LTCFs, the NHSN event-level (person-level) vaccination form will classify individuals as up to date and will apply this new definition beginning 6/27. In order for this to happen, you will need to enter date of birth beginning 6/27 for all individuals in the facility since age is now taken into consideration for determining up to date vaccination status. The Excel Data Tracking Worksheets have been discontinued for LTCFs and removed from the NHSN website since the event-level (person-level) vaccination tool is now available for LTCFs.
  • For all other non-LTC facility types (e.g., dialysis, acute care, ambulatory surgery, etc.), the Excel Data Tracking Worksheet is being updated to incorporate the new definition of up to date vaccination. It should be available in the coming weeks. This Excel tool will be maintained until the NHSN event-level vaccination forms are available for non-LTC facilities.

CMS Memo: QSO-22-17-ALL: Surveys for Compliance with Omnibus COVID-19 Health Care Staff Vaccination Requirements

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  • 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 Disease2019 (COVID-19) Public Health Emergency (PHE).
  • Survey oversight of the staff vaccination requirement for Medicare and Medicaid-certified providers and suppliers will continue to be performed during initial and recertification surveys, but will now only be performed in response to complaints alleging non-compliance with this requirement, not all surveys. Under prior guidance, all surveys included oversight of the staff vaccination requirement.
  • CMS will revise QSO 22-11 to ensure deficiency determinations reflect good faith efforts implemented by providers and suppliers and incorporate harm or potential harm to patients and residents resulting from any non-compliance.

Please see the full memo at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/surveys-compliance-omnibus-covid-19-health-care-staff-vaccination-requirements.

QIPMO Staffing Workshops

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What You Do Matters: Applying Lessons Learned from the Pandemic to Staff Stability and Resident Safety
QIPMO Staffing Workshops | Three-Part Series

June 2, 2022: Register HERE
June 20, 2022: Register HERE
May 16, 2022: Review the recording HERE | Download the handouts HERE
Presenters: David Farrell, MSW, LNHA, Alameda County Public Health Department; Cathie Brady, MS, and Barbara Frank, MPA, B&F Consulting

COVID has highlighted the dedication and courage of long-term care staff, the fragility of residents, and the impact of good leadership. With so much happening outside of leaders’ control, we found that leaders’ practices and decisions about how to communicate with and support staff, residents, and families made the difference. Attendees will take home low-cost, practical strategies that support staff and create the conditions for stability and good outcomes. This three-part series includes action steps in between sessions, to apply person-centered leadership practices immediately. We ask that you please encourage any corporate leaders to attend as well!

COVID-19 Testing Reimbursement and Supplies

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COVID-19 TESTING REIMBURSEMENT ENDING JUNE 15, 2022:
The last day to submit COVID-19 testing invoices for reimbursement via the DSS invoice portal is June 15, 2022. After June 15, 2022, the portal will be closed and no other testing invoices will be accepted.

Additional Testing Resources:
Free Antigen Testing Supplies
The Missouri Department of Health and Senior Services (DHSS) continues to have an adequate supply of free ACON Flow Flex rapid antigen tests all Long Term Care Facilities may apply to receive. Full details regarding the product, CLIA requirements, standing physician orders, and the Rapid Antigen Test Kit Application can be found here: https://ltc.health.mo.gov/archives/15339.

Update for COVID-19 Module Surveillance Pathways and Weekly HCP and Resident COVID-19 Vaccination Module Training dates

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The NHSN Vaccination team will host 2 training sessions in preparation for the upcoming NHSN release on May 30th. These sessions were previously scheduled to incorporate the LTC COVID-19 Module Surveillance Pathways, however the training has been scaled down to solely focus on the COVID-19 Vaccination Module.

Please register to attend one or more sessions to learn how reporting forms will change and how to report data accurately. After registering, you will receive a confirmation email containing information about joining the webinar. Please note these training sessions are repeated and you may not find it necessary to register more than once. After each training session, you will be allowed to ask questions as it pertains to the webinar.

Thanks for your participation!
The NHSN LTCF Team

**COVID-19 Vaccination Modules Webinar**

When: Tuesday, May 17, 2022, 1:00 – 2:00 PM Eastern Time (US and Canada)
Topic: Updates to the COVID-19 Vaccination Modules for Residents and Healthcare Personnel
Register in advance for this webinar:
https://cdc.zoomgov.com/webinar/register/WN_2vwCHWGkQj63Nvka5h5GUA

When: Thursday, May 19, 2022, 1:00 – 2:00 PM Eastern Time (US and Canada)
Topic: Updates to the COVID-19 Vaccination Modules for Residents and Healthcare Personnel
Register in advance for this webinar:
https://cdc.zoomgov.com/webinar/register/WN_dG7knYLOQJu9lwT__8cV2Q

New QIPMO Newsletter – May 2022

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The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls (Volume 9, Issue 3).

In this issue:

  • Addressing Your Residents’ Psychosocial Needs
  • Building and Keeping Great Staff
  • ICAR Corner
  • Down and Dirty in the Dementia Unit
  • Discharge before Admission
  • Visitation and Visitation Guidance

Please visit QIPMO’s website here for this and other previous newsletters.

New Changes coming in May for the COVID-19 Module Surveillance Pathways and Weekly HCP & Resident COVID-19 Vaccination Module

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There will be various revisions to the LTCF COVID-19 Module surveillance pathways and COVID-19 Vaccination Modules for residents and healthcare personnel in the upcoming NHSN May release. CDC will be conducting training webinars next month. Please attend a training session to learn how data entry forms will change and receive instructions for accurate reporting. Below are a few changes you will see starting next month in the COVID-19 Module surveillance pathways.

NHSN COVID-19 Module Surveillance Pathway Forms will be Revised
New Changes Coming in May!!

What are the main changes?

Simplifications

  1. REMOVAL of Supplies and PPE Pathway
    1. Users will no longer need to report data to this pathway
  2. The Resident Impact and Facility Capacity Pathway (RIFC) and the Staff and Personnel Impact Pathway will have several data elements removed:
    1. COVID-19 test type
    2. Vaccine manufacturer (RIFC only)
    3. COVID-19 re-infections
    4. Other respiratory illness
    5. Testing performed and time for receiving results

Possible Additions

  1. Expand vaccination status options for boosters.
  2. Include simplified PPE shortage question.

How should I prepare for the upcoming changes?

  • Review ALL E-mail communication from NHSN
  • Attend COVID-19 Module trainings
  • Review the TOIs to assist with reporting elements
  • Update your CSV files as applicable
  • Templates will be updated on the COVID-19 webpage in May

How can I learn more?
CDC will be conducting training webinars in May. More information on these webinars will be shared in the coming weeks, so stayed tuned!

If you have questions, please send an e-mail to NHSN@cdc.gov with ‘COVID-19 Surveillance Pathway Forms’ in the subject line. Below are the changes that will also take place in the COVID-19 Vaccination Module starting next month.

 

NHSN Weekly COVID-19 Vaccination Cumulative Summary Forms will be Revised
New Changes Coming in May!!

What are the main changes?

Simplifications

  1. COVID-19 vaccination data will no longer be reported by vaccine manufacturer for questions on primary vaccine series and additional/booster doses.
  2. Questions on vaccine supply will be removed.
  3. Completing monthly reporting plans for COVID-19 vaccination modules in the Long-Term Care Facility Component will no longer be required. Instead, upon saving or uploading data, users will agree to the following:
    1. The data reported are consistent with definitions outlined in NHSN surveillance protocols (including tables of instructions and frequently asked questions).
    2. The data will be sent to the Centers for Medicare and Medicaid Services (CMS) to fulfill CMS quality reporting requirements (when applicable).

Additions

  1. Adding a note at the top of form specifying that data can be submitted by completing the questions on the data collection form or by using the new event-level COVID-19 vaccination forms.
  2. Adding a question for facilities to report the cumulative number of individuals who are up to date with COVID-19 vaccination.
  3. Adding two fields to question #4 to report the cumulative number of individuals who received only one booster dose and two or more booster doses of COVID-19 vaccine (Note: For residents only)

How should I prepare?
Facilities should develop or update data tracking mechanisms to collect weekly COVID-19 vaccination data on residents and healthcare personnel for the additional questions.

Tip: Using the new event-level COVID-19 vaccination forms in NHSN’s Long-Term Care Facility Component can simplify the tracking and reporting of data on multiple booster doses and up to date status.

How can I learn more?
CDC will be conducting training webinars in May. More information on these webinars will be shared in the coming weeks, so stayed tuned so you can register for the sessions.

If you have questions, please send an e-mail to NHSN@cdc.gov with ‘COVID-19 Vaccination Data Reporting’ in the subject line.

CDC Health Advisory 463: Updated Info of Treatments COVID-19

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Please see the CDC Health Advisory, number 463, dated 2/25/2022, entitled “Updated Information on Availability and Use of Treatments for Outpatients with Mild to Moderate COVID-19 Who are at Increased Risk for Severe Outcomes of COVID-19.”

Missouri healthcare providers and public health practitioners: Please contact your Local Public Health Agency or the Missouri Department of Health and Senior Services’ Bureau of Communicable Disease Control and Prevention at 573-751-6113 or 800-392-0272 (24/7) with questions regarding this Health Advisory.