The Board of Nursing Home Administrators has put forth guidance regarding 2021 license renewal changes. Please see the memo for details.

In efforts to continue support of the nation’s COVID-19 response, the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) is excited to announce the following updates to the COVID-19 Module for Long-Term Care Facilities (LTCF):

1. An NHSN COVID-19 Module Dashboard for LTCFs is now available for participating groups and The dashboard provides a summary of data entered in the COVID-19 Module and includes an interactive chart display where a user may customize data views. This first edition of the dashboard is concentrated on the Resident Impact and Facility Capacity pathway. However, we’ve already started working on the next edition, which will continue additional pathways and analysis options!! Guidance documents for groups and facilities to assist with navigating and understanding the features are available on the NHSN LTCF COVID-19 Web-page.

2. You asked, and we listened! We recognize that many SNFs are setting up COVID-19 units to receive transfers from other LTCFs, such as Assisted Living Residences. These transfers result in increased demand on the receiving LTCFs. Therefore, the count for “Admissions” has been revised to include admissions and readmissions of residents who were previously diagnosed with COVID-19 from another facility. For additional information, please review the revised data collection form and accompanying instructions for the Resident Impact and Facility Capacity Note: LTCFs may update previously entered “Admissions” counts, but this is not a requirement.

3. We aim to improve the quality of the COVID-19 data being reported. Users will notice Pop-up alerts as a reminder of potential data entry errors. For example, if a user attempts to enter more COVID-19 Deaths than Total Deaths, a pop-up alert will appear to remind user of the definitions. As a reminder, “COVID-19 Deaths” counts must be included in the Total Deaths count since Total Deaths is defined as the number of residents who died for any reason in the LTCF or another location since the last time “Total Deaths” counts were collected for reporting in the NHSN COVID-19 Module. For both counts, only include the NEW deaths since the last time the counts were collected for reporting in the Module, as the intent is to capture incidence.

4. Non-modifiable fields have been added to each of the four pathway screens. Users will notice that each pathway now has three additional pieces of information displayed at the top of each pathway: Date Created, Facility CCN, and Facility Type.

The purpose of Date Created is to display the first date and time of data entry (manual or CSV file upload) for a selected calendar date and pathway. The date and time will automatically save and cannot be modified by the user.

The Facility CCN and Facility Type will also populate for each facility, allowing users to quickly verify the information associated with the data being submitted to CMS. These two variables may be edited by a facility user with NHSN Administrative rights; however, edits must be done outside of the COVID-19 Module by accessing Facility Info on the left navigation panel. Guidance documents are attached to this e-mail, as well as available under Facility Resources on the NHSN LTCF COVID-19 Web-page, which can be accessed through the following link – https://www.cdc.gov/nhsn/ltc/covid19/index.html (you may need to copy and paste web-link into Internet browser).

Be sure to check-out the July NHSN LTCF newsletter for additional information and exciting updates! If you have questions, please send them to nhsn@cdc.gov and include LTCF in the subject line.

Division of Community and Public Health (DCPH) recently reached out to the CDC for guidance regarding long-term care facility (LTCF) residents attending routine off-site appointments and received the following response:

CDC does not recommend LTCF residents who go off-site for routine appointments (such as hemodialysis or other routine appointments or treatments) be kept in observation, in part because the observation period could be permanent for residents who have to leave more than once every two weeks. Additionally, LTCF residents who leave and return for appointments should not be considered new admissions or be housed in a COVID-19 care unit in the LTCF when they return. Placing LTCF residents who return in the observation or COVID area within the facility could put them at higher risk of exposure to COVID-19. While not a CDC recommendation, some LTCFs have opted to manage residents who go off-site for routine appointments as potentially exposed and use full Transmission-Based Precautions and/or have cohorted these residents together into the same area of the building. In these examples, it is very important to ensure these residents, who may be at increased risk of acquiring COVID-19, are NOT being placed into a dedicated COVID-19 unit or with others who are symptomatic/have increased risk of having COVID-19. Doing so would increase the risk of exposing these residents who go off-site to others at even higher risk of COVID. We have also heard about significant challenges with moving residents repeatedly and recognize that determining exposures can be challenging. Additional recommendations: Residents going off-site for dialysis or other appointments should wear a cloth face covering (or facemask) for source control when they leave the LTCF and ideally in the LTCF if they are leaving their room. Regular communication between the dialysis facilities/medical offices where appointments occur and the LTCFs (in both directions) is essential to help identify patients with fever or symptoms consistent with COVID-19 before they enter the facilities and facilitate resident care. Social distancing measures should be implemented, such as minimizing movement of these residents within the facility as much as possible. LTCFs should comply with the infection prevention and control guidance for nursing homes and LTCFs.

The guidance has been updated to request facilities bill Medicare first, if applicable, for testing costs and to provide contact information when submitting invoices. In addition, for SNFs only, updates have been made to the attestation form and information regarding costs being capped per facility.

Please see Updated LTC Guidance Invoicing Process (06222020) for additional information.