Missouri Long-Term Care Information Update

Wanted: COVID-19 Vaccine Champions

The sooner we’re all vaccinated for COVID-19, the safer we’ll all be. And that is especially true for point of care staff. That’s why the Health Quality Innovation Network (HQIN), in collaboration with the Missouri Nursing Home Advisory Council, is seeking brief statements from the frontline – why your staff members chose to be vaccinated.

Peer-to-peer encouragement can boost vaccine confidence as well as vaccination rates.

Would any of your team members be willing to share their vaccination “story?” All it takes is completing a brief online form and uploading a photo, which could be a selfie, the staff member being vaccinated, or even an image to depict the reason they got vaccinated such as to keep their loved ones and residents healthy.

To participate, simply share the COVID-19 Vaccine Experience Consent form with staff or complete it for them (with their consent).

The collection of powerful impact statements will be developed into posters and social media posts so that we can spread the word, rather than the virus.

Questions? Email HQI.

SLCR Life Safety Code Information Series

The Section for Long-Term Care Regulation will be releasing a series of Life Safety Code Information. You may also view the entire Life Safety Code document for reference.

Today’s subject is:

Can residents have a microwave in their room?

K324 – Cooking is not allowed in resident rooms. NFPA 19.3.2.5.3 and 19.3.2.5.4
K925 – Cooking appliances cannot be within 15 feet of an area of administration in a resident room.

NFPA 101, 2012 edition:
18/19.3.2.5.2* Where residential cooking equipment is used for food warming or limited cooking, the equipment shall not be required to be protected in accordance with 9.2.3, and the presence of the equipment shall not require the area to be protected as a hazardous area.
18/19.3.2.5.4* Within a smoke compartment, residential or commercial cooking equipment that is used to prepare meals for 30 or fewer persons shall be permitted, provided that the cooking facility complies with all of the following conditions:

(1) The space containing the cooking equipment is not a sleeping room.
(2) The space containing the cooking equipment shall be separated from the corridor by partitions complying with 19.3.6.2 through 19.3.6.5.
(3) The requirements of 19.3.2.5.3(1) through (10) and (13) are met.

Monthly Infection Control and Prevention Webinar Series: What you need to know to keep you, your patients and community safe.

June 2021 -December 2022 – 2nd Tuesday of each month from 12-1 p.m.: ICP Monthly Webinar Series

June 10 – Inaugural Webinar: Vaccines are Safe – How we know!
Lynelle Phillips, MPH, RN, Assistant Teaching Professor, Department of Public Health, School of Health Professions, Extension Service Nurse Specialist, University of Missouri, Columbia

  • General rules of vaccines
  • FDA approval process and Emergency Use Authorization Use (EUA) process
  • How were we able to get a vaccine to market in such a short time and still cut no corners?
  • Compare the different vaccines – safety and efficacy
  • Is the lesser protection by J&J significant enough to be important? J&J Case Study.

 

July 8 – How do COVID vaccines affect immunity to COVID?
Taylor Nelson, DO, Infectious Disease, Internal Medicine, University of Missouri Health Care, Columbia. Board Certified by the American Board of Internal Medicine/Infectious Disease

  • Natural immunity vs vaccine-induced immunity – which is best?
  • How long does the vaccine protect me?
  • What is Herd immunity and is it reasonable to expect we will ever achieve it?
  • If I’ve had COVID, why get vaccinated?
  • To boost or not to boost?
  • I’m young, isn’t it less risky to take chance with COVID than the vaccine?

 

August 10 – Environmental Health: Air Purification and Quality
Loie Couch, RN, BS, CIC, FAPIC, Infection Prevention Specialist, Barnes Jewish Christian (BJC) Hospital, St. Louis

  • Functions of a ventilation system
  • Benefits and limitations of bi-polar ionization
  • Minimum filtration requirements
  • Apply filtration flexibility on a space-by-space approach
  • Appropriate use of UV light disinfection and accompanying hazards
  • Visible light disinfection and its appropriate use and considerations

2021 Missouri Suicide Prevention Conference

July 28, 2021: Missouri Suicide Prevention Conference

The Missouri Suicide Prevention Network invites you to join us for our annual conference!

This year’s conference is brought to you by the Missouri Department of Mental Health, Missouri Behavioral Health Council and Community Counseling Center.

Visit us online at www.mospn.org/conference.

The virtual conference will be free of charge, unless you are needing continuing education. Continuing Education (CE) will be $10 per person.

The Missouri Behavioral Health Council has approved this program for up to 6.3 behavioral health continuing education contact hours. MBHC will be responsible for this program and maintain a record of your continuing education hours earned. See agenda for session breakdown.

Continuing Medical Education (CME) is currently pending approval for select sessions. See agenda for those eligible sessions.

Missouri partnerships ensure access to COVID-19 vaccines for homebound residents

The Missouri Department of Health and Senior Services (DHSS) announced a partnership between the Area Agencies on Aging, local public health agencies, and Emergency Medical Services (EMS) to ensure homebound adults have a streamlined and accessible vaccination experience across the state. Understanding that various communities have already developed a plan for vaccinating homebound individuals in their area, the partnerships established by the State are to merely supplement and allow these efforts to continue at the local level.

COVID-19 vaccination of homebound persons presents unique challenges to ensure the appropriate vaccine storage, temperatures, handling, and administration to ensure safe and effective vaccination.  Both CDC and CMS define homebound persons as those that need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave their home, or their medical provider believes that their health or illness could get worse if they leave their home, and they typically do not leave their home. 

The homebound referral process begins with the Area Agencies on Aging who are experts in discerning homebound status. Adults who are homebound and want to be vaccinated in their home can register through their local Area Agency on Aging or through the Missouri Vaccine Navigator registry by indicating they are homebound. Individuals reaching out to the State COVID-19 Hotline seeking vaccination for a homebound individual will be directed to their local Area Agency on Aging.  The homebound individual, their caregiver, family member, or healthcare provider can make the referral. 

The Area Agency on Aging makes contact with the homebound individual to obtain consent and gather the pertinent information to coordinate the vaccination in their home.  In some cases, caregivers and other household members may also be vaccinated at the same time as the homebound individual to prevent vaccine wastage. The Area Agency on Aging turns over the list of registered homebound individuals to their local public health agency or EMS provider who then schedules the in-home appointments. The AAA may also provide the homebound individual with courtesy appointment reminders via phone as many do not have internet or email access. 

The City of St. Louis Department of Health teamed up with the St. Louis Fire Department, Team Rubicon and the St. Louis City Area Agency on Aging to provide their homebound residents COVID-19 vaccination opportunity.

“This program will provide much-needed protection against COVID-19 for clients who may find it difficult to visit a vaccine clinic,” says Dr. Fredrick Echols, Acting Director of Health for the City of St. Louis. “By bringing the vaccine to them, we remove the barrier of travel and ensure these clients are not left behind in the vaccination process.”

[View Photo]  James Thompson, EMS Supervisor, and Mary Sullivan with Team Rubicon vaccinate a homebound resident of St. Louis City.

Kansas City’s homebound vaccination strategy involves a partnership between the Mid-America Region Council (MARC) Area Agency on Aging, the local health departments of Cass, Clay and Platte Counties and Kansas City, as well as multiple EMS and fire districts.

Chief Chip Portz of Central Jackson County Fire District said, “By partnering with our local health department and by taking advantage of reimbursement opportunities, the Central Jackson County Fire Protection District is able to provide this vital community service to a very vulnerable population without using emergency crews who would normally be protecting the rest of our citizens. We use off-duty paramedics in a non-emergency role to ensure our emergency response capacity is not diminished or compromised.”

[View Photo]  Central Jackson County Fire District, Captain Paramedic, Nathan Manley is providing vaccination to a homebound resident.

Lee’s Summit Assistant Fire Chief, Dan Manley, who has been instrumental in regional emergency planning, arranged a vaccine event for MARC Aging and Adult Services staff as well as their community partner who is delivering meals to self-isolating congregate and homebound older adults during COVID.

“Having our staff and volunteers vaccinated protects our most vulnerable homebound residents that we serve,” said Manley.

If you or someone you know is homebound or unable to visit a COVID-19 vaccination clinic without assistance, please call the COVID-19 Hotline at 877-435-8411 and press option 4 to be routed directly to your local Area Agency on Aging to make a vaccine appointment. You can also register homebound individuals for the vaccine by visiting Missouri’s COVID-19 website, MOStopsCovid.com. COVID-19 Hotline hours of operation are Monday-Friday 7:30 a.m.-5:30 p.m. and Saturday 8 a.m.-2 p.m. Individuals are encouraged to call soon to ensure their names are added to the list.  

News Release: State adds five additional language options to Missouri Vaccine Navigator

The Missouri Department of Health and Senior Services (DHSS) has launched the Missouri Vaccine Navigator in five additional languages for non-English speaking individuals. Already available in English and Spanish, Vaccine Navigator now also allows individuals to register and find vaccination appointments throughout Missouri in Chinese, French, Korean, Portuguese and Russian.

All individuals over the age of 12 are now eligible to get a COVID-19 vaccine in Missouri, regardless of their citizenship. (Pfizer is the only vaccine authorized for those ages 12-17).

Approximately 775,000 individuals are currently registered in Missouri Vaccine Navigator, which is powered by Qualtrics. The system allows individuals to register and schedule an appointment for a COVID-19 vaccine by viewing vaccination events throughout the state.

In addition to helping individuals register for a vaccine, the Missouri Vaccine Navigator will remind registrants when it is time to schedule their second dose. Two of the vaccines currently authorized for use (Pfizer and Moderna) require two doses, and the second dose is critical to ensure individual and community protection.

The Missouri Vaccine Navigator also integrates with ShowMeVax, the state’s immunization database for providers. Vaccination events using the Missouri Vaccine Navigator for scheduling enables  coordinators to quickly load vaccination administration data into the system and avoid cumbersome data entry.

Once an individual is registered with Missouri Vaccine Navigator, the scheduling platform becomes available and can be accessed as often as needed or until vaccination is achieved.

Those with online accessibility issues are encouraged to call the COVID-19 hotline at 877-435-8411 for registration assistance. Language translation and other services are available to callers.

COVID-19 vaccines are completely free for everyone in the U.S. Get the facts at  MOStopsCovid.com.

SLCR Life Safety Code Information Series

The Section for Long-Term Care Regulation will be releasing a series of Life Safety Code Information. You may also view the entire Life Safety Code document for reference.

Today’s subject is:

What if a sprinkler head gets paint on it or has corrosion?

No one can successfully remove paint or corrosion from a sprinkler head and the facility must replace those sprinkler heads. There is currently not any UL listed paint remover.

NFPA 25, 2011 edition:
5.2.1.1 Sprinklers shall be inspected from the floor level annually.
5.2.1.1.1 Sprinklers shall not show signs of leakage; shall be free of corrosion, foreign materials, paint, and physical damage; and shall be installed in the correct orientation (e.g., upright, pendent, or sidewall).
5.2.1.1.2 Any sprinkler that shows signs of any of the following shall be replaced:

(1) Leakage
(2) Corrosion
(3) Physical damage
(4) Loss of fluid in the glass bulb heat responsive element
(5) Loading
(6) Painting unless painted by the sprinkler manufacturer

5.2.1.1.3 Any sprinkler that has been installed in the incorrect orientation shall be replaced.
5.2.1.1.4 Any sprinkler shall be replaced that has signs of leakage; is painted, other than by the sprinkler manufacturer, corroded, damaged, or loaded; or is in the improper orientation.
5.2.1.1.5 Glass bulb sprinklers shall be replaced if the bulbs have emptied.

Provider Feedback Survey

The Section for Long-Term Care Regulation is again seeking input from providers we serve. We are asking for your help in identifying areas in our Section where excellent customer service is provided and areas where we need to focus on improving our customer service experience.

Please take a couple minutes to complete our 2021 Provider Feedback Survey by June 30, 2021 at https://www.surveymonkey.com/r/CFY7N9T.

SLCR Life Safety Code Information Series

The Section for Long-Term Care Regulation will be releasing a series of Life Safety Code Information. You may also view the entire Life Safety Code document for reference.

Today’s subject is:

How often does the facility need to ensure the generator transfers power within 10 seconds?

  1. What information is required for the documentation?
  2. Does it have to be under load?

The facility staff must document a transfer within ten seconds at least annually. This documentation must include all legs with the amperage under load. The load test must last at least 30 minutes, which is in addition to (warm up is not allowed) cool down times. This is not a load bank test, which is available only for diesel generators who cannot meet at least 30% of load.

NFPA 110, 2010 edition:
4.3 Type. The type defines the maximum time, in seconds, that the EPSS will permit the load terminals of the transfer switch to be without acceptable electrical power. Table 4.1(b) provides the types defined by this standard.

New QIPMO Newsletter – May 2021

The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls – Volume 8, Issue 3.

In this issue:

  • Embracing Diversity in Our Homes
  • Can You See the Light??
  • Just for You: QIPMO Infection Control Manual
  • No-Nose Gang
  • OSHA in tha’ House!
  • Maintaining Life Safety Code Compliance
  • Person-Centered Activities

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

Cream of the Crop Webinars

CE Available for Nurses, Social Workers, Nursing Home Administrators, and pharmacotherapeutics (RX)
We hand selected 12 of our most popular webinars from 2020.
https://web.cvent.com/event/dcf77498-045c-48e7-aa2a-d17a5cd8aa09/summary

Sessions for NHA CE:

Age Friendly Health Systems
John Morley, MD, Professor Geriatrics, St. Louis University Medical School
This session will address recognizing and managing geriatric syndromes. The 4M framework will be included to ascertain specific health outcome goals and care preferences.

Preserving Integrity in Turbulent Times
Cynda Ruston, PhD, RN, FAAN, Anne & George L. Bunting Professor of Clinical Ethics, German Institute of Bioethics/School of Nursing, Professor of Nursing & Pediatrics, John Hopkins University
Listen to a recognized and international leader in nursing ethics, from John Hopkins University. This session will focus on selected sources of moral suffering, consequences of moral suffering, and offers a pathway of moral resilience by restoring integrity.

Medication Considerations in the Elderly During the COVID-Pandemic
Curt Wood, R.PD., BCGP, FASP, Elder Care Pharmacy Consultant, LLC
Medication usage is even more critical in a pandemic as many long-term care communities are experiencing outbreaks of the virus. Ideas on gradual dose reduction and managing chronic diseases will be discussed.

Resiliency: Using Gratitude to Thrive Through Adversity
T.J. Sweet, MHA, Practice Manager, Ellis Administration, University of Missouri Hospital, Columbia
Learn how to use strategies to validate feelings and practical ways to support colleagues when exposed to high stress levels in uncertain times. Learn to thrive despite adversity and maintain a resilient mindset using gratitude.

Reducing Meds – The When, What and How to Minimize Adverse Outcomes
Craig Sever, BS, R.Ph., Clinical Coordinator Eversprings Pharmacy, St. Louis, Missouri
The speaker will provide insight on how to pharmacologically assess the most reducible meds and develop an appropriate reduction strategy for older adults.

Leadership Development Academy for LTC Leaders

Join us for the MU Leadership Development Academy for Nurse Leaders and Nursing Home Administrators in Long-term Care. We know that Long-term Care can be challenging. With an 11 year proven track record, hundreds of graduates and life-changing testimonials, this leadership course is designed for busy LTC professionals, all while earning 50 hours of CE credit.

The academy has been proven to increase leadership skills and improve confidence, which will help to create a working environment that encourages teamwork and quality improvement.

NO COST for RNs and NHAs from Skilled Nursing Facilities in Missouri (excludes Veterans Administration facilities).
The complimentary option is available to Missouri SNFs since the support for this academy is provided by CMP funds designated for Missouri SNFs.

More Information: https://extension.missouri.edu/programs/nursing-outreach/enhanced-leadership-development-academy.

COVID-19 Testing and other Necessary COVID-19 Related Invoices – Important Update: Please Read!

ALFs, ICFs, and RCFs that have billed for “other” costs as of 5/3/2021 may continue to submit “other” necessary COVID-19 related invoices through June 30, 2021. All “other” invoices (as of 5/3/2021) submitted by ICFs, ALFs, and RCFs must include a new signed addendum.

SNFs may continue to bill for “other” necessary COVID-19 related invoices through June 30, 2021.

All Long-Term Care facilities (SNFs, ICFs, ALFs, and RCFs) may continue to submit testing invoices until further notice.

Due to time constraints, please do not wait until the last minute to submit these invoices.

The web portal can be found here: https://apps.dss.mo.gov/LongTermCareCovid19Invoices/

CMS Memo QSO-21-19-NH: Interim Final Rule – COVID-19 Vaccine Immunization Requirements for Residents and Staff

Interim Final Rule – COVID-19 Vaccine Immunization Requirements for Residents and Staff

CMS has issued QSO-21-19-NH, which outlines the Interim Final Rule – COVID-19 Vaccine Immunization Requirements for Residents and Staff. This rule establishes Long-Term Care (LTC) Facility Vaccine Immunization Requirements for Residents and Staff. This includes new requirements for educating residents or resident representatives and staff regarding the benefits and potential side effects associated with the COVID-19 vaccine, and offering the vaccine. Furthermore, LTC facilities must report COVID-19 vaccine and therapeutics treatment information to the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN). Please read through the memo carefully for facility actions and effective dates.

See the memo or visit https://www.cms.gov/files/document/qso-21-19-nh.pdf for complete details.

CMS Social Media Campaign – Community Champions

On May 5, 2021, as a part of CMS’ ongoing COVID response efforts to support the long term care community, CMS debuted their first social media video highlighting staff, also referred to as Community Champions, who moved from being initially uncertain about receiving the COVID-19 vaccine to accepting the vaccine – and encouraging their peers to do the same.

Throughout the COVID-19 pandemic, staff in nursing homes have been providing ongoing care to our nation’s most vulnerable. This social media campaign is intended to help increase vaccine acceptance amongst long-term care staff.

SLCR Life Safety Code Information Series

The Section for Long-Term Care Regulation will be releasing a series of Life Safety Code Information. You may also view the entire Life Safety Code document for reference.

Today’s subject is:

           What kind of documentation should a facility provide to the surveyor when on a fire watch?

Most facilities have one fire watch policy. If a facility has one policy, then the policy must have all the items in Chapter 15 within NFPA 25, 2011 edition. If the facility has two separate policies, the sprinkler system fire watch policy is required to include all the items in Chapter 15.

NFPA 25, 2011 edition:
Minimum Requirements
15.1.1.1 This chapter shall provide the minimum requirements for a water-based fire protection system impairment program.
15.1.1.2 Measures shall be taken during the impairment to ensure that increased risks are minimized and the duration of the impairment is limited.
Impairment Coordinator
15.2.1 The property owner or designated representative shall assign an impairment coordinator to comply with the requirements of this chapter.
15.2.2 In the absence of a specific designee, the property owner or designated representative shall be considered the impairment coordinator.
Tag Impairment System
15.3.1 A tag shall be used to indicate that a system, or part thereof, has been removed from service.
15.3.2 The tag shall be posted at each fire department connection and the system control valve, and other locations required by the authority having jurisdiction, indicating which system, or part thereof, has been removed from service.
Impaired Equipment
15.4.1 The impaired equipment shall be considered to be the water-based fire protection system, or part thereof, that is removed from service.
15.4.2 The impaired equipment shall include, but shall not be limited to, the following: Sprinkler systems, Standpipe systems, Fire hose systems, Underground fire service mains, Fire pumps, Water storage tanks, Water spray fixed systems, Foam-water systems, Fire service control valves
Preplanned Impairment Programs
15.5.1 All preplanned impairments shall be authorized by the impairment coordinator.
15.5.2 Before authorization is given, the impairment coordinator shall be responsible for verifying that the following procedures have been implemented:

(1) The extent and expected duration of the impairment have been determined.
(2) The areas or buildings involved have been inspected and the increased risks determined.
(3) Recommendations have been submitted to management or the property owner or designated representative.
(4) Where a required fire protection system is out of service for more than 10 hours in a 24-hour period, the impairment coordinator shall arrange for one of the following:

(a) Evacuation of the building or portion of the building affected by the system out of service
(b) An approved fire watch
(c) Establishment of a temporary water supply
(d) Establishment and implementation of an approved program to eliminate potential ignition sources and limit the amount of fuel available to the fire

(5) The fire department has been notified.
(6) The insurance carrier, the alarm company, property owner or designated representative, and other authorities having jurisdiction have been notified.
(7) The supervisors in the areas to be affected have been notified.
(8) A tag impairment system has been implemented. (See Section 15.3.)
(9) All necessary tools and materials have been assembled on the impairment site.

Emergency Impairments
15.6.1 Emergency impairments shall include, but are not limited to, system leakage, interruption of water supply, frozen or ruptured piping, and equipment failure.
15.6.2 When emergency impairments occur, emergency action shall be taken to minimize potential injury and damage.
15.6.3 The coordinator shall implement the steps outlined in Section 15.5.
15.7 Restoring Systems to Service
When all impaired equipment is restored to normal working order, the impairment coordinator shall verify that the following procedures have been implemented:

(1) Any necessary inspections and tests have been conducted to verify that affected systems are operational. The appropriate chapter of this standard shall be consulted for guidance on the type of inspection and test required.
(2) Supervisors have been advised that protection is restored.
(3) The fire department has been advised that protection is restored.
(4) The property owner or designated representative, insurance carrier, alarm company, and other authorities having jurisdiction have been advised that protection is restored.
(5) The impairment tag has been removed.

The Resident Advocate Newsletter – May 2021

The May 2021 Resident Advocate is now available.

The Resident Advocate provides:

  • Information on residents’ rights and care issues
  • News and updates on national policy
  • Self-advocacy tips for obtaining person-centered, quality care

This issue includes updates on the coronavirus disease (COVID-19) and suggestions for staying engaged and advocating for yourself to continue to receive the care you deserve. This issue also features an article on COVID-19 prevention tips and ideas to stay connected with friends and family during isolation.

This newsletter is a great resource to share with long-term care residents. Nursing home staff, long-term care Ombudsman programs, family members, and other advocates are encouraged to forward this newsletter to residents or print and share copies with residents. Download this issue or past issues from this webpage.

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS data for October 1 – December 31 (Q4) of CY 2020 must be submitted no later than 11:59 p.m. on May 17, 2021.

The Minimum Data Set (MDS) 3.0 must be transmitted to CMS through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). No additional reporting is required.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to IRFs, LTCHs, and SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

More information about SNF QRP can be found on the following webpages:

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 1/1/21 through 3/31/21 is due on Saturday, May 15, 2021. Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center (1-800-339-9313) no later than the Friday before the submission deadline as the Service Center will be unavailable to assist on the weekend.

More information about PBJ can be found on the following webpages:

Pioneer Network’s Virtual Symposium

June 16, 2021: Envisioning the Future – Dementia Care: 2021 and Beyond

The second in our 2021 four symposium series based on the theme, Envisioning the Future, this virtual event is designed to provide valuable learning on the topic of Dementia Care. Held within a 6-hour window, there will be four general sessions followed by an opportunity to gather together with the general session speakers to ask questions, explore the topics, and further define our vision for the future.

Missouri Guidance for Long-Term Care Facilities

DHSS has updated its guidance to reflect recent changes to CMS’ visitation guidance and to clarify and provide examples of those considered outside health care workers, which includes hospice workers (all disciplines). The changes include:

Visitor Vaccination Status
When both the resident and all of their visitors are fully vaccinated and while alone in a resident’s room or the designated visitation room, residents and their visitor(s) can choose to have close contact (including touch) and to not wear source control. Visitors should wear source control and physically distance from other healthcare personnel and other residents/visitors that are not part of their group at all other times while in the facility.

Visitors shall be given the opportunity to disclose their vaccination status to determine if the visitor may have close contact (including touch) and not wear source control while alone in a resident’s room or the designated visitation room, however the facility may not require visitors to disclose their vaccination status or to show proof of vaccination. Visitors that decline to disclose their vaccination status should adhere to the infection control principles of COVID-19 infection prevention for unvaccinated persons.

Outside Health Care Workers
Clarified and provided examples of outside health care workers and the expectation that outside healthcare workers must be permitted to come into the facility. Health care workers who are not employees of the facility, such as hospice workers (all disciplines), Emergency Medical Services (EMS) personnel, dialysis technicians, laboratory technologists, radiology technologists, social workers, clergy, etc., but provide direct care to the facility’s residents, must be permitted to come into the facility as long as they are not subject to a work exclusion due to an exposure to COVID-19 or showing signs or symptoms of COVID-19 after being screened.

Communal Dining and Group Activities
Fully vaccinated residents can participate in communal dining and group activities without use of source control or physical distancing. If unvaccinated residents are present, all residents should use source control when not eating and unvaccinated residents should continue to remain at least 6 feet from others.

Pioneer Network: Hot Topics – Culture Change in Action

May 6, 2021: Spring Forward: Three Person Centered Care Strategies to Change the Trajectory for Residents in Senior Living
Speakers: Rosemary Laird, M.D.,M.H.S.A; Deanna Vigliotta, National Sales Manager, TZMO USA, Inc; and Penny Cook, President & CEO, Pioneer Network

Join us for a discussion on some Hot Topics, including the importance of a person-centered approach to care; how now may be the perfect time for senior living communities to reevaluate their outdoor space for residents; how rethinking a community’s indoor space may help to increase social engagement for residents; and how revisiting current policies related to continence care may lead to better outcomes and costs savings. Three strategies will be explored in hopes that through education and understanding, together we can change lives.

Revised CMS Memos

The Centers for Medicare and Medicaid Services release two revised QSO memos today. Below is a summary of the major revisions in each memo. Please read each in its entirety for all revisions. DHSS guidance will be updated to reflect the revisions in the CMS Visitation memo, however all facilities may begin using this revised guidance immediately.

CMS QSO-20-38-NH Revised – Updated Guidance Regarding Testing
The major revision to this document is regarding routine testing of staff. Routine testing of unvaccinated staff should be based on the extent of the virus in the community. Fully vaccinated staff do not have to be routinely tested. Facilities should use their county positivity rate in the prior week as the trigger for staff testing frequency.

CMS QSO-20-29-NH Visitation
The major revision to this document is regarding group activities and communal dining. The CDC has provided additional guidance on activities and dining based on resident vaccination status. For example, residents who are fully vaccinated may dine and participate in activities without face coverings or social distancing if all participating residents are fully vaccinated; if unvaccinated residents are present during communal dining or activities, then all residents should use face coverings when not eating and unvaccinated residents should physically distance from others. See the CDC guidance Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination for information on communal dining and activities.

Alert: Postcard Disguised as Official Office of Civil Rights (OCR) Communication

OCR has been made aware of postcards being sent to health care organizations informing the recipients that they are required to participate in a “Required Security Risk Assessment” and they are directed to send their risk assessment to www.hsaudit.org. The link directs individuals to a non-governmental website marketing consulting services.

Please be advised that this postcard notification did not come from OCR or the U.S. Department of Health and Human Services. This communication is from a private entity – it is NOT an HHS/OCR communication. HIPAA covered entities and business associates should alert their workforce members to this misleading communication. Covered entities and business associates can verify that a communication is from OCR by looking for the OCR address or email address, which will end in @hhs.gov, on any communication that purports to be from OCR, and asking for a confirming email from the OCR investigator’s hhs.gov email address. The addresses for OCR’s HQ and Regional Offices are available on the OCR website at https://www.hhs.gov/ocr/about-us/contact-us/index.html, and all OCR email addresses will end in @hhs.gov. If organizations have additional questions or concerns, please send an email to: OCRMail@hhs.gov.

Suspected incidents of individuals posing as federal law enforcement should be reported to the Federal Bureau of Investigation.