April 27th COVID-19 Update
New updates pertaining to the COVID-19 emergency continue to be announced by both the state and federal government on a regular basis. The latest developments for providers of long-term/post-acute care (LTPAC) and senior services are reviewed below.
As a reminder, LeadingAge NY continues to convene weekly webinars on Mondays at 11 a.m. to address emerging questions on COVID-19. A recording of our most recent webinar, held on April 26th, is available here. If you have questions for next week’s update, please send them to Ami Schnauber, and be sure to check your email for the access information, or contact Jeff Diamond.
DOH Updates Return to Work Guidance for Health Care Personnel
On April 22nd, the Department of Health (DOH) issued updated Revised Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following COVID-19 Exposure. Only minor revisions were made to the guidance, including a reference to the new COVID-19 travel guidance issued on April 10th and some rewording of definitions relating to the terms “exposure” and “recently recovered.” All other provisions remain the same.
The April 10th travel guidance and LeadingAge NY’s summary of it can be accessed here.
The latest vaccination information, including updates on the resumption of the Johnson & Johnson vaccine, an April 27th Centers for Disease Control and Prevention (CDC) Clinician Outreach and Communication Activity (COCA) call, a new Executive Order (EO) suspending penalties regarding utilization of vaccine supply within one week, and new guidance on recording first vaccine doses provided out of state, is summarized here.
EO 202.102 Issued
On April 19th, Governor Cuomo issued EO 202.102 extending existing EO 202 provisions (with one exception noted below) to May 19th. As members know, EO 202 sets forth many of the compliance, reporting, and notification requirements for long term care facilities during the COVID-19 emergency. It also provides the many flexibilities granted to providers early on in the pandemic. We will keep members apprised of updates regarding future extensions of these provisions.
EO 202.102 also suspends an EO 202 provision that imposed penalties on vaccine providers unable to fully utilize all vaccine supply within one week:
IN ADDITION, the following directive is no longer in effect:
- The directive contained in Executive Order 202.88 that required any healthcare facility, provider, or entity who has been allocated and has received COVID-19 vaccine, or who has received redistributed COVID-19 vaccine, must administer all such vaccine within one week of its receipt by such facility and provided that failure to administer vaccine in accordance with this process may result in a civil penalty of up to $100,000, and/or reduction or elimination of future allocations of vaccine.
Nursing Home Updates
CDC Issues New Guidance for Fully Vaccinated Nursing Home Residents and Staff
On April 27th, the CDC issued new guidance outlining the following changes:
- Updated COVID-19 testing recommendations;
- Updated visitation guidance describing circumstances when source control and physical distancing are not required during visitation; and
- Added guidance for communal activities and dining in health care settings.
Click here for more information.
DOH Issues IHANS Alert to Nursing Homes Reminding Them of Revised Visitation Guidance
On April 26th, DOH sent an Integrated Health Alerting and Notification System (IHANS) alert to nursing homes to remind them of the March 25th revised visitation guidelines. The message directs providers to update their visitation policy where it was posted or disseminated. Reportedly, DOH has noticed that some nursing homes have failed to update their visitation information on their website, which has caused concern. Members are urged to review the alert and ensure that their website and any other communications reflect the most current policies. Click here to view the alert.
FDA Revokes EUA for Bamlanivimab When Administered Alone
On April 16th, the Food and Drug Administration (FDA) revoked the Emergency Use Authorization (EUA) for bamlanivimab, when administered alone, due to a sustained increase in COVID-19 viral variants in the U.S. that are resistant to this antibody therapy. The FDA determined that the known and potential benefits of bamlanivimab, when administered alone, no longer outweigh the known and potential risks.
The Centers for Medicare and Medicaid Services (CMS) indicates that Medicare will cover and pay for bamlanivimab, when administered alone, for dates of service from Nov. 10, 2020 to April 16, 2021.
Updated New York State Medicaid billing codes that reflect changes in authorization and use of bamlanivimab as a standalone therapy are available here.
The FDA indicates that alternative monoclonal antibody therapies remain appropriate to treat COVID-19 patients, and health care providers may continue using these authorized therapies when administered together:
- Casirivimab and imdevimab
- Bamlanivimab and etesevimab
- Fact Sheet for Health Care Providers – EUA of Casirivimab and Imdevimab, Section 15, Antiviral Resistance
- Fact Sheet for Health Care Providers – EUA of Bamlanivimab and Etesevimab, Section 15, Antiviral Resistance
- Monoclonal Antibody COVID-19 Infusion webpage
- FDA Notice of Bamlavinimab EUA Revocation
Several LeadingAge NY members have been successfully treating residents with this therapy. Please contact us if you would like to connect with other members to learn more.
Local Positivity Rates
A document showing the most recent 14-day test positivity rates for each county in New York State based on both federal and state figures is available here. Thirty counties have test positivity rates above 5 percent based on federal data, with Erie, Niagara, and Cattaraugus counties near 10 percent. The requirement for nursing homes across the state to test staff twice weekly remains in effect. The county positivity data posted by CMS are lagged by a week and are updated each Monday or Tuesday. They are available for download in raw format here. LeadingAge NY extracts the CMS-calculated rates for New York State counties and posts them here, along with positivity rates calculated on state data covering the same two-week period.
Current daily county-level data for New York State are here, 7- and 14-day regional data are here, and ZIP code-level data for New York City showing infection rates during the most recent four weeks are available here. The State’s regional COVID-19 Early Warning Monitoring Dashboard showing new infections, severity of infections, and hospitalization data is available here.
Affordable Housing/Independent Living Updates
HUD Announces June Return to Physical Inspections
On April 23rd, Department of Housing and Urban Development (HUD) Secretary Marcia Fudge announced that HUD will substantially increase housing inspections for Multifamily Housing communities and Public Housing Agencies during the COVID-19 emergency, including properties participating in the National Standards for the Physical Inspection of Real Estate (NSPIRE) demonstration program, beginning June 1st. Click here for more information from LeadingAge National.