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Feb. 16th 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 outlined 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 Tues., Feb. 16th due to Presidents’ Day, 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.

Cross-Sector Updates

CDC Issues Updated Guidance on Quarantine Recommendations for Vaccinated Persons

Last week, the Centers for Disease Control and Prevention (CDC) issued new guidance regarding quarantine after an exposure for fully vaccinated people. Members should review it carefully to understand to whom it does and does not apply. In addition, the CDC provided more guidance regarding testing for tuberculosis and the timing of the COVID-19 vaccine. Click here for more information.

State Issues New Vaccine Guidance

New vaccination prioritization guidance was issued on Feb. 15th which adds individuals with comorbidities and/or underlying conditions to the vaccine eligibility list. This population will be vaccinated by State vaccination sites and local health departments. While hospitals will lose some vaccine supply for reallocation to this new population, they will remain the primary vaccinator for health care providers serving in hospitals and in the broader community.

Additionally, new operational guidance was issued on Feb. 14th regarding temperature excursion reporting for vaccinators in the State vaccination program. While long term care facilities are not currently activated in this program, members are urged to review this guidance for future purposes. The temperature excursion report is only required to be submitted by the vaccinator in the event that the vaccine is either shipped or stored outside of viable storage temperatures.

EO Extensions

On Feb. 11th, Governor Cuomo issued Executive Order (EO) 202.93 extending all EO 202 provisions relating to compliance, notification, visitation, infection control, and reporting for adult care facilities (ACFs) and nursing homes until March 13, 2021. As members know, this EO also includes flexibilities for health care providers relating to utilization of out-of-state provider staff, telehealth, and more.

Members are also reminded that holiday visitation guidance for nursing homes and ACFs continues to be in effect at this time.

ACF/Assisted Living Updates

DOH Adds New Questions to ACF Daily HERDS Survey

Starting Wed., Feb. 17th, the Department of Health (DOH) will add several new questions to the ACF Daily Health Emergency Response Data System (HERDS) survey to get a better sense of the status of vaccinations in those settings. Click here for more information.

Nursing Home Updates

HHS Issues Final Nursing Home QIP Payment

On Fri., Feb. 12th, the Department of Health and Human Services (HHS) distributed the fourth and final round of nursing home infection control Quality Incentive Program (QIP) payments. In New York State, 286 nursing homes shared $44.7 million. This final distribution covers the December performance period from Nov. 30th through Dec. 27th. These payments target homes whose infection rates are below the county’s community infection rate (based on non-public Centers for Medicare and Medicaid Services (CMS) calculations), that report complete and accurate information to the National Healthcare Safety Network (NHSN), and whose COVID-19 mortality rate is below 10 percent. HHS has posted recipient information for both the December and November payments. This information allows us to calculate the facility to county infection rate comparison, which we will circulate to nursing home members shortly. Note that HHS had initially indicated that it was considering making five payments (one for each of four months and one covering the entire four-month period) but opted to distribute all of the available funding through the four monthly payments. Recipients are required to agree to the terms and conditions that govern the funding within 90 days here. The terms and conditions document associated with these payments is the same as for other nursing home infection control distributions and is available here.

DOH Posts List of Designated COVID-19 Nursing Home Units

DOH has posted a list of nursing homes that are approved to operate dedicated COVID-19 units. The facilities are designated pursuant to an agreement with DOH and are designed to care for persistently positive patients. The units are for individuals discharged from a hospital with a positive COVID-19 test, despite being beyond the CDC infectious period, who consent to and require the services of a nursing home but based on molecular COVID-19 testing are otherwise unable to be admitted or returned to a New York State nursing home. Once a resident of a dedicated COVID-19 unit tests negative, they are no longer eligible for the enhanced rate, and the facility should work to effectuate a discharge. Residents of COVID-19 units must receive molecular COVID-19 tests within five days of admission and every three to seven days thereafter. The list of designated homes is here, and a Dear Administrator Letter (DAL) outlining the requirements is here. Billing guidance is here.

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. The test positivity rates remain notably lower than in January, with only two counties in the state (Orange and Hamilton) exceeding 10 percent based on federal data. Nursing homes across the state are still required to test staff twice per week, and members should keep in mind the federal requirement that for homes located in counties where positivity rates exceed 10 percent, visitation is limited to compassionate care.

Current daily county-level data for New York State are here, and ZIP code-level data for New York City showing infection rates during the most recent four weeks are available here. Metrics related to the State’s micro-cluster initiative are available here, and links to updated cluster maps and the address look-up tool are here.

Home and Community-Based Services (HCBS) Updates

Home Care Vaccination Update

LeadingAge NY, working with partners Home Care Association of New York State (HCA) and New York State Association of Health Care Providers (HCP), has issued a survey to ascertain the number of home care workers currently unvaccinated in the state. The New York City Department of Health and Mental Hygiene (NYC DOHMH), as well as regional hub contacts, are asking for these numbers in order to tailor their vaccine efforts to serve this specific population. If you or someone on your staff has not already completed the survey, please do so by Feb. 17th. Click here for more information.

Affordable Housing/Independent Living Updates

COVID-19 Cases Jump in Senior Housing as Financial Strain, Vaccine Access Issues Continue

On Feb. 11th, LeadingAge National released the results of its second quarterly survey measuring the impact of COVID-19 on affordable senior housing providers. Among other pandemic impacts, the informal survey, conducted over two weeks in January 2021, sheds light on trends in COVID-19 cases, financial strain, and resident social isolation concerns for housing providers serving more than 2.5 million older adults with low or extremely low incomes. Click here for more information from LeadingAge National.

HUD: Resident Risk Factors Make COVID-19 Support Critical

A new report from the Department of Housing and Urban Development’s (HUD) Office of Policy Development and Research explores how at-risk populations for COVID-19 are represented among tenants of HUD-assisted housing. The piece compares the COVID-19 risk factors of age, disability, race, income and unemployment, and crowding to the profile of HUD-assisted residents. Click here for more information from LeadingAge National.