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Sept. 20th COVID-19 Update

New COVID-19-related updates for providers of long-term/post-acute care (LTPAC) and senior services continue to be shared on a regular basis by both state and federal authorities. The latest developments are discussed 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 Sept. 19th, is available here, and a list of the items shared by LeadingAge NY staff in the webinar chat can be accessed here. If you have questions for next week’s update, which will be held on Wed., Sept. 28th at 11 a.m. due to Rosh Hashanah, or would like the access information, please contact Jeff Diamond.

Cross-Sector Updates

DOH Delays Enforcement of New “Up-to-Date” COVID-19 Booster Definition Until Oct. 16th

The Department of Health (DOH) has notified nursing homes and adult care facilities (ACFs) that facilities may continue to treat staff and residents who are eligible for a bivalent COVID-19 booster as up-to-date under the prior definition through Oct. 15thAs previously reported, the Centers for Disease Control and Prevention (CDC) recommended the use of updated COVID-19 bivalent boosters for people ages 12 years and older earlier this month and modified its definition of “up-to-date” with COVID-19 vaccines to reflect the new bivalent boosters. The bivalent boosters were developed to target the Omicron BA.4 and BA.5 variants, helping to combat variants that are more transmissible. The change in the “up-to-date” definition affects quarantine requirements, work exclusion for health care personnel who are exposed to the virus, and routine screening testing of personnel in nursing homes. Click here for more information.

LeadingAge NY Advocates for HERDS Reporting Relief Following Expiration of COVID-19 PHE EO

With the recent expiration of the COVID-19 public health emergency Executive Order (EO), LeadingAge NY took the opportunity to call for a change in the collection of COVID-19 data for nursing home, ACF, home care, and hospice members. In this letter, we urged Governor Hochul to work with us to capture needed data points in a less onerous way than the current Health Emergency Response Data System (HERDS) reporting requirements.

PRF Reporting Window Closing Sept. 30th

The third reporting period for recipients of federal COVID-19 Provider Relief Funding (PRF) ends on Sept. 30th. Members who received PRF distributions totaling more than $10,000 during the period Jan. 1, 2021 through June 30, 2021 are required to report on the use of the funds by the Sept. 30th deadline. The time period is likely to include some Phase 3 General Distribution funding (which began in December 2020) and will include infection control quality improvement program funding for November 2020 and December 2020 performance for qualified nursing homes. Please note that due to the timing of the distributions, a number of providers may not need to file a report for this reporting period if they did not receive the threshold $10,000 in aggregate payments during the first half of 2021. The Health Resources and Services Administration (HRSA) website contains many reporting resources, from training webinars to fact sheets to lost revenue guides to examples and worksheets.

Nursing Home Updates

DOH to Submit Waiver for Approved TNA to CNA Programs

The Centers for Medicare and Medicaid Services (CMS) provided more information related to waivers of the Nurse Aide Training Competency and Evaluation Program (NATCEP) requirements in QSO-22-15-NH & NLTC & LSC, revised on Aug. 29th.

CMS is aware that there may be instances where the volume of aides who must complete a state-approved NATCEP exceeds the available capacity for enrollees in a training program or taking the exam. This may cause delays in nurse aides becoming certified. If a facility or nurse aide has documentation that demonstrates their attempts to complete their training and testing (e.g., timely contacts to state officials, completion of the weekly Drupal, multiple attempts to enroll in a program or test), a waiver of these requirements (42 CFR §483.35(d)) is still available, and the aide may continue to work in the facility while continuing to attempt to become certified as soon as possible.

DOH has verified that capacity issues exist in both training and testing; therefore, the Department will be sending a statewide or county waiver to CMS on behalf of those facilities that received approval for a temporary nurse aide (TNA) to certified nurse aide (CNA) program under the 1135 waiver and have responded to the weekly Drupal. At this point, all approved TNA to CNA programs should submit their application for testing to Prometric regardless of whether the facility has completed the TNA to CNA training.

CMS has informed DOH that the portal to submit the waiver request is not able to receive waiver requests at this time. CMS has indicated that additional guidance on the waiver application is pending. To make clear, the Department will be submitting a waiver on behalf of approved TNA to CNA programs and those who have responded to the Drupal.

NHSN Reporting: Security and Defining “Up-to-Date”

A reminder to nursing homes that when reporting resident and staff vaccination status to the National Healthcare Safety Network (NHSN) this week (i.e., Sept. 19th-25th), homes will still be reporting using the previous definition of “up-to-date” that includes age distinctions. For NHSN, Monday the 26th marks the start of a new reporting quarter, which will be the first week that the definition of up-to-date will be updated to reflect the recent bivalent vaccine guidance. The CDC will hold a webinar this Wed., Sept. 21st, at 1 p.m. to review this change. Registration is available here.

NHSN reporters should be aware that enhanced security features require additional permissions (along with Secure Access Management Services (SAMS) Level 3 security) to access the event-level reporting forms used to streamline the reporting of vaccination data. For access to the form, the individual must be specifically enabled to “Add, Edit, Delete” and “View,” even if they have been conferred “All Rights” or “Administrator Rights.” The additional permissions can only be granted by the individual designated as the Facility Administrator in NHSN. The process is described here. Homes with new staff or those that expect someone who does not typically report to require access to the forms may want to ensure that necessary permissions are in place. A great article from LeadingAge National covering NHSN issues, including the resolution of the Monthly Reporting Plan issue, is available here.