COVID-19 Update #274
HFAM Update

Thanks for all you continue to do to provide quality care to Marylanders in need in your centers and on your campuses. As you know, the CDC continues to define a COVID-19 outbreak in our sector as a single case. Most outbreaks in our sector at this point are a single case or a small handful of cases, often among staff not directly providing care. Today we estimate that about 30 skilled nursing and rehabilitation centers in Maryland and 16 assisted living centers have an outbreak of at least a single case—that is a record low. Keep up the great work and remain vigilant!
Thankfully, deaths are rare with the current vaccination levels, applied care learnings, and treatments such as Monoclonal Antibody Treatment. However, we must remain diligent in our ongoing work with our hospital partners, Maryland State and county leaders, our long-term care pharmacy partners, and National Guard bridge teams to ensure the further vaccination of new patients, residents, and staff. The truth is, until we increase staff vacation, perhaps to a target of 75 percent vaccinated, we will likely see isolated outbreaks.

Here are five important facts, some requiring action:

  • HFAM continues to promote vaccination and work with our hospital partners, Maryland leaders, and long-term care pharmacy partners on supply chain issues; we also continue to deploy HFAM/AHCA and MDH communications tools and resources.

  • Some assisted living providers have mandated all staff to be vaccinated. Most skilled nursing and rehabilitation center operators are actively reviewing and considering the timing of mandating vaccination among employees.

  • Supply chain issues and the fear of losing staff are holding back skilled nursing operators from mandating staff vaccination. Both skilled nursing and rehabilitation center operators and assisted living campuses are looking at creative ways to incentivize vaccination – perhaps a small gift card or bonus, followed by a retention bonus. As you know, the Maryland State government has literally funded a lottery prize for vaccination.

  • The closing of the J&J plant here has created a considerable PR crisis. People in the hospital headed to short-term rehab in our settings often don't want the J&J vaccine. Often, staff don't want it. Supplies of it will likely NOT be replenished by the feds for deployment in Maryland in the near term. So in the near term, we can expect to deploy Pfizer and Moderna in our sector (with some J&J being offered by our LTC pharmacy partners).

  • MOST IMPORTANTLY: We do expect a future Maryland Department of Health order that will require skilled nursing and rehabilitation center operators and assisted living campuses to register for ImmuNet, to have freezers onsite, to have the ability to receive a direct allocation of vaccine, and to administer that vaccine. Stay tuned. Plan now. Perhaps the order will be issued in June for July.

As you know, ImmuNet is Maryland’s Immunization Information System (IIS), a confidential and secure database that is HIPAA compliant. It stores an individual’s vaccination records, and is a web-based tool for healthcare providers and schools to keep their patients/students vaccinated on time and avoid under or over vaccinated. With ongoing vaccination efforts, it is more critical than ever that your center register ASAP with ImmuNet. Once centers are registered, they can receive vaccines directly. Click here for a registration guide.

It was fantastic to spend quality time with both HFAM members and non-member skilled nursing and rehabilitation center and assisted living owner/operators at E-Cap in Miami this week. Clif Porter from AHCA did an outstanding job representing our sector and shared valuable insights. It was good to spend time with and support my colleague leaders from New Jersey, New York, and Florida, among others. And as always, JJ Rabinowich from the AHCA Ambassadors group was a stalwart and engaged leader, Mensch. The formal sessions were valuable, and the informal discussions perhaps more valuable. It is clear that owner-operators are focusing on the proper financial tools, people resources, and profitability measures to ensure continued access to quality care, be a quality care resource to people in need, slowly rebuild census in centers, and navigate the new way forward with innovation and resilience. Specifically, on E-Cap:
  • I want to congratulate founder and operator Hersch Krohner for another fantastic event.
  • I also want to thank Ryan C. Harkins from Greystone for making the time to compare notes.
  • Ray Kwiatek, I am impressed with your climate control product from Setpoint.
  • In my mind's eye, from a data perspective, Marc Zimmet had the quote of the conference, "No pandering, no rhetoric, no politics. We are taking a deep dive into the primary issue impacting the "National" SNF industry... that there is NO "National" SNF industry." I look forward to presenting at the ReimbursementCon in August—join us there!
  • Finally, it was fantastic to share time with our #1 HFAM Ambassador and my dear friend, Alan Zuccari, Owner, Alan J. Zuccari, Inc. t/a Hamilton Insurance Agency.

As Always
  • Focus on what is in your control and not what is out of your control.
  • Overcommunicate.
  • Adapt and innovate.
  • Rely on your partnerships.
  • Speak up when you need help.
  • Double efforts on infectious disease protocols, training, and operations.
  • Take and document your action; keep a timeline.
  • CLICK HERE for the Dr. Katz Video, and please see the Donning and Doffing Checklist we have been sharing.
Joe DeMattos
President & CEO
Nursing Home Media Toolkit

Check out the new Nursing Home Media Toolkit from the Maryland Department of Health. The password to access the materials is Vaccine2021.

Please use the materials in this media toolkit to spread the word about vaccination with staff.

You'll find flyers, ads, social media posts, videos, and posters. 
CMPs to Start June 14

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) published an Interim Final Rule on COVID-19 Vaccine Requirements. This rule applies to residents, clients, and staff of Skilled Nursing Facilities (SNF) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID). CMS also published a QSO memo to state survey agencies on how to operationalize this new requirement. 

The rule was scheduled to go into effect on May 21, 2021. However, CMS has publicly stated that it will not enforce compliance until June 14. 

AHCA/NCAL recommends that facilities implement several important steps before June 14 to ensure compliance with this new requirement.
Other COVID-19 Updates

SNFs/NFs: Reduce the Risk of CMPs and Citation by Reporting Vaccination and Therapeutics Data to NHSN Before June 13: Earlier this month, CMS published an Interim Final Rule and a QSO memo that requires nursing homes to submit COVID-19 vaccination rates and treatments given to residents. Read More

Guide: Building Vaccine Trust and Increasing Rates Among CNAs: Download the new, research-based guide and toolkit that speaks directly to the challenges nursing homes have expressed about the COVID-19 vaccine. Created by the Center for Public Interest Communications for the AHRQ ECHO National Nursing Home COVID-19 Action Network, it offers practical tools for building vaccine confidence in nursing homes.

The 2021 HFAM Conference “Together We Re-Imagine” will be held in person October 4 – 7, 2021 at the Maryland Live Hotel and Casino in Hanover, Maryland. Hundreds of long-term care leaders will connect, share best practices and discuss actionable insights on how we can reflect, reform, rebuild, and revolutionize quality care. You and your teams will not want to miss this opportunity as we come together again.

Visit the conference website to learn more and register.
Thank you to our current sponsors!
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