Coronavirus Update #195
HFAM Update, AHCA/NCAL Survey, New Infection Control Program,
Additional COVID Updates and Upcoming Webinars
HFAM Update


Proud of you and counting on you and your teams as we are at the beginning of the fall/winter surge of COVID-19. Below are some important updates, reminders, and resources.


As you know, the Maryland Department of Health’s (MDH) Nursing Home Orders requires centers to have a 30-day supply of PPE by the end of November and a 60-day supply by the end of January. We are all concerned about production challenges and the supply chain. Throughout this process Steve Mazzola at Medline has been a tremendous resource; Medline has been there for AHCA/NCAL and the entire sector. Our collective partnership with Lifespan and LeadingAge Maryland has also been an important resource for PPE. We are in a tough time that is getting tougher. Here is the bottom line: I know you will comply with the PPE supply orders. Despite the urge to store and not use PPE, I know that PPE will be deployed as needed both now and going forward. 

If you are in a PPE emergency, let us know and we will alert the State. Also, as we shared last week, CMS plans to call skilled nursing and rehabilitation centers that report shortages of PPE and/or staffing to offer assistance.


As you know, MDH’s Nursing Home Orders follow the CMS August 26 Rule, which links testing in our sector to the local jurisdiction’s positivity rate. Some Maryland skilled nursing and rehabilitation centers continued with more frequent commercial testing, despite their jurisdiction’s positivity rate. Others used the opportunity to combine commercial testing with point-of-care (POC) testing. Here is the bottom line on testing: we can likely expect State orders for increased testing and the use of POC and commercial lab testing, it just makes sense given the surge.

As we advised earlier on testing, cautious nursing homes might consider serial weekly POC testing of all staff, POC testing of all visitors and vendors, and weekly PCR commercial testing of patients and residents. We remain very concerned about the critical need for the testing of ambulance personnel, dialysis employees, and state health inspectors, which has not been ordered.


I think most in our sector made the deadline to sign-up for the federal vaccination program through CVS/Walgreens. The optimistic timeline for distribution is still December/January. If you have questions, email

Mutual Assistance

  • We continue conversations with the State on staffing and testing. Yesterday, HFAM had a productive virtual meeting with the Maryland Hospital Association (MHA) and we are engaged in follow-up work going forward. It is important to remember as this surge ramps up, the workforces of hospitals and skilled nursing and rehabilitation centers are impacted. Nursing homes have team members who have contracted or been exposed to the virus, as do hospitals. And, we are increasingly pulling from the same RN workforce.

  • The current order regarding various healthcare matters asks for hospitals to help nursing homes, and seeks to have nursing homes mutually support each other as the surge continues. In a crisis, the expectation and hope is that all will help where they are able. We continue to work with MHA to reinforce and build specific hospital/nursing home safety net partnerships, and to identify specific nursing homes who might need help as the surge advances. We also continue to work with MDH on more detailed guidance.

  • We continue to work with MDH and National Guard leaders on the State bridging of perhaps 20 percent of the sector. We are working within parameters that the State identified to us in early September. As we previously advised, the State’s expectation is that our sector will largely self-bridge during this fall and winter COVID-19 surge. Unlike the first surge in March and April, State bridge teams will be very limited.

  • The support of State and National Guard Technical Assistance Teams has been helpful. Even now, those teams are doing a second round of review and instructional visits. But again, the State’s expectation is that our sector will self-bridge during this fall and winter COVID-19 surge.

  • As with earlier surges, HFAM will continue to be proactive in coordination with the Maryland Hospital Association, UMMS, Johns Hopkins Medicine, and Lifebridge and other hospital partners on issues of emergency RN staff supervision/training support, and in general coordination.

NOTE: Governor Hogan will have a press conference today at 2 p.m. We will keep you updated on any news for our sector.

Reminders, as always:

  • People first, quality counts.
  • Our sector MUST double our efforts on infectious disease protocol, staffing, PPE, observation, and testing.
  • Train, train, and train teams again on infectious disease protocol.
  • Recognize that COVID-19 fighting fatigue is an issue across the county, not just in our sector.
  • Overcommunicate with residents, patients, families, staff, and government partners.
  • Work with your hospital partners, and coordinate with local and state regulatory partners.
  • Take and document your action; keep a timeline
  • CLICK HERE for the Dr. Katz Video, and please see the Donning and Doffing Checklist we first distributed a couple of months ago.
Joe DeMattos
President and CEO
Please Complete the AHCA/NCAL COVID-19 Impact Survey

AHCA/NCAL is asking providers (SNF, AL, ID/DD) to complete a 15-20 minute survey regarding COVID-19’s impact on your facility/company. Providers will be asked about several topics, including workforce, personal protective equipment, testing, and finances. You may download a copy of the questionnaire if you wish to gather the necessary information before filling it out online. 

Information from this survey will help AHCA/NCAL address questions from policymakers and advocate for ongoing resources to the profession. Please complete the survey by end of the day on Friday, November 20.  
A New Infection Control Program Designed for Skilled Nursing and Assisted Living Staff

Five eLearning modules that provide basic knowledge in the following areas:

  1. Infection Prevention and Control for All Staff
  2. Coronavirus Disease (COVID-19)
  3. Personal Protective Equipment (PPE)
  4. Hand Hygiene
  5. COVID-19: PPE Guidance for Use

Five eCompetencies with evidence-based digital checklists that allow evaluators to confirm step-by-step knowledge and competency for:

  1. Personal Protective Equipment (PPE): Applying and Removing
  2. Handwashing
  3. Surgical Face Mask: Application and Removal
  4. N95 Respirator Application and User Seal Check
  5. Cleaning and Disinfecting Environmental Surfaces
Have Questions?
Call (866) 323-4169 or e-mail
Other COVID-19 Updates

OSHA Releases Frequently Cited Standards Related to COVID-19 Inspections: OSHA released a one-pager on frequently cited standards related to COVID-19 inspections. Some of these include fit tests for respirators, providing a medical evaluation before fit testing or using a respirator, PPE availability, training on properly using PPE, and more. Read More

Information to Help SNFs Excluded from September’s HHS Performance Payments: AHCA/NCAL previously shared details of the HHS Quality Incentive Payment program for skilled nursing facilities. If you are a SNF that did not receive a September incentive payment, download this zip file of an Excel spreadsheet to help understand why your center specifically may not have received a payment. (Member login required.Read More

NHSN To Update Reporting Pathways: The National Healthcare Safety Network verbally announced there will be updates issued to two reporting pathways. The Resident Impact and Facility Capacity Pathway and the Staff and Personnel Impact Pathway will undergo a variety of changes in November. Read More
Upcoming COVID-19 Webinars

Thursday, November 19, 2020
Hosted by BD

Monday, November 23, 2020
Hosted by BD

Wednesday, December 2, 2020
Hosted by BD

Monday, December 7, 2020
Hosted by BD
Upcoming Webinar: Maryland Pre-Admission Screening and Resident Review (PASRR) for Individuals with Mental Illness 

Date: Friday, November 20, 2020
Time: 10:30 am-12:30 pm

This interactive webinar will focus on the history as well as the current roles, responsibilities and processes of the Pre-Admission Screening and Resident Review (PASRR) program in Maryland for Individuals with Mental Illness. Attendees will learn about PASRR Level I and Level II process requirements and review case scenarios to reinforce the information provided. Target audience includes hospital discharge planners, nursing facility social workers, Adult Evaluation and Review Services teams, and anyone else interested in learning more about this federal requirement.

2.0 CEUs available.
Did you miss HFAM's previous alerts?

Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
Thank you.

We cannot thank you enough for the dedication and diligence in doing all that you can for the residents in your communities. HFAM continues to monitor the COVID-19 pandemic with our state and national partners and will do all we can to support you during this time.