Coronavirus Update #36

Updated Resource Request Process
MDH Waiver of PASRR and MDS Validation
CARES Act Memo
Updated COVID-19 Resource Request Process

This afternoon, the Maryland Department of Health (MDH) shared important clarifying information regarding the current process that hospitals and other healthcare entities should use to request PPE and other health related equipment or supplies, except for ventilators. Requests for ventilators will be routed differently and as soon as the Hospital Surge Team completes their process, it will be shared.

The process for requesting health and hospital related materials should be routed from the requester to their respective local health department using THIS FORM.

The local health department (LHD) will provide the requested items if available. If the LHD is unable to fulfill the request, the form should be forwarded to the local office of emergency management (OEM). Prior to sending to the OEM, the LHD should ensure that all required information is completed and that the request is appropriate.  For example, requesting N-95 respirators when CDC and state guidelines indicate that only surgical masks are to be used. The OEM should enter the request into WebEOC and attach the request form.

The ordering form assists the local OEMS to input the requests and provides data needed for MEMA and MDH to respond to numerous federal requests for data and certifies that the requesting agency is conforming to CDC’s PPE conservation guidance.

Here is the detailed explanation of the ordering process, the order form and a contact list for local OEMS for your convenience. 

MDH acknowledges that the changing requesting processes present lots of challenges we must, in this instance, comply with the guidelines of the various federal agencies. MDH is trying to best comply with minimal impacts on providers and is trying to make each request serve as many purposes as possible.

The data that providers supply with request helps to inform the required PPE burn rate that must be submitted daily as well as assuring that MDH is doing their best to comply with conservation guidelines. Both are required for continued eligibility to receive federal assets.

As this crisis evolves, be prepared for the system to change again. 

Thank you for all that you are doing and for you continued flexibility to ever-changing federal guidance. 

IMPORTANT NOTE : Please do not use previously provided request form or contact sheet. If your request is not documented on the updated sheets and contact emails, it will NOT be processed.
MDH Waiver of PASRR Requirements and MDS Validation

Today, the Maryland Department of Health (MDH) shared this announcement from Secretary Neall that PASRR requirements have been waived for up to 30 days post-admission and that MDS Validation has been suspended in order to assist nursing facilities in meeting the many challenges that they are facing because of the COVID-19 pandemic.

MDH does not intend to enforce requirements related to the Preadmission Screening and Resident Review (PASRR). The Centers for Medicare and Medicaid Services have agreed to waive the requirement that PASRR Level I screens and Level II evaluations be completed prior to nursing facility (NF) admission. Effective immediately and until further notice, new admissions can be treated like exempted hospital discharges. Nursing facilities (NF) will be given up to 30 days following NF admission to complete the Level I screen.

In addition, MDH and its utilization control agent, Telligen, will defer conducting Minimum Data Set (MDS) Validation in nursing facilities. This deferment will be in effect until the Maryland Department of Health deems it safe for reviewers to visit nursing facilities again.
CARES Act Memo

Our partners at the American Health Care Association/National Center for Assisted Living recently shared a memo to answer questions regarding the Small Business Administration (SBA) section of the Cares Act as it relates to our sector.

As you know, on March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”), Pub. L. No. 116-136. Section 1102 of the CARES Act creates a “paycheck protection program” by which small business concerns and certain other employers can obtain loans through a new program administered by the Small Business Administration (“SBA”). The eligibility requirements for the new loan program are outlined in the memo.

The application of those eligibility requirements to skilled nursing facilities (“SNFs”) and assisted living facilities (“AL”) will necessitate an examination of each organization’s unique facts and circumstances, particularly as it relates to application of the SBA’s affiliation rules that are used to determine an organization’s size.
Medline Product

Medline recently shared that this microporous coverall is available on a first come, first serve basis. This product is recommended to be worn to protect against penetration by airborne solid particulates and infective agents, limited light sprays and aerosols, and liquids. Product features include: taped seams, attached hood, elastic wrists/ankles, zipper front with storm flap cover, and elasticated waist.

For additional information, questions, or product assistance, contact your Medline sales representative or call 1-800-Medline.
Special Thank You Audio Message

HFAM has recorded a  special thank you  to those of you working in Maryland skilled nursing and rehabilitation centers and on assisted living campuses. Please distribute broadly to your teams.

We are all navigating together in these uncharted waters of the COVID-19 pandemic.  Now more than ever, it is important that we recognize we are in this together, and that we are stronger together.
Temporary Nurse Aide Training & Competency Checklist 

As AHCA/NCAL shared in Update #26 recently, the Centers for Medicare and Medicaid Services (CMS) issued a blanket waiver that includes an allowance for nursing centers to temporarily employ individuals who have completed alternative training paths, as long as they are competent to provide relevant nursing and nursing related services. 

Along with AHCA/NCAL, we have have been advocating for CMS to issue such a waiver to assist in addressing staffing shortages due to the COVID-19 pandemic. This is now allowed on the federal level. State approvals, such as state occupational licensing and state regulatory requirements, may also need to be granted. 

AHCA/NCAL has a training program ready to use as state occupational and licensing agencies approve these waivers. This 8-hour online Temporary Nurse Aide training course is free to all participants.
AHCA/NCAL has also developed a skills competency checklist  for facilities to use on-site when they hire individuals to work as Temporary Nurse Aides. It is important to know the federal requirement at §483.35(c) is still in effect , which requires facilities to ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents’ needs, as identified through resident assessments, and described in the plan of care. 
COVID-19 Case Study (Not Maryland)

Please see this  Case Study that HFAM wrote after being contacted by a SNF provider in another part of the country.

Please review this case study and share with your teams -- it includes critical insight and real time experience.
Child Care for Essential Personnel

Maryland Family Network (MFN) is partnering with the Maryland State Department of Education (MSDE) to make it fast and easy for essential personnel to find safe quality child care during the State of Emergency.

Maryland’s child care providers are essential to stemming the spread of and finding a cure for the COVID-19 pandemic. Our region is teeming with the Nation’s top researchers, doctors, and policy makers. As the Coronavirus continues to spread and demands on these and other essential personnel grows, they need to know their children are safe in order to stay focused on keeping the rest of us safe and healthy.

Visit this  site  to learn more or call 877-261-0060 to locate child care.

While all child care is closed for the general public, child care is  not closed for essential personnel. In addition to new programs being developed by the State, MSDE recently launched a program to allow child care providers that would otherwise be closed to open to serve children of essential personnel exclusively. There will be additional child care providers approved under this new provision and available to provide child care.   LOCATE will have the listing of approved sites for these services for your stakeholder's staff to identify child care services.

Please urge your staff to visit: for more information on these child care options.

AHCA/NCAL has developed a web portal where people wanting to reach out to seniors and providers can record messages of support and even offer donations. This website encourages and facilitates social media messages of support for our nursing home and assisted living residents. Visit CareNotCOVID to learn more.

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.
Please email for additional questions, and visit for additional information and resources.
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.