COVID-19 Update #297
Photos from FutureCare Northpoint Vaccination Event on May 4, 2021.Courtesy of Governor Hogan's Office.
HFAM Update
Yesterday Maryland Governor Larry Hogan mandated vaccination for employees in hospitals and skilled nursing and rehabilitation centers and included in the mandate a serial testing alternative to vaccination in alignment with federal guidelines.
Later yesterday, the Biden Administration accelerated discussions and a decision timeline for mandating the COVID-19 vaccine just in nursing homes and has been messaging the potential for the federal government to withhold Medicare and Medicaid funding relative to employees in our sector remaining unvaccinated.
  • Hospitals and nursing homes staff are required to show proof of first/single dose COVID-19 vaccination by Wednesday, Sept. 1. (page 4)
  • Each facility shall develop own procedures to handle compliance with a minimum of once a week testing and PPE.
  • Each facility shall develop a process for reasonable accommodation of medical/religious reasons.
  • Added penalties section.

  • Nursing homes are encouraged to request that visitors show vaccination and adopt visitation policies allowing fully vaccinated visitors. 
  • Added penalties section.
Here are some already asked questions and answers from MDH:
  • Q: Can weekly testing of unvaccinated staff be POC or PCR?
  • A: Testing can be either POC or PCR. If POC is positive, or POC is negative with symptoms, PCR should be conducted.

  • Q: Does weekly testing start immediately for unvaccinated staff? Or after Sept. 1?
  • A: Sept. 1 for weekly testing requirement.

  • Q: Does weekly testing of unvaccinated staff who get one dose before September 1 continue until they are fully vaccinated (2 weeks after last dose)?
  • A: Weekly testing continues after Sept. 1 until the staff shows proof of full vaccination.

  • Q: What does “enhanced PPE” mean?
  • A: We don't know what you are referencing by "enhanced PPE," but the order specifies "required to wear appropriate personal protective equipment, as determined by each facility's management, in consultation with the relevant federal and state guidance, while on the facility's premises.”
NOTE: I want to personally thank my friend and colleague Allison Ciborowski from LeadingAge Maryland for presenting and collaborating with our state colleagues in posing these questions. Thank you, friend.
Here is some of what I said with Governor Hogan yesterday:
“Governor Hogan, your announcement and orders today will save lives in the coming weeks and months.
Since you and I first met on COVID-19 in March of 2020, your pattern of leadership and orders has been consistent. First, you publicly consider, then you recommend, and finally, you order. You have been recommending for weeks and sharing your frustration on the low vaccination rates among some healthcare workers in nursing homes and hospitals. Today, you are doing the right thing by moving from recommendation and frustration to mandate and requirement.
I am proud of our work together and of our sector on vaccination. On average, 88 percent of nursing home residents and patients in Maryland are vaccinated, and 79 percent of the staff are vaccinated. In addition, several hospitals and nursing homes have already mandated staff vaccination.
But still, there are far too many outlier centers at closer to 40 percent staff vaccination. While all employers have strongly encouraged and provided opportunities for vaccination, there are skilled nursing centers where employees have been extremely resistant to get the vaccine.
So, with these mandates, together, we will do better. And we will work to save the lives of Marylanders.”
More On the Biden Administration Intent to Mandate Vaccine
Click here for a message from President and CEO of ACHA/NCAL Mark Parkinson on this subject.  Interestingly, some organized labor organizations and advocates oppose vaccine mandates.
On a related note: AHCA/NCAL nationally and HFAM here in Maryland have stressed to government leaders the critical workforce challenges and shortages we face. In Maryland, here is what we wrote MDH leaders: “To account for possible staff turnover, the State should also consider providing temporary relief of minimum staffing requirements and or ratios during the immediate period around the vaccination deadline.” All healthcare associations in Maryland are united in this push. We have not as of yet achieved traction on this critical issue with either national or state leaders. We will keep pushing.
The Current COVID-19 Delta and Breakthrough Surge in Maryland is Just Beginning:
  • CLICK HERE for the HFAM fact sheet.
  • In early July, COVID-19 outbreaks, mostly staff, were in the single digits—in just a handful of hundreds of skilled nursing and rehabilitation centers and assisted living campuses.
  • On August 4 there were 33 skilled nursing and rehabilitation center and 10 assisted living campus outbreaks.
  • On August 16 there were 58 skilled nursing and rehabilitation center and 26 assisted living campus outbreaks.
  • Today, there are 80 skilled nursing and rehabilitation center and 39 assisted living campus outbreaks.
We are entering a severe surge of and a
several-week fight against the COVID-19 virus.
IMPORTANT, Monoclonal Antibody new EUA:
  • Regeneron can be used for post-exposure prophylaxis for unvaccinated persons at high risk and for those who have been vaccinated but not expected to have mounted an adequate immune response, even with the vaccine.
  • Regeneron may be administered subcutaneously when IV infusion is not available in a timely manner.
  • Regeneron can be ordered directly through the supplier - AmerisourceBergen
  • Here is a link to administration information
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.
Be well,

Joe DeMattos
President and 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. 
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.

Safety is our top priority. Please note that proof of vaccination will be required for attendance.

Visit the conference website to learn more and register.
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from our federal and state partners.
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