Greetings!

Earlier today a group of VHCA-VCAL leaders and staff held a conference call with Gov. Ralph Northam and Secretary of Health and Human Resources Daniel Carey. Members relayed information to them about your immediate needs for Medicaid funding for staffing, supplies, and non-labor costs associated with COVID-19. While the administration is not ready to commit to a funding approach until they understand the ramifications of COVID-19 to the overall state budget, they understood and appreciated the information we provided regarding the experiences on the ground and the costs already being incurred.
 
In addition to meeting with us, Gov. Northam recorded a message at our request for residents and staff. We hope his video gives everyone a boost.
 
This message also contains information on:
  • AHCA/NCAL’s revised screening checklist for visitors and staff;
  • CMS’s blanket regulatory waivers and a link to access the AHCA/NCAL summaries; and
  • details about the Temporary Nurse Aide Training and Competency Checklist AHCA/NCAL created.
 
We will continue to keep you updated.

Sincerely,

April Payne, LNHA
Vice President of Quality Improvement | Director of VCAL
Virginia Health Care Association | Virginia Center for Assisted Living 
Governor’s Message to Residents and Staff

We are excited to share a video Gov. Ralph Northam recorded for nursing facilities and assisted living facilities. We encourage you to show it to your residents and staff and share it on your social media channels. 
The video is accessible on YouTube: https://youtu.be/krYYV1NeCbU.
Revised Screening Checklist

AHCA/NCAL has updated the screening checklist for visitors and staff based on the latest guidance from CMS and CDC. Revisions include changes to Section 3B to reflect when a staff person has worked in facilities or locations with recognized COVID-19 cases, and the staff person has worked with a person with confirmed COVID-19. They should be required to wear PPE including masks, gloves, gown before any contact with residents.
 
Section 4 was also expanded to include CDC guidance for health care provider use of PPE when there are cases of COVID-19 present or not in the facility, as well is in the community. Please replace the prior version of this checklist with this revised version.
CMS Issues Blanket Regulatory Waivers

CMS issued COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers yesterday. Pages 9-12 cover the waivers for long term care providers. The blanket waivers are in effect with a retroactive effective date of March 1, 2020 through the end of the emergency declaration.
 
AHCA/NCAL’s Update #26: CMS Issues Blanket Regulatory Waivers contains detailed summaries of the waivers. The waivers cover the following:
 
Nurse Aide Training Requirements and Creating COVID-19 Segregated Buildings
  • Training and Certification of Nurse Aides
  • Resident Groups
  • Resident Roommates and Grouping
  • Physical Environment
  • Resident Transfer and Discharge
 
Reimbursement-Related Waivers
  • Section 1812(f)—3-Day and Spell of Illness Waivers
  • Formerly State-by-State Section 1135 PASRR Waiver
  • Medicare Provider Enrollment
  • Cost Reporting
  • Medicare Appeals in Fee for Service and Medicare Advantage
  • Expanding Availability of End Stage Renal Disease to Nursing Home Residents
  • CMS Facility without Walls (Temporary Expansion Sites) Transfers of COVID-19 Patients
 
Requirements of Participation Waivers
  • Minimum Data Set
  • Staffing Data Submission
  • Physician Visits
Temporary Nurse Aide Training and Competency Checklist

AHCA/NCAL had been advocating for CMS to issue a waiver to allow 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.
 
Under the blanket waiver mentioned above, 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 .
 
An AHCA/NCAL training program is ready to use when the state occupational licensing and state regulatory agency approves such waivers. AHCA/NCAL is offering an eight hour online Temporary Nurse Aide training course free to all participants.
 
AHCA/NCAL 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.
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