Greetings!
I'm resending this message because we forgot the link so you can use the chat feature on today's call--sorry for the mix-up!
Today we're hosting a member call
on COVID-19 at 3:30 pm. Call in numbers are included below. (This will be an audio only call, not a webinar.)
This message also includes updates on:
- Continuing education
- CDC guidance on when HCP can return to work
- CMS guidance for PACE organizations
- AHCA/NCAL guidance on therapy services
- Pharmacy and pharmacists procedures during the outbreak
Sincerely,
April Payne, LNHA
Vice President of Quality Improvement | Director of VCAL
Virginia Health Care Association | Virginia Center for Assisted Living
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VCHA-VCAL Member Call: COVID-19
March 20, 2020 | 3:30 pm
Join Zoom Meeting
Meeting Phone Number: 646-876-9923
Meeting ID: 798 944 431
One tap mobile
+16468769923,,798944431#
We will work to mute all the particpant lines except those for VHCA-VCAL staff to cut down on the background noise. Please remember to mute your line as an added step to improve the sound quality on the call. Zoom has a chat feature that I encourage you to use to send questions or comments if you've joined via your computer.
Agenda
- Welcome | Novel Martin | Chairman of the Board
- Update from VHCA-VCAL | Keith Hare | President and CEO
- Communications Update | Amy Hewett | Vice President of Strategy and Communications
- Hot Topic Review | April Payne | Vice President of Quality Improvement and Director of VCAL
- Q&A
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Virginia Board of Long-Term Care Administrators
Grants Extension
You are encouraged to complete continuing education hours online before the renewal deadline (per the Board’s regulations, up to 10 of the 20 hours may be obtained through internet or self-study courses.) Remember that you will have to make up incomplete hours and will not be able to double count CE hours for the next renewal period.
On the renewal form, you will need to check “no” to the question about completion of continuing competency requirements. Do not falsify information on the form by checking “yes” if you are using the six-month extension. You will still be able to renew and your license/registration will be valid. There will be a notation in the system that you have a six-month extension.
During the six month extension, programs delivered via teleconference or webcast where there is an opportunity to interact with the speaker in real time (“interactive course”) will count toward the 10 hours of continuing competency requirements that must be taken in addition to the 10 hours of internet or self-study hours. Evidence of attendance or participation as provided by the approved sponsor for each interactive course taken is still required to be maintained for a period of three renewal years.
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CDC Guidance on When HCP Can Return to Work
Many members are asking when a staff person who is staying home because of fever or respiratory symptoms can return to work. CDC posted
guidance
from March 16, 2020 on criteria for returning to work. Use one of the below strategies to determine when health care personnel (HCP) may return to work in health care settings:
- Non-test-based strategy. Exclude from work until:
- At least 3 days (72 hours) have passed since recovery, defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
- At least 7 days have passed since symptoms first appeared
- Test-based strategy, if tests are available. Exclude from work until:
- Resolution of fever without the use of fever-reducing medications and
- Improvement in respiratory symptoms (e.g., cough, shortness of breath), and
- Negative results of an FDA Emergency Use Authorized molecular assay for COVID-19 from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens)
If HCP were never tested for COVID-19 but have an alternate diagnosis (e.g., tested positive for influenza), criteria for return to work should be based on that diagnosis.
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CMS COVID-19 Guidance for PACE Organizations
On March 17, CMS released
guidance
for Programs of All-Inclusive Care for the Elderly (PACE) Organizations on how to respond to the COVID-19 pandemic, specifically related to infection control procedures and efforts to mitigate the spread of the virus, given that PACE organization participants are older adults who typically have serious chronic conditions and therefore are at higher risk.
CMS has directed PACE organizations to implement the following procedures:
- Establish, implement, and maintain a documented infection control plan that includes procedures to identify, investigate, control, and prevent infections in each PACE site, and in each participant’s place of residence.
- Frequently monitor for potential symptoms of respiratory infection and follow state and federal requirements.
- Contact their state or local health department if they suspect a PACE participant or personnel (employee or contracted) has COVID-19, AND, if experiencing an increased number of respiratory illnesses (regardless of suspected etiology) among participants and/or caregivers.
PACE organizations can use strategies such as telehealth for patient assessments, care planning, monitoring, release of pharmacy Part D “refill-too-soon” edits, home delivery, etc. to help mitigate the risk to beneficiaries from the virus. CMS will consider the implementation of non-programmatic efforts around COVID-19 on a case-by-case basis during oversight and audits activities.
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AHCA/NCAL Guidance on Therapy Services During COVID-19
This
document p
rovides guidance for therapists on how LTC Facilities (SNFs and ALs) can operationalize federal and state guidance to significantly restrict visitors and non-essential personnel, as well as restrict communal activities inside LTC facilities as part of the effort to prevent COVID-19 from spreading. When deciding if a therapist needs to enter a building (regardless of their being an employee or outside contractor), we advise LTCs to consider the intent of the federal and state guidance in deciding. The intent is to restrict entry of as many people as possible, as each additional person entering increases the risk of COVID-19 entering.
Of course, this also needs to be balanced with trying to meet the needs of the resident. That risk-benefit trade off needs to be made on a case-by-case basis but should incorporate the high morbidity and mortality associated with contracting this virus in the elderly over 80 (estimated at 15-20 percent or more).
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Pharmacy and Pharmacists Procedures
During COVID-19 Outbreak
Nursing facilities, assisted living communities, and pharmacies should work together to ensure appropriate access to the facilities and to medical records so that pharmacists and pharmacy personnel can continue to provide essential services to their residents while adhering to guidance on restricting entry to the building to only essential personnel.
There is currently no waiver in the requirements of participation for skilled nursing facilities in Medicare/Medicaid related to a pharmacist’s review. A pharmacist or pharmacy personnel must still be able to perform functions such as drug replenishment, controlled drug security/destruction, refilling electronic cabinets/eKits, and medication regimen review (MRR).
MRR reviews and some other pharmacy related duties can be performed remotely when possible, as long as the pharmacist has access to the full medical record. This may involve access to multiple electronic systems or a sequestered room within a facility (paper charts). Other emergency procedures include making deliveries dropped off at a dedicated location, such as a loading dock or secure area outside.
If a pharmacist or pharmacy staff need to enter the nursing facility or assisted living building to perform regulatory-required services, the pharmacy staff must follow appropriate screening and PPE procedures.
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