Greetings!

This message includes:
  • information on the revised criteria for infection control surveys and survey FAQs;
  • guidance on CLIA POC test reporting;
  • a memo from DSS on the plans for scheduling vaccination clinics at ALFs;
  • links to attend today’s CMS and CDC “fireside chat” on vaccination questions from frontline caregivers; and
  • new #GetVaccinated resources from AHCA/NCAL.

Sincerely,

April Payne, MBA, LNHA
Vice President of Quality Improvement | Director of VCAL
Virginia Health Care Association | Virginia Center for Assisted Living 
CMS Releases Revised Criteria for Conducting
Focused Infection Control Surveys and Survey FAQs

In QSO-20-31-All (Revised 01/04/2021), CMS has released updated guidance on the frequency of focused infection control (FIC) surveys as well as providing frequently asked questions (FAQs) regarding health, emergency preparedness (EP), and life safety code (LSC) surveys.
 
Updated FIC Guidance 

CMS will continue to require state agencies to conduct onsite FIC surveys within three to five days of identification of a facility with three or more new confirmed COVID-19 cases or one confirmed case in a facility that was previously COVID-free. However, CMS is updating this guidance to require states to also consider additional factors to determine whether to conduct a FIC, such as multiple weeks with new COVID cases, low staffing levels, and allegations or complaints related to concerns of abuse or quality of care such weight loss and decline in functioning. CMS adds that during FIC surveys, surveyors should investigate concerns related to residents that have had a significant decline in condition such as weight loss or mobility. Providers should continue to proactively monitor any of these quality of care concerns including quality measure indicators and document their efforts through their quality improvement processes. 
 
In addition, CMS is limiting the frequency of FIC surveys, stating that facilities that have had a FIC in the past three weeks—whether a standalone FIC survey or as part of a recertification survey—do not need to be re-surveyed if they meet the criteria to be surveyed again within a three-​week period. However, a facility could be re-surveyed in the fourth week or thereafter. 
 
Survey FAQs 
 
CMS also included several FAQs regarding health, EP, and LSC surveys. The FAQs provide guidance on several topics, such as: 
 
  • Protocols for surveyors to follow while onsite, including:  
  • Wearing appropriate PPE supplied by the state agency;  
  • Adhering to practices for COVID-19 infection prevention including screening;  
  • Not entering facilities when experiencing signs and symptoms of infection; and 
  • Assigning separate surveyors to COVID-19 residents or wings, residents under observation, and not moving between these areas of the building.  
  • Information on modifications to certain elements of the survey, such as the resident council interview and dining tasks, to prevent COVID spread. 
  • Adjustments to EP and LSC survey procedures during the PHE, such as the facility tour and records review, and not citing providers for ITM activities that have been waived during the PHE. (Note: Facilities with ITM deficiencies that cannot be corrected due to vendor access restrictions during the PHE should request temporary LSC waivers, as applicable, as part of their POC.) 
 
The FAQs also note that while facilities may offer to test surveyors for COVID-19 prior to entry, they cannot require testing or proof of testing as a condition for surveyors entering. Further, CMS states that while surveyors should attempt to safely complete the survey process, including resident interviews in person, they should use opportunities to conduct additional survey activities such as additional phone interviews, record or document reviews, and exit conference, offsite.  

The memo also includes a list of F-tags and K-tags waived or partially waived through 1135 waiver authority during the PHE.  
 
We encourage you to review these FAQs, which are attached to the CMS memo, in greater detail. If you have any questions, please email [email protected]
CLIA POC Test Reporting Requirement

As a reminder, from the June 4, 2020 HHS memo on laboratory testing (see page 2), CMS is requiring the reporting of point-of-care (POC) antigen test results. At this time, CMS is not requiring any particular way of reporting CLIA POC test results but is rather requiring some form of reporting.
 
VDH has advised facilities to report these POC results via the COVID 19 POC Portal to meet the current CLIA POC requirements. Please contact April with any questions.
 
According to a January 4 DSS memo on COVID-19 Vaccination Updates and Frequently Asked Questions, ALFs can be scheduled for their vaccination clinics beginning Monday, January 11, 2021. CVS and Walgreens will be in touch with facilities for scheduling a clinic. The memo asks providers to be patient and wait for the pharmacies to contact them.
 
DSS also provided links to the latest information and tools to assist ALF residents and staff: 
COVID-19 Vaccine Safety
A Fireside Chat with CMS, CDC, and Front Line Staff

Join CMS and CDC on Wednesday, January 6 at 4:00 pm for a fireside chat on vaccine safety.
 
This is the second discussion in a special series, a part of the CMS National Nursing Home Stakeholder Call Series, aimed at addressing staff questions and concerns about the new COVID-19 vaccine. Each session will be moderated by CMS with speakers from CDC and representatives of front line staff and providers. 
 
This chat will continue to address myths surrounding vaccine danger with the following panelists:  
  • Dr. Lee Fleisher, CMS Chief Medical Officer and Director, Center for Clinical Standards and Quality (CMS)  
  • Dr. Amanda Cohn, Chief Medical Officer (Acting), Office of Vaccine Policy, Preparedness, and Global Health, Office of the Director (CDC)  
  • Cassandra Lowe, Certified Nursing Assistant (CNA) 
 
Questions for the panel discussion should be sent in advance to [email protected]. There will not be a Q&A session during the call. The CDC's long term care toolkit is also available here
New #GetVaccinated Videos Now Available

Dr. David Gifford, AHCA/NCAL Chief Medical Officer, addresses important questions about the COVID-19 vaccine in a series of new videos as part of the AHCA/NCAL #GetVaccinated campaign. Questions include:
 
 
Additional vaccine and video resources will be added soon, so continue to check the AHCA/NCAL #GetVaccinated page. 
Quick Links
www.vhca.org | (804) 353-9101 | Calendar of Events