November 23, 2020
The Centers for Disease Control and Prevention (CDC) released updates to testing and management considerations for nursing home residents with acute respiratory illness symptoms when COVID-19 and influenza viruses are co-circulating. The CDC says that the following practices should be considered when both COVID-19 and influenza viruses are found in the community, based upon local health surveillance data and testing at local healthcare facilities. The considerations are specific to nursing home resident care but could be adapted for use in other long-term care settings including assisted living facilities. 
The CDC released criteria on COVID-19 cases that should be assessed for suspected reinfection. The criteria outlines standards that laboratory testing should meet when evaluating specimens for reinfection. The CDC issued a protocol intended to provide state/local health departments with standardized framework and a toolkit for investigating COVID-19 reinfection suspected cases. Read more.
The Department of Health (DOH) has published an Options for Practicing as a Nurse document to provide insight on how nurses can practice in Washington during this time. The document outlines options and descriptions for each pathway to nurse practice in Washington. The options and descriptions include:
  • Practice as a volunteer healthcare provider
  • Temporary Practice Permits (RNs, LPNs, and ARNPs)
  • Washington State License by Interstate Endorsement
  • Washington State License by Examination
  • Emergency Interim Permit (for new graduates only)
  • Advanced Registered Nurse Practitioner (ARNP) License
  • Nursing Technician Registration

The document also shows approximate timelines for each option.
The Centers for Disease Control and Prevention (CDC) notified National Healthcare Safety Network (NHSN) long term care users via email that module updates go into effect Monday, November 23. These updates to the modules include the Resident Impact and Facility Capacity pathway and the Staff and Personnel Impact pathway. The CDC also identified that they will be having office hours to review the November changes to the LTCF COVID-19 module pathways.  

You must register in advance to participate in the following webinar​. Please note that this same webinar was offered today and will be offered again tomorrow.

Topic: Office Hours: Review November changes to LTCF COVID-19 Module Pathways: Resident Impact and Facility Capacity and Staff and Personnel Impact 
Date: Tuesday, Nov 24, 2020 
Time: 8:00 – 8:45 AM PST
Register in advance for this webinar here

After registering, you will receive a confirmation email containing information about joining the webinars.

There are MANY new updates to the LTCF COVID-19 Module webpage. Check the LTCF COVID-19 Module website for updates. The POC Test Reporting Tool slides and video are now available.
Registration for the Pharmacy Partnership for Long-Term Care program is still be available for facilities/agencies by registering through the Washington State Department of Health survey. The program was created by the Centers for Disease Control and Prevention (CDC) and is a partnership with CVS and Walgreens to offer on-site COVID-19 vaccines to residents of nursing homes, assisted living facilities, and other community-based, congregate living settings where most individuals over 65 years of age are receiving care, supervision, or assistance.

If facilities/agencies have not already registered, please ask them to register as soon as possible through this link.

A few questions that we’ve heard from facilities/agencies:
  • What is the cost for the program? The program is free to the facility and there will be no direct cost for the resident. 
  • What will the pharmacy do? The pharmacy will work as a support team to manage the vaccine handling and storage, administration, and documentation of the vaccine for residents at the facility/agency location. 
  • Will the vaccines be given at the facility? The pharmacy will coordinate directly with the facility for onsite vaccinations at the facility for residents who are interested.
  • What if the facility already has a partnership with a long term care facility? This is a short-term process to help vaccinate this high risk population.  The pharmacy will also return two more times to give the second dose of the vaccine, but the facility can return to prior long term care pharmacy partnerships after the initial vaccines are provided. 
  • Do all of the patients/residents have to be immunized? The vaccine will only be given to residents who choose to be immunized. 
  • Can caregivers/employees be vaccinated at the same time? The caregivers/employees may be able to be immunized in an earlier phase of the program, but if not already done they can be immunized along with residents.

If you have questions, you can reach out to Kathy Bay, RN, CENP, Office of Immunizations and Child Profile, Department of health via email or via telephone at (360) 236-3540.
AHCA/NCAL has received some questions from providers around billing for VA COVID-19 testing. According to the VA, their goal is to ensure that COVID-19 viral testing, as defined by the Centers for Disease Control and Prevention, is available to eligible veterans as widely as possible, whether through VA health care centers or through their community health care partners. VA will reimburse in-network Community Care Network (CCN) providers, if a referral or authorization exists, for COVID-19 viral testing of eligible veterans. 

The VA has informed AHCA/NCAL that they want providers processing the labs to bill the VA directly. While the VA is currently reimbursing testing providers who don’t have consults (pre-authorized tests), the Office of Community Care has indicated that they want testing providers (labs) to have consults issued by the VA if possible. In addition, the lab should have all the information they need to bill the CCN third party administrator. The lab would have gotten information from the third party administer when they signed the contract with the CCN, but can also find information on the Filing a Claim for Veteran Care webpage. If the lab is not part of the CCN, they can still find info on billing VA at this link. 

There are phone numbers for questions listed in the FAQ. More information in general on the Community Care guidance on COVID testing can be found on the VA website here.
The BD Biosciences Webinar Series is an ongoing, informative program in which senior scientists, professionals in the community, and clinicians present online seminars covering a broad range of topics. Click here to watch past webinars on demand. An upcoming webinar in the series may be helpful to long term care providers. Here are the details:

Clinical Performance 101
Monday, December 7, 2020 | 12:00 noon PST
WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.