COVID-19 UPDATE #124
January 8, 2021
CDC CHANGE ON HHS REQUIREMENT TO REPORT POC TESTING CAUSES CONFUSION
Providers are Still Required to Report Testing Data
The Centers for Disease Control and Prevention (CDC) recently made a change on their website regarding the HHS requirement to report point-of-care test results to NHSN. The change from the CDC has caused confusion. While it states that facilities “may” report to NHSN, rendering it optional, the CDC does not have any enforcement authority over nursing homes and as a result does not have the authority to make this change. The HHS memo they reference in their guidance still indicates that facilities “shall” report to NHSN as found in this excerpt:

4. CMS-certified long-term care facilities shall submit point-of-care SARS-CoV-2 testing data, including antigen testing data, to CDC’s National Healthcare Safety Network (NHSN). This requirement to submit data to CDC’s NHSN applies only to CMS-certified long term care facilities. Test data submitted to NHSN will be reported to appropriate state and local health departments using standard electronic laboratory messages. Other types of LTC facilities may voluntarily report testing data in NHSN for self-tracking or to fulfill state or local reporting requirements, if any.

The American Health Care Association (AHCA) followed up with the CDC, CMS, and HHS and received confirmation that on December 22, 2020, HHS rescinded its prior requirement that nursing homes report COVID-19 point-of-care test results to NHSN. This does not eliminate the requirement that any provider using point-of-care tests under a CLIA waiver must report their test results. It provides the flexibility to report those results through state and local public health departments **OR** through NHSN. This also does not eliminate the requirement to report positive cases of COVID-19 through NHSN. If you have questions about reporting testing data, please email Elena Madrid or call her at (800) 562-6170, extension 105.
DEAR ADMINISTRATOR LETTER ANNOUNCES FILING OF CR-103 TO EXTEND EMERGENCY RULE FOR SNFs
In a Dear Administrator letter dated January 8, 2021, skilled nursing providers are informed that Residential Care Services (RCS) has filed a CR-103E (WSR 21-02-074) to extend an emergency rule related to WAC 388-97-0300 and clinical records. The rule will now expire May 5, 2021. The amendment of WAC 388-97-0300 lengthens the time nursing homes have to provide the resident access to, or copies of, the requested clinical record from two to ten days. The amendment does not permit the nursing facility to deny the resident access to records. If you have questions, you may email Lisa Herke, Nursing Home Policy Program Manager, or call her at (509) 209-3088.
DOH PROVIDING RESPIRATORY PROTECTION PLANS AND N95 FIT TEST TRAINING WEBINARS
The Department of Health (DOH) and Department of Labor and Industries (L&I) will be providing two webinars about Respiratory Protection Plans and N95 fit testing for long term care providers in Washington State. These webinars will take place on January 13 and January 20 at 11 AM. The first hour covers development of a respiratory protection plan and regulations related to use of N95 respirators. For those facilities who have a qualitative fit testing kit, the second hour will be a follow-along demonstration of qualitative fit testing procedures. These webinars are optional and no educational credits will be provided. To register for webinars, please click your preferred date/time below. Please note that the content is the same for both dates, and you only need to register for ONE webinar.
HHS EXTENDS PUBLIC HEALTH EMERGENCY
The US Department of Health and Human Services (HHS) Secretary Alex Azar has extended the public health emergency (PHE) due to COVID-19 effective January 21. The PHE is issued in 90-day increments and is slated to expire April 2021. The PHE extension means:

Because of the CARES Act statutory link to the PHE, the Medicaid increased FMAP continues until the end of the quarter in which the PHE ends. Therefore, the increased FMAP will flow to the states until June 2021. More information is available here. 
NEW #GET VACCINATED VIDEOS NOW AVAILABLE
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) has created videos that can be used to address important questions about the COVID-19 vaccine. Dr. David Gifford, Chief Medical Officer for AHCA/NCAL is featured in the videos that address the following topics/questions:
RESIDENTS MUST HAVE ACCESS TO ECONOMIC IMPACT PAYMENTS
Millions of Americans are slated to receive a second Economic Impact Payment (EIP) as part of the recently passed and enacted Coronavirus bill. This follows the EIP that was distributed in 2020 as part of the response to the COVID-19 pandemic under the Coronavirus Aid, Relief, and Economic Security (CARES) Act. These payments aim to support Americans and provide some financial relief. 

It is important to note that CARES Act EIP requirements also apply to the EIPs in the most recent stimulus package, as well as any future payments. If you or someone you know serves as a representative payee for a Social Security or Supplemental Security Income (SSI) beneficiary, that designee is only responsible for managing Social Security or SSI benefits. The EIP is not an SSA benefit, and it belongs to the beneficiary. Representative payees should discuss the payment with the beneficiary, when possible. If the beneficiary requests access to the funds, representative payees are obligated to provide it.

Learn more about EIPs, including how they’re being delivered to people with representative payees, at the Consumer Financial Protection Bureau site. You can also learn more about these payments from the Internal Revenue Service (IRS). AHCA/NCAL also recorded a webinar in 2020 focused on EIPs from the IRS and important facts for skilled nursing facilities, ICFs/IID, and assisted living centers to know on the use of them. A variety of resources from the Social Security Administration to the National Center on Elder Law and Rights are available at the end of the webinar.
HHS ASPR LAUNCHES THERAPEUTICS DISTRIBUTION LOCATIONS INTERACTIVE MAP
The US Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) has announced the launch of the HHS Protect Public Data Hub displaying locations that have received shipments of the COVID-19 monoclonal antibody (mAb) therapeutics under the U.S. Food and Drug Administration Emergency Use Authorization (EUA) authority.  

The mAb therapeutic treatments have shipped nationwide. However, the shipment locations displayed on the therapeutics distribution locations interactive map include the states that have opted to have their locations displayed on the public website.  

Supply of mAbs is not an issue, but rather there is an underutilization of the therapeutics. HHS ASPR has created a frequently asked questions webpage to help long term care facilities navigate the process of getting the therapeutics into centers and to the vulnerable populations they serve. Through the Special Projects for Equitable and Efficient Distribution (SPEED) program, HHS ASPR is working with the American Society of Consultant Pharmacists (ASCP) and AMDA (the Society for Post-Acute and Long-Term Care Medicine) to streamline allocation of the mAbs to every long term care facility—including nursing homes and assisted living communities—that require treatment. ASCP and AMDA have produced a readiness document for pharmacies and LTCFs.  

In addition, home infusion can also be utilized to facilitate treatment. The National Home Infusion Association (NHIA) has provided a PDF listing of home infusion providers in the mAb pilot program. Facilities are encouraged to reach out to their current pharmacy to see if they are already participating in the federal allocation of mAbs. If they are not participating but are interested, they should submit their pharmacy name, address, contact person/information, and Amerisource Bergan customer identification number or pharmacy license number to Chad Worz. You can email the ASPR for more information on SPEED or to find out how to participate in the SPEED program. Information regarding Washington State long term care access to monoclonal antibodies can be found here. Facilities interested can email Jennifer Dixon at DOH.
CO-ADMINISTRATION OF THE COVID-19 VACCINE
The Centers for Disease Control and Prevention recently updated its guidance to clarify that long term care facility residents or health care personnel may get the COVID-19 vaccine administered within 14 days of another vaccination. For these individuals, the potential benefits of the vaccination are deemed to outweigh the potential unknown risks of co-administration with another vaccine (e.g. influenza, etc.).
ADDITIONAL RESOURCES
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.