COVID-19 UPDATE #93
October 23, 2020
UPDATED HHS NHSN REPORTING REQUIREMENTS FOR SKILLED NURSING FACILITIES
In an updated memo from the Department of Health and Human Services (HHS), the point of care testing results are now required as part of the National Healthcare Safety Network (NHSN) system. The HHS memo identifies that, “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).” To report the point of care test results to NHSN, facilities will need to upgrade from SAMS Level-1 access to SAMS Level-3 access. While this new requirement goes into effect immediately, we have been told that enforcement discretion will be utilized until November 20 to allow time for centers to make the upgrade from Level-1 to Level-3.

Centers must immediately take action to upgrade from Level-1 to Level-3 to avoid enforcement penalties and to meet this new requirement. This process can take up to four weeks, so do not delay. To facilitate upgrade to SAMS Level-3, you must:
  • Have two forms of identification ready to submit.
  • Login to SAMS and use the Update Profile menu option on the left side of the page. Confirm that your home mailing address is correct and current within your SAMS profile.
  • Ensure that your name and address match how they appear on your submitted identification (such as your state-issued driver’s license).
  • Once you submit your identification, SAMS must confirm your identity. Once confirmed, SAMS will send you a “Welcome to SAMS” email as well as a SAMS Grid Card mailed to your residential/home address via USPS. The SAMS Grid Card permits Level-3 access to NHSN.
  • After receiving your SAMS Grid Card, you must login to SAMS. Underneath the National Healthcare Safety Network System header, select the “NHSN Reporting” link. Note: do NOT access NHSN LTC Reporting as this option will direct you back to Level-1 security.

Alternatively, facilities can email nhsn@cdc.gov with the subject line, “Enhancing Data Security” to begin upgrading their SAMS access to use this pathway.
UPDATED REPORTING REQUIREMENTS TO THE PROVIDER RELIEF FUND
On Thursday, the Department of Health and Human Services (HHS) announced changes to the reporting requirements and expanded the types of providers who could apply for Provider Relief Funds.

Key Takeaways:
  • HHS is returning to its previous definition of lost revenue, a decrease from 2019 revenue, rather than using the September 19 version which would have capped funds to a facility’s 2019 net revenue.
  • HHS has created new flexibility around reporting at the parent and subsidiary level.
  • HHS is now allowing private pay assisted living facilities to apply for Phase 3 awards.

From the HHS press release:

In response to concerns raised, HHS is amending the reporting instructions to increase flexibility around how providers can apply PRF money toward lost revenues attributable to coronavirus. After reimbursing healthcare related expenses attributable to coronavirus that were unreimbursed by other sources, providers may use remaining PRF funds to cover any lost revenue, measured as a negative change in year-over-year actual revenue from patient care related sources.

All Phase 3 applicants will have until 11:59PM EST on November 6, 2020, to submit their applications for payment consideration.

Learn more:
WEIGHING PHARMACY OPTIONS FOR THE CDC VACCINE DISTRIBUTION PROGRAM FOR ASSISTED LIVING AND SKILLED NURSING FACILITIES
There is risk associated with which pharmacy option you select for the Pharmacy Partnership for Long Term Care Program. Long term care facilities need to identify by October 30 how they want to receive and administer the COVID-19 vaccine when it becomes available. 

Providers have four options to select from: 
1) Work with CVS; 
2) Work with Walgreens;
3) Work with their existing pharmacy partner; or 
4) Work with an alternative partner (e.g. hospital, local/state health department). 

If selecting options three or four, AHCA/NCAL strongly recommends providers first ask to see a signed copy of that entity's provider agreement with their state and CDC, otherwise they run the risk of not being included in early rounds of vaccine delivery and distribution. This could result in delays in your facility obtaining the vaccine. More information can be found on AHCA/NCAL’s program overview and FAQs. As a reminder, skilled nursing facilities sign up through NHSN and assisted living facilities sign up through REDCap.
DEAR ADMINISTRATOR LETTERS PROVIDE ADDITIONAL INFORMATION ON PHARMACY PARTNERSHIP FOR COVID-19 VACCINATION TO ALL PROVIDER TYPES
In a Dear Administrator letter dated October 23, 2020, skilled nursing providers are given information on the Pharmacy Partnership for Long Term Care Program for COVID-19 Vaccination. In another Dear Administrator letter dated October 23, 2020, to assisted living communities, adult family homes, and other home and community-based settings, the Pharmacy Partnership for Long Term Care Program for COVID-19 Vaccination is also addressed.

The letters both state the program is free to facilities and review how the program will work. Another important message in the letter is, “Please note: Signing up does not mean you will receive vaccine. CMS and the Centers for Disease Control and Prevention (CDC) are awaiting Advisory Committee on Immunization Practices (ACIP, a committee within CDC) recommendations regarding which settings will be the populations of focus for the vaccine. Sign up does ensure you have a plan in place to be contracted by CVS or Walgreens when the vaccine is available.” The letter to skilled nursing providers has the sign-up information for nursing homes, and the letter to all other provider types has the sign-up information for them. 
DEAR ADMINISTRATOR LETTER TO SNFs PROVIDES CLARIFICATION ABOUT FACILITY TESTING OF PASRR EVALUATORS AND OTHER ESSENTIAL PERSONNEL
In a Dear Administrator letter dated October 23, 2020, skilled nursing providers are provided clarification about facility testing of PASRR evaluators and other essential personnel. The letter explains that CMS suspended or amended rules under authorization of the 1135 waivers, and one of the rules amended was regarding Preadmission Screening and Resident Review (PASRR). The letter points out the PASRR screenings are deferred, not waived. Because the screenings are required under the regulation, the PASRR evaluators who complete the Level 2 screenings are considered essential personnel and must be permitted access to the resident in order to complete evaluations.

Clarification about testing of essential personnel is provided in the letter as well. If you have questions about testing PASRR evaluators and other essential personnel, please email Lisa Herke, Nursing Home Policy Program Manager, or call her at (509) 209-3088.
BD VERITOR SYSTEM | NEW TRAINING RESOURCES
BD has released new training resources on batch testing and reporting with the BD Veritor System. Members who are using the BD Veritor System for Point of Care (POC) COVID-19 testing are strongly encouraged to check out these new resources. 
  • Reporting: New reporting updates cover the different options for connectivity on Veritor on the reporting website​.
  • Batch testing: New video tutorial on how to batch test is available on the training website
NWHRN HEALTHCARE CAPABILITY SURVEY FOR ASSISTED LIVING AND SKILLED NURSING FACILITIES | APPLIES TO CERTAIN COUNTIES ONLY
For several months, Northwest Healthcare Response Network (NWHRN) has been tasked by the Governor’s Office with gathering data to help assess the state of healthcare regarding space, staff and supplies for the Western Washington Coalition Service Area. The NWHRN service area includes Clallam, Grays Harbor, Island, Jefferson, King, Kitsap, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Snohomish, Thurston, and Whatcom counties. This survey is designed for facilities in these counties only; facilities outside these counties should not complete the survey.

This weekly survey helps NWHRN gain perspective on the current state of healthcare, gives awareness to areas of concern and creates a clearer picture of response needs. This information directly supports state agencies and local response partners in decision making for healthcare response needs. They recently updated the survey to better capture some of the unique challenges that long term care faces and hope you can provide clarity by completing this survey. 

While not mandatory, the NWHRN appreciates your time and understands this is not the only ask of you, but it is critical, as it directly supports response work and your local emergency management partners' awareness to the LTC-specific concerns. Please see an email provided by NWHRN with further information about how to complete this survey.

Each week a new email will be sent to those facilities on the NWHRN emailing list with an updated link to complete the survey. They utilize the survey to generate a report that is also shared weekly alongside the agency snapshot with information from around the region. If you have any further questions or need more information, please reach out to Planning Section Chief – HECC via email.
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.