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Note about COVID- related Waivers 

1135 Federal Blanket Waivers (Nursing Homes):  The updated the LeadingAge blanket waivers chart is here  to help members stay up to date with what waivers are in play.  At this time, the Qualifying Hospital Stay (3-day stay) waiver remains in effect until the end of the national public health emergency.

Expiring 1135 Waiver Reminder - On April 7, 2022. CMS released QSO-22-15-NH & NLTC & LSC  to announce that most 1135 waivers related to nursing homes will be ending ahead of the end of the national PHE.  Key Points:

• Some waivers terminated on May 7, 2022. See FSSA announcement and other related documents here - IHCP Bulletin on COVID-19 Waiver expirations; Assisted Living / mLTSS Bulletins - BT202220 (Business Acumen Training); and BT202234 (AL waiver/HCBS trainings)

• Additional waivers ended on June 6, 2022. This included the nurse aide training waiver.  
• The 3-day stay waiver does not have a termination date attached to it at this time.
• Read here (initial rundown) and here (June 6 rundown) for additional information about what this means for our nursing home providers; and check out the updated Nursing Home Blanket Waivers Chart here to see what has changed and what stays the same.
• This fact sheet also outlines those waivers to help your organization understand what was terminated and in which date range – 30 or 60 days.

New FSSA Waiver Announcements:

• IHCP Bulletin on COVID-19 Waiver expirations.
• Assisted Living / mLTSS Bulletins - BT202220 (Business Acumen Training); and BT202234 (AL waiver/HCBS training).

IDOH Newsletter - 2022-14 – 03/17/2020

• Emergency Order for COVID-19 Waivers – Reissued and expired July 1, 2022
• As a reminder, here is a list of state waivers that will/might be impacted on July 1; federal waivers are included for reference as well.  
• The IDOH list of Waivers can be viewed here - https://www.coronavirus.in.gov/covid-19-actions-regulatory-waivers/ .

Links to COVID Information

 

LeadingAge Indiana COVID Updates	IDOH Infection Control Updates
Vaccination Information	IDOH Nursing Home Newsletters
Visitation Guidance	Governor Executive Orders
LeadingAge National Updates	IDOH Reporting Guidance
IDOH News & Updates	IDOH Treatment of Testing

   

Quick Links

 

COVID-19 Resources

CMS.GOV	IDOH
Division of Aging	CDC.GOV
Indiana Medicaid News, Bulletins, and Banner	IDOH Nursing Home Waivers

 

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COVID-19 E-News Updates from LeadingAge Indiana

 

January & February 2023 Updates

November & December 2022 Updates

September 2022 & October Updates

July 2022 & August 2022 Updates

May 2022 & June 2022 Updates

March 2022 & April 2022 Updates

January 2022 & February 2022 Updates

November 2021 & December 2021 Updates

September 2021 & October 2021 Updates

August 2021 Updates

July 2021 Updates

June 2021 Updates

May 2021 Updates

April 2021 Updates

March 2021 Updates

February 2021 Updates

January 2021 Updates

2020 Archives

 

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Vaccination Information

• See Vaccine Dropdown under "Industry News" for most recent information. 

IDOH Updated Survey Rules - On April 14, 2022 - IDOH released a new Newsletter ( 2022-18 – 04/14/2022) which detailed - Updated Survey Documents for Healthcare Staff Vaccination Requirements Centers for Medicare and Medicaid Services (CMS) revised QSO-22-09-ALL and Attachment A, regarding the healthcare staff vaccination requirements, on April 5, 2022. The survey resources file has been updated to include the Long Term Care Survey Process Procedure Guide, Staff Matrix for F888 and the Infection Prevention, Control & Immunizations Pathway.

Updates to CMS Vaccine Mandate Survey documents for nursing homes.  The updates are effective as of January 27, 2022. There are new items on the entrance conference worksheet that need to be produced within 4 hours of entrance including a vaccine matrix that may be used for the mandatory task of infection control. CMS has outlined the surveyor steps they will follow during a nursing home annual or focused infection control survey. The following links will open to the main CMS page where the zip files can be accessed; look for the date of January 2022 for the updates; 

• LTC Survey Process Revisions
• Entrance Conference Worksheet and Staff Matrix Survey Resources January 2022 (1/25/22) (ZIP)

CMS Issues Memo Outlining SURVEYOR Vaccination Expectations. CMS issued a memo today outlining its expectations regarding vaccination of surveyors. Read it here. Providers may not request proof of vaccination or exemption as a condition of entry.

Click on Vaccine Information link above and see the CDC section below.

Guidance on HIPAA and COVID-19 vaccination status disclosure. HHS has released guidance to clarify when and why requesting disclosure of COVID-19 vaccination status is NOT a HIPAA violation. Check out this guidance  here. We note that this guidance applies only to the HIPAA Privacy Rule.

See CDC resources noted below and the the CDC page for additional information. 

OSHA

March 2022 - OSHA Announces Focused Inspections of Nursing Homes and Hospitals: OSHA has announced that they will initiate focused inspections and investigations of nursing homes and hospitals that treat COVID-19 patients. Inspections opened under this initiative shall comprise 15% of all inspections per Region for the designated three-month period. An OSHA memorandum outlines instructions and guidance for the short-term inspection initiative. This initiative supplements OSHA’s targeted enforcement under the COVID-19 National Emphasis Program (NEP) by focusing on follow-up and monitoring inspections of hospitals and skilled nursing care facilities that OSHA had previously inspected or investigated.  OSHA noted in the announcement that although OSHA withdrew the non-recordkeeping portions of the Healthcare Emergency Temporary Standard (ETS) on December 27, 2021, the agency will accept continued compliance with the Healthcare ETS as satisfying an employers’ related obligations under the General Duty Clause, Personal Protective Equipment, and Respiratory Protection standards.

OHSA recently published guidance requiring fit-testing of N-95 masks (and other types of respirators) in certain health care scenarios (Red and Yellow zones).  Enforcement fines may be levied for non-compliance.   

• This Guidance can be found here ; here and here  (memo indicates approval of enforcement discretion where facility can show that a fit test was preformed upon issuance of the N-95 mask, and when a facility can further show an on-going good faith effort to comply with the OSHA standards).  
• General ISDH guidance on this issue can be found here.
• Strict compliance will be difficult as most facilities cannot presently access properly sized N-95 masks. The key is to have a plan for compliance - and to document that plan and your efforts toward achieving the goals contained in it (i.e. - good faith effort at compliance).  LeadingAge Indiana has developed such a template for members to use.  It is here - Please download it below and modify as you see fit.
• Respiratory Protection Program Plan (member template) DOWNLOAD HERE

Additional OSHA Resources and Hotlinks within the plan can be found here.

CDC

LeadingAge National collects the latest resources, analysis, and information you need on COVID-19 vaccines. Visit the  LeadingAge Vaccine Resources Page.  Also see:

• QSO-22-07-ALL ,
• QSO-22-09-ALL , and 
• QSO-22-11-ALL

New IDOH Newsletter contains new CDC Vaccine rules - 2022-22 – 05/26/2022

• COVID-19 Second Booster Guidance and “Up to Date” Status – Update

CDC Definition of “Up to Date”: With the rise of the omicron variant, CDC began talking about vaccination status in a new way, using the phrases “up to date” and “not up to date”:

• An individual who has completed a primary series and received a booster is up to date.
• An individual who has completed a primary series and is not yet eligible for a booster is up to date.
• An individual who has completed a primary series and is eligible for a booster but has not received the booster is not up to date.

CDC has overhauled guidance for all healthcare: CDC has streamlined guidance for healthcare settings into 3 main source documents.

• Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the COVID-19 Pandemic is the main source document for healthcare providers and settings. CDC advises us that this guidance should be used in settings where healthcare is provided, including places like an assisted living where healthcare is provided by home health.
• Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Transmission in Nursing Homes will continue to be the main source document for nursing homes and long-term care settings. Updates to this guidance include changes to recommendations around testing in nursing homes. CMS has issued a revised memo QSO-20-38-NH-REVISED to adopt these recommendations for testing.
• Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection and Exposure to SARS-CoV-2 is the source document for determining when staff should be restricted from work and when staff can return to work. This document will also help nursing homes determine which staff should be tested during outbreak testing

See also - recent CMS QSOs: 

• New CMS QSO-20-38-NH (Revised)  - Surveying updates
• New CMS QSO-20-39-NH (Revised)  - Nursing Home Visitation updates

Eligibility for a COVID-19 Booster Shot: CDC  updated the “Who is Eligible for a COVID-19 Vaccine Booster Shot?” page. This additional dose of an mRNA-COVID-19 vaccine is intended to improve  immunocompromised people’s  response to their initial vaccine series.

Frequently Asked Questions About COVID-19 Vaccination: CDC updated their frequently asked questions page about COVID-19 vaccinations.

COVID-19 Vaccine Social Media Toolkit: CDC updated the COVID-19 vaccine social media messaging toolkit. The page includes sample Facebook messages, Facebook digital resources, sample Instagram messages, Instagram digital resources, sample Twitter messages, and Twitter digital resources for the following topics: about the COVID-19 vaccines, vaccine benefits, vaccine FAQs, vaccine safety, what to expect after vaccination, and vaccine effectiveness.

  

CDC - Group Homes for Individuals with Disabilities: CDC updated their guidance for group homes for individuals with disabilities.

 

CDC - Vaccinating Older Adults and People with Disabilities: CDC updated their guidance on vaccinating older adults and people with disabilities. Many older adults and people with disabilities may have substantial challenges accessing COVID-19 vaccination services and warrant specific considerations to support equitable vaccine access. CDC also updated their resources, tools, and guidance for people with disabilities .

 

CDC - Caregivers of People Living with Dementia: CDC updated their guidance for caregivers of people living with dementia.

 

CDC - What people can do “When You’ve Been Fully Vaccinated.”   Healthcare (and other) organizations are expressly NOT included in this guidance.  

CDC - Key things to know — The web pages Key Things to Know about COVID-19 Vaccines and  About COVID-19 Vaccines have been updated to include the recommendation that adolescents aged 12 and older get vaccinated. 

 

CDC - Myth-buster about infertility — It is safe for people who would like to have a baby one day to get a COVID-19 vaccine. This question and answer explains why. 

 

CDC - Myth-buster about menstrual cycles — Your menstrual cycle cannot be affected by being near someone who received a COVID-19 vaccine. This question and answer explains why.

 

Summary of recent CDC Vaccine-related and other Guidance is found here. and  here. and here.

 

Building Confidence in COVID-19 Vaccines

CDC updated general information related to the COVID-19 vaccine.

Benefits of Getting a COVID-19 Vaccine CDC released a summary of the benefits of COVID-19 vaccination based on what we currently know. CDC will continue to update this page as more data become available.

B usting Myths and Misconceptions about COVID-19 Vaccination: CDC released information to bust myths and misconceptions about COVID-29 vaccination.

Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States

 

LeadingAge National Updates & Resources

LeadingAge is gathering the most relevant and essential tools for you as you prepare your organization for the possibility of an outbreak. We are working with our state partners to monitor the situation closely, and, in collaboration with peer organizations and federal agencies, we will ensure that the health of the older adult population is a top priority during this time.

 

Visit this page frequently for added resources, links, and updates.

Reference the LeadingAge Pandemic Playbook

Go to LeadingAge.org for all of the latest

LeadingAge has altered its frequency of briefing calls.  They continue to be typically held Monday and Wednesday at 3:30 p.m. EST – check the registration  link below for dates. On these calls, you will hear from LeadingAge policy experts about the most up-to-date information on guidance, regulation, and legislation related to the pandemic and its impact on aging services providers. They'll also answer member questions. Recordings are posted on the LeadingAge website, so you can listen even if you can’t dial in. Members will have to register the new 3:30 calls. You only have to register one time and will then be registered for a 3:30 call -  Register Here