STATE NEWS

Need Help with Staffing During a COVID-19 Outbreak? Nursing Homes and State Licensed-Only Adult Care Homes Are Eligible
KDHE has partnered with KFMC Health Improvement Partners to assist long-term care facilities and state licensed homes, impacted by COVID-19, with emergency temporary staffing services. KFMC has developed a Rapid Response Staffing Support Center (RRSSC) to manage the intake and fulfillment of the staffing support requests.

The Kansas Department of Health and Environment (KDHE) was awarded funds through the Epidemiology and Laboratory Capacity (ELC) Cooperative Agreement funds to assist with supporting long-term care facilities, and state licensed homes, during their response to SARS-CoV-2 infections, and to build and maintain the infection prevention infrastructure necessary to support resident, visitor, and facility healthcare personnel safety. These funds will be used to provide emergency, temporary staffing services to long-term care and state licensed nursing homes experiencing staffing shortages due to an active COVID-19 outbreak.

The RRSSC is only for staffing requests directly related to COVID-19 in which staff shortages are impacting resident care. Requests are submitted via a designated intake form, is limited to short term assistance, and is not intended to be a long-term staffing solution. You can request support here: RRSSC Request – KFMC. If you have any questions, please call Brenda Groves at 785-271-4150 or email at bgroves@kfmc.org.

FEDERAL NEWS

CMS Revises Guidance for Staff Vaccination Requirements
On Oct. 26, CMS released QSO 23-02-ALL, replacing QSO 22-07-ALL and QSO 22-11-ALL. The new version revises guidance for staff vaccination requirements and includes multiple attachments for each provider type. Nursing homes should continue to refer to Attachment A.

• Update to Enforcement Actions. The facility vaccination rate for compliance continues to be 100% of all staff who do not have a qualifying medical or religious exemption. Organizations that are under that percentage and considered non-compliant may not be subject to enforcement actions if there is a plan to achieve a 100% staff vaccination rate and that plan is implemented. 
• Discretion to Choose Additional Precautions Additional infection prevention and control precautions are required for staff with an approved medical or religious exemption. The memo clarifies that the organization can choose which additional precautions to implement. There are no choices listed in this QSO as in previous QSO memos. Nursing homes should ensure these additional precautions should be determined based on the organization’s assessment of the best interventions to mitigate the transmission and spread of COVID-19 for all staff who are not fully vaccinated.
• Surveyor Guidance Updated. Vaccine mandate surveys will occur during initial certification surveys, standard recertification surveys, and only for complaint surveys where the complaint explicitly alleges noncompliance with the vaccine mandate. Surveyors have the discretion to verify the accuracy of NHSN data on surveys based on a complaint alleging the organization is not following the vaccine mandate. Procedures for doing this are updated and available in the surveyor resources folder found on the CMS website. Surveyors are directed to also survey at F880 to check for adherence to appropriate infection control practices regardless of the organization’s compliance with the vaccine mandate.
• Citing Scope and Severity. If the organization is out of compliance with the vaccine mandate, the surveyors will cite the deficient practice at F888. CMS further dictates the scope and severity of the citation with a severity level of one and a scope of C. This survey citation will be based on the failure of the organization to implement the appropriate policies and procedures per the vaccine mandate. This scope and severity level would change to level two with a scope of F only if there were significant noncompliance where it appears the organization disregarded the mandate altogether.

Questions? Contact Rachel at rachel@leadingagekansas.org or Jodi at jeyigor@leadingage.org

LEADINGAGE KANSAS NEWS

Friday Webinar
Join us this Friday for an update on what is going on pertaining to COVID, updates on the association front, and much more.

If you haven’t registered already, you can do so here. You can also see archived webinars and get handouts here.

LEADINGAGE NATIONAL NEWS

LeadingAge Coronavirus Update Call on Wednesday November 2nd at 2:30 PM CT. What’s Your Pandemic Business Plan?
On Wednesday we will highlight a new Pandemic Toolbox from the Health Action Alliance and will hear from Dan Pasquini, who authored a Pandemic Business Plan for action. He will share the latest lessons learned and tools being used by major corporations as they respond to COVID-19.

 If you haven’t registered for LeadingAge Update Calls, you can do so here. You can also find previous call recordings here. Note that to access recordings of the calls you need a LeadingAge password. Any staff member of any LeadingAge member organization can set up a password to access previous calls and other “members only” content.

RESOURCES

Racial and Ethnic Disparities in Outpatient Treatment of COVID-19
CDC published an MMWR on racial and ethnic disparities in outpatient treatment of COVID-19 in the United States from January to July, 2022. Outpatient medications are effective at preventing severe COVID-19 and are important to pandemic mitigation. Paxlovid is the most commonly prescribed medication and the preferred outpatient therapeutic for eligible patients. Racial and ethnic disparities persisted in outpatient COVID-19 treatment through July 2022. During April–July 2022, the percentage of COVID-19 patients aged ≥20 years treated with Paxlovid was 36% and 30% lower among Black and Hispanic patients than among White and non-Hispanic patients, respectively. These disparities existed among all age groups and patients with immunocompromise. Expansion of programs to increase awareness of and access to available outpatient COVID-19 treatments can help protect persons at high risk for severe illness and facilitate equitable health outcomes.

Notes From the Field: Dispensing of Oral Antiviral Drugs for Treatment of COVID-19 by Zip Code–Level Social Vulnerability
CDC published an MMWRon dispensing of oral antiviral drugs for treatment of COVID-19 by zip code–level social vulnerability in the United States from December 23, 2021 to August 28, 2022. Equitable access to COVID-19 therapeutics is a critical aspect of the distribution program led by the U.S. Department of Health and Human Services (HHS). Two oral antiviral products, nirmatrelvir/ritonavir (Paxlovid) and molnupiravir (Lagevrio), received emergency use authorization (EUA) from the Food and Drug Administration (FDA) in December 2021, to reduce the risk for COVID-19–associated hospitalization and death for those patients with mild to moderate COVID-19 who are at higher risk for severe illness. HHS has been distributing these medications at no cost to recipients since their authorization. Data collected from provider sites during December 23, 2021 to May 21, 2022, indicated substantial disparities in the population-adjusted dispensing rates in high social vulnerability (high-vulnerability) zip codes compared with those in medium- and low-vulnerability zip codes. Specifically, dispensing rates for the 4-week period during April 24 to May 21, 2022, were 122 per 100,000 residents (19% of overall population-adjusted dispensing rates) in high-vulnerability zip codes compared with 247 (42%) in medium-vulnerability and 274 (39%) in low-vulnerability zip codes. This report provides an updated analysis of dispensing rates by zip code–level social vulnerability and highlights important intervention strategies.

COVID-19’s Lasting Impact on the Body
NIH released a news story on COVID-19’s lasting impact on the body. Researchers at the NIH Clinical Center, the National Institute of Dental and Craniofacial Research (NIDCR), and the National Institute of Allergy and Infectious Diseases (NIAID) performed autopsies on the bodies of patients with COVID-19. The researchers found that even in patients who had mild or asymptomatic cases of COVID-19, evidence of SARS-CoV-2 infection was present throughout the entire body and stayed there until the patients’ deaths, which in some cases occurred more than seven months after the start of symptoms. The researchers examined tissue from many different sites in the body from 44 patients who had died of COVID-19 or who had tested positive for the disease before they died. The autopsies were performed at the NIH Clinical Center between April 2020 and March 2021. Analysis of the patients’ samples revealed SARS-CoV-2 in almost every organ and organ system of their bodies, including their skin, eyes, stomachs, muscle, fat, glands, and six different parts of their brains. SARS-CoV-2 was present even in asymptomatic patients, patients who had had mild cases of COVID-19, and patients who had first been diagnosed with the disease months before their death. This suggests that even mild cases of COVID-19 spread quickly and the virus can remain in our tissue for a long time.

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