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CMS Issues New Vaccine Requirements for Nursing Homes <p>The Centers for Medicare and Medicaid Services (CMS) on May 11 issued an <a href="https&#58;//;cm_cat=Interim+Final+Rule+on+COVID-19+Vaccine+Requirements+for+LTCF+and+ICFs-IID&amp;cm_pla=All+Subscribers&amp;cm_ite=Interim+Final+Rule+on+COVID-19+Vaccine+Requirements.&amp;;cm_ainfo=&amp;&amp;&amp;&amp;&amp;">Interim Final Rule on COVID-19 Vaccine Requirements. </a>The rule applies to residents, clients, and staff of Long Term Care (LTC) facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID) and focuses on new education and data-gathering initiatives tied to the vaccination effort. </p><p>CMS also published a <a href="https&#58;//;cm_cat=Interim+Final+Rule+on+COVID-19+Vaccine+Requirements+for+LTCF+and+ICFs-IID&amp;cm_pla=All+Subscribers&amp;cm_ite=QSO+memo&amp;;cm_ainfo=&amp;&amp;&amp;&amp;&amp;">QSO memo </a>to state survey agencies on how to operationalize this new requirement. The rule is scheduled to go into effect on May 21, which is 10 days from its publication in the <em>Federal Register. </em></p><p>This rule specifies that LTC facilities must develop and implement policies and procedures to&#58; </p><p>•&#160;Educate all residents and staff about COVID-19 vaccines; </p><p>•&#160;Offer vaccination to all residents and staff; and </p><p>•&#160;Report to the Centers for Disease Control and Prevention (CDC) via National Healthcare Safety Network (NHSN) certain data regarding vaccination status for residents and staff as well as any therapeutic treatments (for example, monoclonal antibody use). Note that this requires additional reporting via NHSN modules&#58; reporting the Resident Therapeutics Pathway found on <a href="https&#58;//;cm_cat=Interim+Final+Rule+on+COVID-19+Vaccine+Requirements+for+LTCF+and+ICFs-IID&amp;cm_pla=All+Subscribers&amp;cm_ite=COVID-19+LTCF+Module%2c&amp;;cm_ainfo=&amp;&amp;&amp;&amp;&amp;">COVID-19 LTCF Module, </a>as well as reporting via the <a href="https&#58;//;cm_cat=Interim+Final+Rule+on+COVID-19+Vaccine+Requirements+for+LTCF+and+ICFs-IID&amp;cm_pla=All+Subscribers&amp;cm_ite=Weekly+HCP+and+Resident+COVID-19+Vaccination+Module.&amp;;cm_ainfo=&amp;&amp;&amp;&amp;&amp;">Weekly HCP and Resident COVID-19 Vaccination Module. </a></p><p>Additionally, CMS said ICF-IID facilities must educate all clients and staff about COVID-19 vaccines and offer vaccination to all clients and staff. The agency said reporting is not required for ICFs-IID; however, CMS strongly encourages voluntary reporting. </p><p>In response, David Gifford, MD, chief medical officer of AHCA/NCAL, said the LTC profession has been supportive of publicly reporting COVID-19 vaccination rates in long term care since the vaccines were first approved, and it greatly appreciates CMS taking this step today. </p><p>“Reporting vaccination rates is critical to facilitating in-person visitations in nursing homes, tracking the effectiveness of the vaccines, and helping ensure the industry meets our goal to vaccinate 75 percent of staff by the end of June,” he said.<br></p><p>Gifford also said “it is important that we not judge facilities with low vaccination rates, but instead seek to understand whether additional resources or outreach can be done to encourage more staff and residents to get the vaccine, or help facilities acquire additional vaccines for new patients and hires.”<br></p><p>He said the LTC profession believes transparency on vaccination rates should be expanded to all Medicare providers, including hospitals, home health, and inpatient rehabilitation facilities, where many seniors may also receive care and the virus can still remain a threat. <br>“All Medicare providers should have a streamlined effort to report their vaccination rates,” Gifford said.</p><p>The comment period for the interim final rule closes July 12. CMS is also requesting feedback on the feasibility of implementing similar requirements in other long term care settings that accept Medicare or Medicaid payments, including assisted living.</p>2021-05-11T04:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/vaccination.jpg" style="BORDER&#58;0px solid;" />COVID-19Patrick ConnoleThe rule requires that providers educate residents, staff about COVID vaccine and report data on status.
Nursing Homes See Occupancy Bump Higher in Latest NIC Data<p>Nursing home occupancy levels increased to 71.2 percent in February 2021 compared to 70.7 percent from the previous month, according to NIC MAP® data prepared and released by NIC MAP Vision, which are both products of the National Investment Center for Seniors Housing and Care (NIC).</p><p>This brought the occupancy rate back to its December 2020 level. Despite the February improvement, occupancy remains 13.7 percentage points below its pre-pandemic level, NIC said.</p><p>The February NIC MAP occupancy data are starting to reinforce trends from other data sources. COVID-19 case counts at skilled nursing facilities are down 98 percent since December 2020 and the launch of the long term care vaccination program, <a href="https&#58;//">according to NIC. </a></p><p>Additionally, more than four in five operators in senior housing and skilled nursing are reporting an increase in lead volume since the beginning of the year, according to NIC’s latest <a href="https&#58;//">Executive Survey Insights.</a></p><p>“February’s NIC MAP data underscore what some skilled nursing facility operators have been saying the past few months&#58; They are starting to see occupancy stabilization,” said Beth Burnham Mace, NIC’s chief economist. “Data from the next few months will be extremely important, as it will signal whether this is the start of a longer trend toward recovery.”</p><p>NIC MAP data powered by NIC MAP Vision show traditional Medicare revenue per patient day was steady at $555, but the share of Medicare revenue declined to 23.4 percent from 25.1 percent in January. The share of Medicare Advantage revenue increased to 11.1 percent, up from its pandemic low of 8.3 percent in May of 2020.</p><p>“Hospitals resuming elective surgeries and discharging patients to skilled nursing facilities may be responsible for greater share of Medicare Advantage revenue, thereby boosting occupancy,” said Bill Kauffman, senior principal at NIC. “Occupancy is still near historic lows, and many facilities will need to see substantial increases in occupancy in order to stabilize the balance sheet.”</p><p>NIC said as nursing homes begin to move beyond the pandemic, occupancy is an important indicator of recovery. Older adults continue to need an array of options for long term care, given personal preferences and health and mobility status. These include institutional settings for people with acute or multiple chronic conditions or mobility challenges and home- and community-based options, NIC said.<br>Click here to access the latest<a href="https&#58;//"> NIC MAP skilled nursing data.</a><br></p>2021-05-10T04:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/0220_News1.jpg" style="BORDER&#58;0px solid;" />Management;COVID-19Patrick ConnoleMore than 80 percent of senior housing, skilled nursing operators report increase in lead volume.
Washington State Nursing Homes Grow Gardens to Nurture Residents<p>Seven Washington state skilled nursing facilities will receive two Eldergrow indoor therapeutic sensory gardens each, along with Eldergrow’s therapeutic horticulture program, as part of a state and federally funding program aimed at providing therapy for residents, notably those with dementia. </p><p>Seattle-based Eldergrow offers therapeutic gardening programs to seniors in residential and skilled communities. With this new partnership, the company said residents at Lake Ridge Center and Columbia Crest Center in Moses Lake, Wash., Orchard Park in Tacoma, Wash., Ballard Center in Seattle, Montesano Healthcare &amp; Rehab in Montesano, Wash., Linden Grove Center in Puyallup, Wash., and Everett Center in Everett, Wash., are now able to nurture a lush indoor garden from the safety of their community.</p><p>The Therapeutic Horticulture Program includes an indoor, mobile garden filled with fragrant and colorful plants that provide sensory stimulation and reminiscing opportunities for residents. The program includes an Eldergrow Educator who conducts interactive classes and garden maintenance twice a month. <br></p><p>The indoor gardens are constructed in partnership with a job training program that employs and trains veterans and adults living with disabilities. The gardens include a custom grow light and wheels that mobilize the garden. </p><p>“We are incredibly honored to partner with these communities because they uniquely care for their residents and see the healing benefits of nature,” Eldergrow Founder Orla Concannon said.</p><p>According to a University of Washington report, daily gardening can be a preventive measure to help reduce the onset of dementia by 36 percent. For those living with some form of dementia, access to gardens helps reduce agitation and injuries, while improving mood and sleep. In response to these findings, Eldergrow created its indoor gardening programs, the company said.</p><p>An Eldergow spokesperson said while the organization is currently kicking off the Washington state gardens, they are a nationwide company with nearly 300 gardens in 24 states and will look to keep expanding the program.​</p>2021-05-03T04:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/0320_News4.jpg" style="BORDER&#58;0px solid;" />ManagementPatrick ConnoleFor those living with dementia, access to gardens helps improve mood and sleep, report finds.
Survey Shows Dramatic Rise in Long Term Care Staff Wanting Vaccine<p>Post-acute care software company OnShift said senior care employee willingness to take the COVID-19 vaccine has risen sharply over the winter, with its new March survey showing a 94 percent increase in acceptance of the vaccine from its December measurement.<br></p><p>The company also said there was a 41 percent decrease in staff members planning to decline a COVID-19 vaccine over the same time frame.<br></p><p>In addition to vaccination plans, OnShift said the March survey examined the reasons behind vaccination decisions and explored employee perceptions of the value of vaccine education. Additional key findings include&#58;<br></p><ul><li>The respondents’ primary reasons for vaccination are to help prevent family and friends from infection (30 percent), to avoid getting COVID-19 themselves (13 percent), and to put an end to community lockdowns, gathering restrictions, and/or virtual schooling (12 percent).</li></ul><ul><li>The respondents’ primary reasons for declining vaccination include concerns that the vaccine is too new (26 percent) and potential safety and side effects (23 percent). Another 10 percent believe getting the vaccine is unnecessary because they have already had the virus.</li></ul><ul><li>Respondents cited the need for additional education on the safety and side effects of the vaccine (28 percent), how the vaccine works in protecting against COVID-19 (15 percent), and what to expect in the workplace if they decline the vaccine (14 percent).</li></ul><ul><li>A total of 62 percent of respondents expressed their willingness to take the vaccine, up from 32 percent in December.</li></ul><p>Mark Woodka, chief executive officer (CEO) of OnShift, said the company was encouraged to see “this seismic shift across the industry in the acceptance of the COVID-19 vaccine in just a few short months.”<br></p><p>He added that “this insight into the mindset of senior care employees is critical information for providers and the industry as they continue staff outreach, education, and support. OnShift is dedicated to senior care organizations and their employees, and we will continue working together to help ensure a transparent and safe environment for everyone.”<br></p><p>Woodka said survey results depicting a growing acceptance for the vaccines among long term care staff is extremely encouraging and echoes what OnShift has heard from providers across the country who witnessed higher uptake with each round of on-site vaccination clinics.<br></p><p>“Now, we need public health officials to ensure long term care is prioritized for a steady, ongoing allocation of vaccines for new hires and admissions, as well as current residents and staff who have since decided to get the vaccine,” he said.<br></p><p>He pointed to the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) <a href="https&#58;//" target="_blank">#GetVaccinated</a> campaign as an effort OnShift supports to educate staff about the safety of the vaccines and thoughtfully listening to any of their concerns, so they can make an informed decision. The nursing home industry set a nationwide goal to have 75 percent of staff vaccinated by the end of June, and knowing these new data, Woodka said he is optimistic “we’ll meet that goal.” <br></p><p>In response to the survey and vaccination efforts in the nursing care profession, Mark Parkinson, president and CEO of AHCA/NCAL, said, “Our caregivers are eager to protect themselves, their family members, and their residents, and these vaccines are a beacon of hope.”<br></p><p>David Schless, president, American Seniors Housing Association, called the survey an important source of useful information about vaccination uptake in senior living and long term care settings. “While we see evidence of progress, the results reaffirm the importance of continued, targeted education among those who work with older adults in these communities,” he said.<br></p><p>And, James Balda, president and CEO, Argentum, said, “We are extremely pleased to see this substantial increase in intent by senior living employees to get the COVID-19 vaccine. It’s been such a challenging year for them, and their dedication to caring for and protecting those they serve continues to shine through. We applaud them for their ongoing commitment.”<br></p>2021-05-01T04:00:00Z<img alt="" src="/Monthly-Issue/2021/May/PublishingImages/0521-news1.jpg" style="BORDER&#58;0px solid;" />COVID-19Patrick Connole​OnShift said senior care employee willingness to take the COVID-19 vaccine has risen sharply over the winter.



Protecting Our Staff Has Never Been More Critical Our Staff Has Never Been More Critical<p>Our nation’s most vulnerable population has been amongst the hardest hit by the historic COVID-19 pandemic. Since day one, caregivers in nursing homes and assisted living communities have worked tirelessly to ensure the health and safety of their residents and staff, but facilities were forced to fight the virus with limited resources. <br><br>Critical resources, essential in fighting the virus, were hard to come by in almost every facility. Specifically, access to personal protective equipment (PPE) was a challenge for many facilities. Worldwide supply chain issues and soaring demand across every industry left long term care providers scrambling to acquire and afford the masks, gowns, and gloves they needed to help keep staff members safe and prevent further spread of the virus.<br><br>Many suppliers delayed or limited the size of providers’ orders, and many providers got taken by scammers pretending to have legitimate PPE.<br><br>The long term care industry made repeated calls to federal and state officials to prioritize these settings for PPE, but shortages remained. Many facilities were forced to reuse items like N-95 masks or use handmade cloth facemasks, all in accordance with guidance from the Centers for Disease Control and Prevention (CDC) on how to optimize PPE supplies.<br><br>Moreover, early on in the pandemic, public health officials focused on a symptoms-based approach even though we knew the virus was spreading through asymptomatic and pre-symptomatic carriers. The CDC did not revise its guidance to nursing home personnel to wear facemasks at all times throughout the facility until June 2020—five months into the pandemic.<br><br>While access to PPE has improved since last year, long term care providers still struggle to afford the high cost of quality equipment, and suppliers anticipate continued strain on items such as gloves. Some believe facilities should be fined or issued citations by the Occupational Safety and Health Administration (OSHA) or other regulators in an effort to enforce use of PPE. But that approach would only make the situation worse. <br><br>The health and safety of long term care staff and the residents they care for is and always should be the top priority. Facilities have taken historic steps to keep the virus out of facilities and limit its spread if it does make its way in. Their efforts have saved lives. Fining a facility for lack of PPE due to global supply shortages would help no one. We need a public and private partnership so that health care settings, including long term care facilities, have the necessary supplies to protect our health care heroes on the frontlines.<br><br>We should all be working together to ensure facilities have the resources they need, not making matters worse with fines that only draw resources away from where they should be focused: on our residents and staff. <br><br><strong><a href="">David Gifford, MD, MPH,</a></strong> is chief medical officer and senior vice president, quality and regulatory affairs, of the American Health Care Association/National Center for Assisted Living.<br>​</p>Our nation’s most vulnerable population has been amongst the hardest hit by the historic COVID-19 pandemic. 2021-03-04T05:00:00Z<img alt="" src="/PublishingImages/Headshots/DavidGifford.jpg" style="BORDER:0px solid;" />COVID-19;WorkforceDavid Gifford, MD, MPH

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