Coronavirus

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​In response to the coronavirus (COVID-19) pandemic, we are working nationally with the federal government​​​ to ensure nursing hom​​es, assisted living communities, and intermediate care facilities for indiv​​iduals with intellectual disabilities receive necessary supplies and guidance to prevent the spread ​of this disease.

Visit this website regularly for the latest information that AHCA/NCAL has to share with long term care providers about COVID-19. 


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How You Can Help Prevent the Spread of COVID-19

 Providers

Please note that skilled nursing providers should consult the guidance put forth by CMS and the CDC, and assisted living communities can consult AHCA/NCAL's guidance​. Providers should also check their local and state health departments for updates and potentially stricter guidance, but these are general, national prevention and containment tips: 

 
Infection Control: Maintain i​nfection control policies and procedures, updated where needed and increase transmission-based precautions.
 
Staff: Remind about hand hygiene and proper use of PPE. Tell them to stay home if they're sick. Screen all personnel coming into the building.
 
Limit Interactions: Restrict all non-essential visitors and group activities. Implement social distancing within the facility.
 
PPE: Preserve your current supply if you're running low. Ask for help from local and state officials and document requests.
 
Communicate: Report suspected or confirmed cases to authorities. Keep residents, families and staff informed about your developing situation. Prepare for media inquiries.
 
Engagement: Keep residents connected with loved ones remotely and stimulated with meaningful activities adapted for this situation.


If a staff member shows symptoms of COVID-19: Have them go home immediately. 

If a resident shows symptoms of ​COVID-19​: Implement droplet precaution, and contact the local health department. ​

 Families

Coronavirus (COVID-19) poses a serious threat to older adults (especially 80 years old and older) and those with underlying health conditions. This is why the federal government and many state governments are restricting visitors to nursing homes and assisted living communities. Exceptions may be made on a case-by-case basis for end-of-life visits. We understand this is difficult, but the safety and wellbeing of your loved one is our top priority.  

Here’s how you can continue to stay in touch with them, and how you can help: 

  • Communicate with your loved ones through alternative ways for the time being, whether by phone, video, social media, or other methods. Ask the facility about ways they can help with this.  
  • Make sure your loved one’s facility has your emergency contact information. The facility may need to communicate with you about any developments regarding your loved one or about the facility as a whole.  
  • If you must come to the facility, such as a loved one is near end-of-life, coordinate with the staff ahead of time.  
    • They may ask you some questions before or when your arrive. This is to make sure you do not pose as a potential risk to residents and staff.  
    • If you are asked to not enter the building, please understand this is for the safety of your loved one and everyone else in the building. Nursing homes and assisted living communities are following direction from the government to prevent the spread of this virus.  
    • ​If you are permitted in, please wash your hands or use alcohol-based hand sanitizer immediately upon entering and throughout your visit. Avoid touching your loved ones or other individuals in the building. Again, we know this is difficult, but the virus is very contagious and social distancing is important at this time. ​
  • ​Warn your loved ones about potential scammers during this crisis and encourage them to be cautious.​

 Residents

Coronavirus (COVID-19) poses a serious threat to older adults (especially 80 years old and older) and those with underlying health conditions. This is why the federal government and many state governments are restricting visitors to nursing homes and assisted living communities. We understand this is a difficult and stressful time. Those who work in long term care facilities are focused on your safety and wellbeing.  

Here’s how you can continue to stay in touch with your loved ones, and how you can help: 

  • Ask the facility about other ways you can communicate with your loved ones, whether by phone, video or social media.  
  • Follow everyday preventive actions such as: 
    • ​Washing your hands or using alcohol-based hand sanitizers 
    • Covering your cough and sneezes ​
  • ​Ask other individuals (including staff) to avoid touching you with handshakes, hugs or kisses. Ask them to wash their hands. Do not be shy! It’s okay to remind people.
  • Watch out for potential scammers​ during this crisis. 
  • If you begin to experience difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat, new loss of taste or smell​, tell a staff member immediately.​

 

 

Considerations when testing residents and employees and screening employees for COVID-19https://www.ahcancal.org/News-and-Communications/Blog/Pages/Considerations-when-testing-residents-and-employees-and-screening-employees-for-COVID-19.aspxConsiderations when testing residents and employees and screening employees for COVID-199/24/2020 4:00:00 AM<p></p><div>With test kits being distributed to SNF and ALs, there are several considerations to take into account around screening employees and testing both employees and residents for COVID-19. </div><div><br></div><div>The <a href="https://www.shrm.org/resourcesandtools/tools-and-samples/hr-forms/pages/memo-covid-19-employee-screening-procedures.aspx" target="_blank">Society for Human Resource Management (SHRM)</a> recommends employees be screened privately. Medical information, including an employee’s temperature and answers to screening questions will need to be maintained as a private medical record.  </div><div><br></div><div>Time spent waiting for the health screening and testing should be recorded as time worked for non-exempt employees.  </div><div><br></div><div>The <a href="https://www.eeoc.gov/wysk/what-you-should-know-about-covid-19-and-ada-rehabilitation-act-and-other-eeo-laws" target="_blank">U.S. Equal Employment Opportunity Commission (EEOC)</a> reminds employers that typically, measuring an employee’s body temperature is a medical examination. Employers may measure employees’ body temperature because the CDC and state/local health authorities have acknowledged community spread of COVID-19 and issued precautions.  </div><div><br></div><div>Applying the Americans with Disabilities Act (ADA) standard to the COVID-19 pandemic, employers may take screening steps to determine if employees entering the workforce have COVID-19 because an individual with the virus will pose a direct threat to the health of others. Testing administered by employers consistent with the current CDC guidance will mee the ADA’s “business necessity” standard. This would apply to SNF, AL, and IDD providers.  </div><div><br></div><div>An employer may not require an antibody test before permitting employees to re-enter the workplace. The antibody test, at this time does not meet the ADA’s “job-related and consistent with business necessity” standard for medical examinations. This does not apply to the diagnostic tests mentioned above.  </div><div><br></div><div>For staff conducting COVID-19 testing, the <a href="https://www.osha.gov/Publications/OSHA3993.pdf" target="_blank">Occupational Safety and Health Administration (OSHA)</a> categorizes workers who collect/handle specimens from potentially infectious patients as very high occupation exposure risk. This is the highest risk category for occupation risk for COVID-19.  </div><div><br></div><div>It is important that staff conducting COVID-19 tests and/or handling specimens are utilizing the appropriate PPE per OSHA and CDC guidance.  </div><div><br></div><div>Additional answers to frequently asked questions around the ADA, Rehabilitation Act, and other EEO Laws can be found on the <a href="https://www.eeoc.gov/wysk/what-you-should-know-about-covid-19-and-ada-rehabilitation-act-and-other-eeo-laws" target="_blank">EEOC’s website</a>. </div><div><br></div><div>Work-related employee COVID-19 cases are recordable illnesses on the OSHA 300 Logs. Additional information and guidance is available <a href="/Survey-Regulatory-Legal/Emergency-Preparedness/Documents/COVID19/OSHA-Guidance-Recording.pdf" target="_blank">here</a>.<br><br></div>With test kits being distributed to SNF and ALs, there are several considerations to take into account around screening employees and testing both employees and residents for COVID-19.
Abbott BinaxNOW™ Resourceshttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Abbott-BinaxNOW™-Resources-.aspxAbbott BinaxNOW™ Resources9/23/2020 4:00:00 AM<p>​<span style="font-size:11pt;">Skilled nursing facilities and assisted living communities who are receiving the Abbott BinaxNOW™ test kits can refer to the following resources from Abbott: <br></span><span style="font-size:11pt;"><br><strong><span style="text-decoration:underline;">Contact Information:</span> </strong>  </span></p><div><ul><li><span style="font-size:11pt;">​To report shipping issues / order quality concerns (these should be sent to Abbott at: <a href="mailto:ARDxUSGovernmentSupport@abbott.com" target="_blank">ARDxUSGovernmentSupport@abbott.com​</a>)   </span></li><li>For technical u<span style="font-size:11pt;">sage questions about the BinaxNOW™ test, contact Abbott directly at: Technical support: <a href="mailto:ts.scr@abbott.com" target="_blank">ts.scr@abbott.com</a> or 1-800-257-9525  </span></li><li>For all other questions related to your distribution, please contact HHSBINAX@hhs.gov, this inbox was established to coordinate the distribution of government procured Abbott BinaxNOW™kits. This inbox should NOT be used to request kits for facilities not currently receiving these tests.  </li></ul></div><div><span style="font-size:11pt;"><strong style="text-decoration:underline;">Training Information:</strong>   </span><br></div><div><br></div><div><ul><li>For access to access training videos and documents, please visit the <a href="https://www.globalpointofcare.abbott/en/support/product-installation-training/navica-brand/navica-binaxnow-ag-training.html" target="_blank">BinaxNOW™ COVID-19 Ag Card and NAVICA™ App Set-Up and Training portal</a>. </li><li>For CLIA FAQs and information, click <a href="https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA" target="_blank">here</a>.    </li><li>For policy regarding performance of antigen tests authorized by the FDA under an Emergency Use Authorization (EUA) at the point of care or in patient care settings operating under a CLIA Certificate of Waiver, please refer to CMS’s policy <a href="https://www.cms.gov/files/document/clia-poc-ag-test-enforcement-discretion.pdf" target="_blank">here</a> and PREP Act guidance <a href="https://www.hhs.gov/sites/default/files/prep-act-coverage-for-screening-in-congregate-settings.pdf" target="_blank">here</a>.  </li><li>For FDA recommendations to health care providers who are ordering authorized tests outside their authorization (e.g., antigen tests for asymptomatic individuals), please see <a href="https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/faqs-testing-sars-cov-2#general-screening-asymptomatic" target="_blank">FDA’s FAQ on Testing for SARS-CoV-2</a>.   </li></ul></div><div><span style="font-size:11pt;">Abbott has also indicated that they will be providing a link to the recorded version of their recent webinar for assisted living facilities that was hosted on Friday, September 18, as well as a Q&A list. AHCA/NCAL will share this with members once it becomes available. </span><br><br></div>Skilled nursing facilities and assisted living communities who are receiving the Abbott BinaxNOW™ test kits can refer to the following resources from Abbott.
HHS Releases PRF Reporting Guidancehttps://www.ahcancal.org/News-and-Communications/Blog/Pages/HHS-Releases-PRF-Reporting-Guidance.aspxHHS Releases PRF Reporting Guidance9/23/2020 4:00:00 AM<p></p><div>On September 21, the Department of Health and Human Services (HHS) <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/reporting-auditing/index.html" target="_blank">released new information</a> regarding reporting requirements for recipients of funds from the CARES Act Provider Relief Fund as well as additional information related to potential future audits.   </div><div><br></div><div>This update provides guidance for our sector that CARES Act funds can be used to make up for lost revenue up to 2019 net operating income levels. AHCA/NCAL has worked with HHS to advocate for an updated definition of revenue, which is a significant improvement over a preliminary set of reporting guidance shared with stakeholders in August.  </div><div><br></div><div><strong>What the HHS Announcement Means </strong></div><div><br></div><div style="text-decoration:underline;">Reporting Requirements </div><div><br></div><div>In July, HHS <a href="https://www.hhs.gov/sites/default/files/provider-post-payment-notice-of-reporting-requirements.pdf" target="_blank">provided a preview of reporting requirements</a> for entities that received funds through the Provider Relief Fund. In the preview, HHS indicated that <strong>entities receiving over $10,000</strong> would be required to submit reports within 45 days of the end of the calendar year. Also, HHS indicated reporting requirements on August 17. After a delay, HHS released the <a href="https://www.hhs.gov/sites/default/files/post-payment-notice-of-reporting-requirements.pdf" target="_blank">more detailed reporting requirements​</a>.   </div><div><br></div><div>Notable pieces of the reporting requirements: </div><div><br></div><div><ul><li>​<strong>Purpose of funds</strong> – at a high level, reporting entities will need to report on: 1) healthcare-related expenses attributable to coronavirus; and 2) payment amounts attributable to “lost revenue”;<br></li></ul></div><div><ul><li><strong>Acceptable expenses</strong> – the guidance discusses what expenses HHS views as appropriate for purposes of healthcare-related expenses attributable to coronavirus;<br></li></ul></div><div><ul><li><strong>“Lost Revenue” defined</strong> – the guidance offers insight into how HHS views “lost revenues”; <br></li></ul></div><div><ul><li><strong>Accounting other funds</strong> – as part of the “lost revenue” definition, HHS will be asking applicants for an accounting of other assistance the provider received, including loans from Treasury and the Small Business Administration, CARES Act testing funds, and other sources of public and private revenue; and <br></li></ul></div><div><ul><li><strong>Single Audit requirements</strong> – Entities that expended over $750,000 of federal funds (including the Provider Relief Fund) will be subject to <a href="https://www.hhs.gov/about/agencies/asfr/data-act-program-management-office/single-audit/index.html" target="_blank">Single Audit Requirements</a> and details are located at the <a href="https://www.hhs.gov/about/agencies/asfr/data-act-program-management-office/single-audit/index.html" target="_blank">HHS website on Single Audit Requirements</a>. </li></ul></div><div><span style="font-size:11pt;">​HHS notes the September 21 guidance does not apply to Nursing Home Infection Control distribution nor Rural Health Clinic Testing distribution or claims from the HRSA fund for the uninsured. Reporting requirements for these distributions will be released at a later date.   </span><br></div><div><br></div><div><strong>Additional HHS Information</strong>  </div><div><br></div><div>HHS has also released a <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/reporting-auditing/index.html" target="_blank">new webpage</a> with additional information about reporting and audits. Through the new webpage, HHS has indicated they will be posting the reporting template, case examples, and the reporting system portal which will be available in “early 2021.” HHS had previously indicated the reporting system would open in October 2020.  </div><div><br></div><div><strong>What It Means for the Membership </strong></div><div><br></div><div>The membership should consider both Reporting and Single Audit:  </div><div><br></div><div><strong><em>Reporting</em></strong>:  Anyone who has received funds from the Provider Relief Fund should review these new reporting requirements and ensure they are prepared to comply early next year based upon the September 21 release as well as additional information AHCA/NCAL will share as soon as HHS provides additional detail; and </div><div><br></div><div><strong><em>Single Audit</em></strong>:  The American Institute for Certified Public Accountants (AICPA) has made available a free webinar on Single Audit. Of note, the AICPA Governmental Audit Quality Center webinar is targeted to the usual entities subject to Single Audit, Not-for-Profit entities. The “Preparing for First Single Audit for Auditees” event is located <a href="https://www.aicpa.org/interestareas/governmentalauditquality/resources/single-audit-archived-events.html" target="_blank">here</a>. Registration is required and there is no fee. Once registered, AHCA/NCAL members will immediately have access to the webinar as well as AICPA’s COVID-19 information. There is no CPE for listening to an archive. Later in October after HHS releases the PRF Single Audit guidance, AICPA will make a second free webinar available tailored to For-Profit entities.   ​<br></div><p>​</p>On September 21, HHS released new information regarding reporting requirements for recipients of funds from the CARES Act Provider Relief Fund as well as additional information related to potential future audits.
CMS to Update County Data for COVID-19 Testing Weekly and Allow Use of State or County Data in Updated Methodologyhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/CMS-to-Update-County-Data-for-COVID-19-Testing-Weekly-and-Allow-Use-of-State-or-County-Data-in-Updated-Methodology.aspxCMS to Update County Data for COVID-19 Testing Weekly and Allow Use of State or County Data in Updated Methodology9/21/2020 4:00:00 AM<div><span style="font-size:14.6667px;">​​The Centers for Medicare and Medicaid (CMS) has updated the <a href="https://data.cms.gov/download/hsg2-yqzz/application/zip" target="_blank">Excel file</a> that flags COVID-19 positive test rates in counties. CMS modified the method for classifying a county as green, yellow, or red and expanded the measure to cover results over a 14-day period in each county instead of seven days. SNFs should use the color classification provided in the file. </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">The revised methodology results in some red counties with rates >10% being reclassified to yellow:  </span></div><div><ul><li><span style="font-size:14.6667px;">Green = Counties with test percent positivity <5.0% or with <20 tests in past 14 days </span></li><li><span style="font-size:14.6667px;">Yellow = Counties with test percent positivity 5.0%-10.0%; OR with <500 tests and <2,000 tests/100k and >10% positivity over 14 days </span></li><li><span style="font-size:14.6667px;">Red = >10.0% and not meeting the criteria for “Green” or “Yellow” </span></li></ul></div><div><br></div><div><strong>Posting Frequency: </strong>CMS also clarified that it will <a href="https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg/" target="_blank">post county data weekly​</a>. It stated that facilities must check weekly and should pick one day of the week to check each week. They should document their plan for checking and document the dates used by CMS for the data in the top of the Excel file.  <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>Using State or County Data: </strong>CMS has indicated on several national calls that facilities can use test positivity data released by their state or county if the data is more recent than the CMS data. The facility must document the source and date of the data being used. </span></div>CMS to Update County Data for COVID-19 Testing Weekly and Allow Use of State or County Data in Updated Methodology

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