The Lead September 30, 2021 - LeadingAge Illinois

Nursing and Rehabilitation:
IDPH Adopts Rules on Antibiotic Stewardship, Life Safety Code, Alzheimer’s, Strikes, and More
SNF PDPM Calculator for FY 2021
Training Tools from AHRQ and Nursing Home COVID-19 Network
Reporting Plans Update

Home and Community Based Services (HCBS):
IDPH Adopts Rules on Approving Home Health Orders

Top Stories:

Vaccination Updates
We have a few updates today on the COVID-19 Vaccination and booster shots, including:

CDC Recommendations for Booster Shots
CMS Will Cover Cost of Boosters for Eligible Consumers
HUD Reimbursements for Costs Related to Resident Vaccinations, Testing
IDPH Adopts CDC Recommendations for Pfizer-BioNTech COVID-19 Vaccine Boosters
Vaccine Conversation Guide

CDC Recommendations for Booster Shots:
As of Friday, September 24, CDC recommends and the FDA has approved a booster shot of the Pfizer COVID-19 vaccine as follows:

People 65 years and older and residents in long-term care settings shouldreceive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series
People aged 50–64 years with underlying medical conditionsshould receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series
People aged 18–49 years with underlying medical conditionsmay receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks, and
People aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting mayreceive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.

Read the CDC statement here. Additionally, check out this FAQ document provided by the CDC. Only the Pfizer vaccine has received FDA approval for a booster dose. CDC continues not to recommend mixing of COVID-19 vaccines, as discussed in this guidance. This means that only individuals who completed an initial vaccine series with Pfizer should consider a booster if eligible as outlined above. Individuals who completed an initial vaccine series with Moderna, Johnson & Johnson, or another vaccine are not recommended to receive a booster dose at this time. Members who are organizing vaccine clinics should take caution to identify primary vaccine series for residents and staff when considering additional doses for immunocompromised individuals or booster doses for those recommended as above.

CMS Will Cover Cost of Boosters for Eligible Consumers:
CMS will continue to cover COVID-19 immunizations, including boosters, for eligible consumers, with no cost sharing, according to a press release from the agency today. Those with Medicare pay nothing for the vaccine or its administration, and there is no applicable copayment, coinsurance or deductible. Nearly all Medicaid and CHIP beneficiaries will also not have any cost sharing obligations.

IDPH Adopts CDC Recommendations for Pfizer-BioNTech COVID-19 Vaccine Boosters:
The Illinois Department of Public Health (IDPH) is adopting the Centers for Disease Control and Prevention’s (CDC) recommendation for a booster shot of the Pfizer-BioNTech COVID-19 vaccine in certain populations and a booster dose for those in high risk occupational and institutional settings. Click here for the full announcement.

Vaccine Conversation Guide:
MyCNAjobs has created a guide to help you navigate and explore different strategies to talk about the vaccine to inspire new thinking, conversations, and the required dialog to keep people safe and exit the pandemic. (Download the guide here).

HUD Reimbursements for Costs Related to Resident Vaccinations, Testing:
Affordable housing providers have an important role to play in facilitating resident access to vaccines and testing; to support this effort, HUD has implemented a temporary reimbursement process to offset costs related vaccines and testing access, as well as other COVID-19 costs at properties. Reimbursement options for providers include costs associated with organizing and hosting an on-site vaccination clinic or testing event, or transportation costs to help residents access off-site testing or vaccination. The deadlines for incurring the costs are October 31. Actual costs of the vaccine or test, or for other medical services to residents, cannot be reimbursed. More information here.

Application Open for Federal COVID-19 Provider Relief Funding
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced a new application cycle for $25.5 billion in COVID-19 provider funding. Applicants will be able to apply for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments during the application process. PRF Phase 4 is open to a broad range of providers with changes in operating revenues and expenses. ARP Rural is open to providers who serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP). See a detailed list of eligible provider types here.

The application is open now and will close on October 26, 2021 at 10:59 p.m. CST. Providers who have previously created an account in the Provider Relief Fund Application and Attestation Portal and have not logged in for more than 90 days will need to first reset their password before starting a new application. In order to streamline the application process and minimize administrative burdens, providers will apply for both programs in a single application.

HHS recently hosted a briefing session to provide information about these upcoming funding opportunities – view the video here. HRSA will also host webinar sessions featuring guidance on how to navigate the application portal. Register now for the Tuesday, October 5 session from 2:00 – 3:00 p.m. CST.

Nursing and Rehabilitation:

IDPH Adopts Rules on Antibiotic Stewardship, Life Safety Code, Alzheimer’s, Strikes, and More
The Illinois Department of Public Health (IDPH) has adopted regulatory amendments to the Skilled Nursing Facilities Code that became effective August 2, implementing various Public Acts and federal regulations.

The rulemaking:

Incorporates federal regulations regarding patient abuse, neglect, privacy, and confidentiality;
Requires facilities to establish antibiotic stewardship programs to prevent overuse of antibiotics and development of antibiotic-resistant bacteria;
Requires federally certified facilities to comply with the 2012 edition of the National Fire Protection Association 101 Life Safety Code;
Requires facilities to comply with the Alzheimer’s Disease and Related Dementias Services Act [410 ILCS 406].
Requires facilities to notify IDPH and submit an operations contingency plan in the event of an impending strike by direct care staff.
Facilities must maintain facility-specific email addresses (not issued to individual staff members) that will not change without prior notification to IDPH.

SNF PDPM Calculator for FY 2021
The PDPM calculator has been updated to reflect the PDPM rates effective October 1. These tools can be used by members to:

Calculate the component rates that must be entered into the billing software.
Calculate a budget for a given time period based on patient days and length of stay for each of the PDPM case-mix classifications.
Estimate the revenue from a particular stay for a potential admission. This function is also useful in evaluating if the billing software rates were picked up correctly.
Run “what-if” scenarios on revenue changes to patients cared for in rehab units.

Training Tools from AHRQ and Nursing Home COVID-19 Network
AHRQ provides free training and mentorship to nursing homes across the country through the National Nursing Home COVID-19 Action Network. The Network supports the implementation of evidence-based prevention and safety practices within nursing homes to protect residents and staff from infection. Please click on the link and review the tools AHRQ has put together from across agencies and organizations.

Reporting Plans Update
The monthly reporting plan was required for nursing homes reporting vaccination data through NHSN beginning this week ending October 3. The CDC has built in a work-around that will allow nursing homes to report data without submitting a monthly reporting plan through March 2022. All other changes to reporting are effective with this reporting week ending October 3. For more information on the changes to reporting, check out the Tables of Instructions here. Also, if you missed last week’s training, the slides are available here.

Home and Community Based Services (HCBS):

IDPH Adopts Rules on Approving Home Health Orders
The Illinois Department of Public Health (IDPH) adopted amendments to the Home Health, Home Services, and Home Nursing Agency Code effective August 27, replacing emergency amendments that were effective May 3. The amendments align the Part with federal regulations by allowing a health care professional (formerly, physician or podiatrist) to approve orders for home health services.