COVID-19 Updates

As information continues to be made available regarding the Coronavirus, officially named COVID-19, the PHCA team is here to ensure you receive all appropriate guidance and necessary supplies to prevent the spread of this virus in your communities.

The CDC expects an increase of confirmed COVID-19 cases in the coming days and weeks and is relying on health care providers to take action and help prevent the spread of the virus. Due to the rapidly changing nature of the spread of COVID-19 around the world, it is important for our communities to be prepared.

For additional resources, please visit the links below:

In addition, the Hospital & Healthsystem Association of Pennsylvania (HAP), in partnership with the Pennsylvania Department of Health Bureaus of Epidemiology and Emergency Preparedness & Response, and Emergency Medical Services holds a statewide COVID-19 call for long-term care facilities, home care, post-acute, dialysis, and similar facilities every Tuesday at 1 p.m.

These calls will occur weekly until the risk of COVID-19 has subsided and will help infection prevention and control staff, hospital communicators, and frontline staff coordinate your hospital/facility’s coronavirus preparedness and response. To call in, dial 929-436-2866. The meeting ID is 621414465#.

Thank you for keeping our residents and communities safe!

If you have any questions, please reach out to PHCA staff:

  • For regulatory questions, contact Gail Weidman, Director of Policy and Regulatory Affairs, at gweidman@phca.org.
  • For quality questions, contact Chris Fisher, Director of Quality Initiatives, at cfisher@phca.org.
  • For communications support or questions about responding to media inquiries, contact Shayna Varner, Director of Communications, at svarner@phca.org.

 

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Tuesday, June 2, 2020 – 7:33 p.m.

Today, the Department of Health confirmed 612 new positive cases of COVID-19 in Pennsylvania – an increase of 256 cases as compared to yesterday. This brings the statewide total to 72,894.

County-specific information and a statewide map are available here.

A few important updates:

PHCA to Host Tele-Townhall with Pennsylvania Senator Pat Toomey
Join us tomorrow at 3:45 p.m. for a tele-townhall with Pennsylvania Senator Pat Toomey. During the call, we’ll discuss the challenges facing long-term care providers in the midst of the COVID-19 pandemic.

There will be opportunities for us to ask questions of Senator Toomey as well.

To request call-in information from PHCA, click here.

New Guidance Released re: Risk Assessment and Work Restrictions
Today, the Department of Health released new guidance to simplify the determination of risk exposures to COVID-19 that warrant work restrictions.

If you have any questions, please contact Gail Weidman or Chris Fisher.

Upcoming PHCA Webinar on Focused Infection Control Surveys
In light of yesterday’s announcement by CMS that it will increase fines as it relates to infection control measures, PHCA will be hosting a webinar to provide the most up-to-date information about what this enhanced enforcement policy means for nursing homes, and the strategies you can employ to mitigate potentially crippling new enforcement remedies.

Webinar information is below:

CMS Mandates On-Site Focused Infection Control Surveys: Implications and Strategies
Friday, June 5, 2020 – 11 a.m. to noon
This webinar is for nursing home administrators, directors of nursing, infection preventionists, social workers, environmental services, dietary and the entire nursing home interdisciplinary team. Attendees are eligible to receive one CEU credit.

To register, click here.

 

Monday, June 1, 2020 – 7:41 p.m.

Today, the Department of Health confirmed 356 new positive cases of COVID-19 in Pennsylvania – a decrease of 155 cases as compared to yesterday. This brings the statewide total to 72,282.

During today’s DOH press conference, Secretary Levine encouraged long-term care providers in need of additional support to contact the Department of Health as quickly as possible to ensure access to all available resources.

If you need additional support related to DOH issues, or you just need to ask for help, please reach out to Chris Fisher or Gail Weidman at PHCA so we can connect you with the appropriate Health contact.

County-specific information and a statewide map are available here.

A few important updates:

Please Take A Minute to Say ‘Thank You’!
This morning, you received an email from PHCA, regarding our ‘thank you’ campaign for legislators across the state. Our Representatives and Senators stepped up and directed nearly $300 million in critical emergency funding to support nursing homes, personal care homes and assisted living communities.

We know your time is extremely limited, so we made this as simple as possible. If you haven’t already, please take a minute and say ‘thank you‘ to your legislators and Governor Wolf for their help.

CMS Announces Tougher Penalties, Enforcement for Infection Control Deficiencies
This evening, CMS announced it will increase fines for providers who consistently perform poorly in infection control measures, and they will begin imposing enforcement actions on lower level deficiencies “to ensure they are addressed with increased gravity.”

CMS said it will toughen penalties based on early COVID-19 data trends, as well as findings of the agency’s targeted infection control inspections.

As soon as we have more information, we will share it with you.

DOH Releases New Guidance Impacting Survey123 Tool
Over the weekend, the Department of Health released new guidance – PAHAN-509 – which provides updated guidance for testing in long-term care settings.

A few important things to note:

SNF providers: Facilities are now being asked to report the total number of cases going back to March 6, not January 1. In addition, the Department will also be adding a second question to the Survey123 tool to collect the number of new cases in the past week.

The Department is having issues updating Survey123 questions to align with guidance included in the FAQ document. The survey questions may not align with this FAQ document; however, the Department is continuing to troubleshoot these issues.

 

 

Friday, May 29, 2020 – 6:12 p.m.

Tonight, we have a very important update for you.

After weeks of diligent advocacy, aggressive messaging and a refusal to back down, we can tell you that help is officially on the way.

Earlier this afternoon, Governor Tom Wolf signed House Bill 2510, the COVID-19 Relief legislation, into law.

This legislation includes $245 million in emergency funding for Pennsylvania’s nursing homes, as well as $50 million for our AL/PC communities.

The Fiscal Code bill was also signed into law, which includes a $16 million Medicaid Day One Incentive (MDOI) payment for our high Medicaid nursing facilities.

There will be more details about how this funding will be distributed to providers in the days and weeks to come, but we wanted to share this news with you as soon as possible.

There’s really only one thing to say: thank you.

Thank you for all your hard work throughout this epidemic.

We could not be proud to represent the most dedicated staff and provider community in Pennsylvania.

This is a very proud day for PHCA, and this is a fantastic achievement for our membership.

 

 

Thursday, May 27, 2020 – 7:19 p.m.

Today, the Department of Health confirmed 625 new positive cases of COVID-19 in Pennsylvania – a decrease in 155 cases as compared to yesterday. This brings the statewide total to 70,042.

County-specific information and a statewide map are available here.

A few important updates:

Important News! Funding for Long-Term Care Heads to Governor Wolf for Approval
Moments ago, long-term care providers in Pennsylvania were officially honored and recognized by the Pennsylvania General Assembly. Thanks to leadership in the House and Senate, we are one step closer to the critical emergency funding you so desperately need.

The Pennsylvania General Assembly – in a united, bipartisan effort – has approved nearly $300 million to directly support nursing homes, personal care homes and assisted living communities.

The funding is contained in House Bill 2510, and that bill now heads to Governor Tom Wolf’s desk. The Governor can sign it into law, veto it or take no action for 10 days (when it will become law without his signature). We have urged Governor Wolf to sign this bill as soon as possible to get you the funding you need.

Today’s action by the General Assembly sent a clear message of support to PHCA members across the state.

We could not be more proud to report this news to you, and we’ll keep you updated on the Governor’s action.

Clarification on New Reporting Requirements for AL/PC
We know there have been questions regarding the new reporting process for assisted living residences and personal care homes.

This morning, we received clarification on the final reporting guidance issued yesterday from the Director of BHSL:

  • If the community has no COVID-19 positive cases in the community, no reporting is required.
  • If the community has no COVID-19 positive cases and is testing residents and/or staff, no reporting is required unless a test comes back positive.
  • If the community has at least one COVID-19 positive case, the community is required to report all residents and/or staff tested in the community and the results of the test.
  • The report, if possible, should be sent encrypted, as it includes resident and staff identifying information. If this is not possible, the report can be sent via fax.

If you have any questions, please don’t hesitate to reach out to Gail Weidman or Kevin Cysyk on the PHCA team.

 

 

Wednesday, May 26, 2020 – 7:30 p.m.

Today, the Department of Health confirmed 780 new positive cases of COVID-19 in Pennsylvania – an increase of 329 cases as compared to yesterday. This brings the statewide total to 69,417.

County-specific information and a statewide map are available here.

A few important updates:

PA Legislature Expected to Take Action on Long-Term Care Funding & State Budget
Since the beginning of the COVID-19 epidemic, PHCA members have advocated for more support and state dollars from Governor Tom Wolf and members of the General Assembly.

We’ve told you before: the state and your elected officials have heard you, loud and clear.

As it stands now, nursing homes are set to receive $245 million in emergency funding, and AL/PC providers will receive $50 million from the federal CARES Act.

This funding is currently being considered in the state Senate, and we expect to see movement and final approval this week.

We could not be more proud to report this news to you, and we’ll keep you updated.

Reminder: New Reporting Requirements for AL/PC Go Into Effect Tonight
For our AL/PC members: we have been working with DHS to obtain additional details regarding the new reporting requirement that was issued last Friday, May 22.

Effective tonight at midnight, all personal care homes and assisted living residences will be required to submit information regarding all residents and staff who test positive for COVID-19, including resident deaths.

Late last night, DHS issued final reporting requirement guidance and a facility COVID-19 tracker (Excel document) to be used for reporting purposes. This tracker should be completed upon the first notification of a positive COVID-19 case and submitted as new cases are identified.

If you have any questions, please don’t hesitate to reach out to Gail Weidman or Kevin Cysyk on the PHCA team.

CMS Announces New Webinar for Nursing Home Providers
CMS will be hosting a new webinar, Establishing an Infection Prevention Program and Conducting Ongoing Infection Surveillance in the Nursing Home, tomorrow at 4 pm. This webinar will help participants to identify the basic components of an infection prevention program in the nursing home setting; describe the best-practice strategies needed to establish a program; and understand the key elements necessary for ongoing infection prevention surveillance.

Advanced registration is required. To register, click here.

Once you register, you will receive an email with a unique web link to join the webinar.

 

 

Tuesday, May 26, 2020 – 7:12 p.m.

Today, the Department of Health confirmed only 451 new positive cases of COVID-19 in Pennsylvania – a decrease of 22 cases as compared to yesterday. This brings the statewide total to 68,637.

County-specific information and a statewide map are available here.

A few important updates:

DHS Offers Expedited Direct Care Staff Training Program for AL/PC Providers
The Department of Human Services is offering a new expedited direct care staff orientation training program to help train new staff quickly in the event a facility experiences a staffing shortage. This training is being offered by Temple University Harrisburg and includes all required trainings at-hire (except those that must be provided at the facility).

To access the training program, go to TUHLearn.com and select Direct Care Staff Training for Personal Care Home and Assisted Living Residences. The program is free to participants, will take approximately 4 hours to complete, and includes Knowledge Checks throughout the modules.

Lancaster County Offering COVID-19 Support to Long-Term Care Providers
Lancaster County officials are working with nursing homes to provide additional support and resources including disinfecting services, expanded testing capabilities and infection control training to mitigate COVID-19.

Nursing facilities and personal care homes in Lancaster County in need of disinfecting services can submit a request here.

The county has also approved agreements with two lab providers to offer high-volume COVID-19 testing of asymptomatic residents and staff. These providers are prepared to visit all nursing homes in Lancaster County to collect specimens. Test results will be provided within 72 hours. In order to be tested, residents and front line staff will need to authorize the release of test results to third parties for tracing purposes. All specimens will be collected with nasopharyngeal swabs. For more information about this testing program, click here. To request testing support, click here.

In addition, nursing facilities interested in onsite reviews, infection prevention protocol and PPE training can request these services here.

All costs associated with these services will be covered by Lancaster County using COVID-19 funds.

PHCA COVID-Related Webinars Available
Our next PHCA webinar is:

Truth or Fiction: COVID-19 Reporting in Pennsylvania
Tomorrow, May 27 – 2 p.m. to 3 p.m.
This webinar will examine state and federal requirements for reporting COVID-19 data to federal, state, and local agencies; strategies for communicating with residents, families, and staff; and review best practices for documentation.

This webinar is for nursing facilities, nursing facility administrators, directors of nursing, social workers and business office managers. Attendees are eligible to receive one CEU credit.

To register, click here.

 

 

Friday, May 22, 2020 – 6:09 p.m.

Today, the Department of Health confirmed 866 new positive cases of COVID-19 in Pennsylvania – a decrease of 114 cases as compared to yesterday. This brings the statewide total to 66,258.

County-specific information and a statewide map are available here.

During this afternoon’s press conference, Gov. Tom Wolf announced eight additional counties will move to yellow and 17 counties will move to green, beginning Friday, May 29. The counties moving to yellow on May 29 are Dauphin, Franklin, Huntingdon, Lebanon, Luzerne, Monroe, Pike, and Schuylkill.

The 17 counties moving to green are Bradford, Cameron, Clarion, Clearfield, Crawford, Elk, Forest, Jefferson, Lawrence, McKean, Montour, Potter, Snyder, Sullivan, Tioga, Venango and Warren.

A few important updates:

SNF Member Alert: Survey123 Reporting Requirement
Earlier today, we sent out a member alert to all nursing home administrators regarding the Department of Health Survey123 reporting requirement.

This morning, the Department confirmed it will be using that tool to publicly report their data, but they need help ensuring every facility completes it on a daily basis.

With this in mind, we encourage you to sign-up (if you haven’t already) and complete the Survey123 tool. Here are several resources that may be helpful:

Please email the RA Account at RA-DHSNFQUESTION@pa.gov, with any enrollment, submission, or data discrepancies.

New Reporting Requirements Released for AL/PC
This morning, the Department of Health issued an order related to DHS facility reporting. The order goes into effect at 12:01 a.m. on Thursday, May 28. 

According to the order:

  • All licensed Personal Care Homes and Assisted Living Facilities must begin reporting the data elements established by the Department of Human Services in consultation with the Department of Health.
  • Reports will be made on a schedule and in a manner established by the Department of Human Services in consultation with the Department of Health.
  • The Department of Human Services will report the data collected from all Personal Care Homes and Assisted Living Facilities to the Department of Health in a format acceptable to the Department of Health.

Based on our discussions with Jeanne Parisi, BHSL’s director, the reporting tool will be an Excel spreadsheet that must be completed and submitted to the RA headquarters account. AL/PC providers will be required to send updates as new cases are identified.

We will share the specific details on the reporting tool as soon as they are available.

AHCA/NCAL Launches Professional Liability Benchmark Survey
AHCA/NCAL – our national organization – is working with Marsh & McLennan to conduct a long-term care professional liability report for our sector. This study is a critical component in various insurance industry initiatives and supports multiple state tort reform efforts.

This year’s analysis is critical to establish a pre-COVID-19 baseline, and we strongly encourage participation (the completion date is June 1). We ask this, knowing full well you are inundated with surveys, reporting and other required mandates from the government.

Review this resource for more information and consider utilizing this template to make the data collection as easy as possible. This information should be provided separately for assisted living facilities and skilled nursing facilities.

If you have any questions, please contact Zane Barrick.

PHCA COVID-Related Webinars Available
Our next PHCA webinar is:

Truth or Fiction: COVID-19 Reporting in Pennsylvania
Wednesday, May 27 – 2 p.m. to 3 p.m.
This webinar will examine state and federal requirements for reporting COVID-19 data to federal, state, and local agencies; strategies for communicating with residents, families, and staff; and review best practices for documentation.

This webinar is for nursing facilities, assisted living residences, and personal care homes. Attendees are eligible to receive one CEU credit.

To register, click here.

 

Thursday, May 21, 2020 – 6:30 p.m.

Today, the Department of Health confirmed 980 new positive cases of COVID-19 in Pennsylvania – an increase of 234 cases as compared to yesterday. This brings the statewide total to 65,392.

County-specific information and a statewide map are available here.

A few important updates:

PHCA Response to DOH Public Reporting Failures
As we first reported on Tuesday, the initial data compiled and released by the Department of Health to the general public included inaccuracies, inconsistencies and incorrect information. We’ve heard from dozens of members – including nursing homes, personal care homes and assisted living communities – regarding the misleading data.

And as we reported yesterday, our call with DOH and the Governor’s Office gave us little to no confidence as to how they were compiling the data themselves.

So last night and throughout today, we spoke out in several interviews with newspaper, radio and television outlets across the state and made our displeasure well-known. We have demanded DOH and the Governor’s Office correct the data as soon as possible, and we continue to review our options to rectify this unfortunate situation.

As a reminder, we’ve created these talking points to help you with any questions you receive.

Please know: we will continue to support you in any way we can.

Changing the Perception of Long-Term Care
As situations arise throughout Pennsylvania, such as Tuesday’s reporting error, we promise to communicate the challenges you are facing every day in your facilities. The critical support you need on the front lines – emergency funding, testing, personal protective equipment – is finally being addressed by reporters and media outlets across the state. Frankly, these issues are too important to ignore. And your elected officials are hearing this as well.

Every day this week, we’ve participated in critical interviews. We’re working to get your message out, and to ensure your voice is heard.

Here is a quick collection of stories we have contributed to over the last several weeks. Special thanks to a few PHCA members who are featured as well:

REMINDER: Testing Survey
Earlier this week, a new testing survey was sent to every nursing home asking for a response no later than Monday, May 25. The goal of the survey is to help the state understand how many nursing facilities have already implemented or are pursuing testing for residents and staff.

Today, AL/PC providers should’ve received a similar survey, issued by the Department of Human Services, which is due Tuesday, May 26. That link can be found here.

The goal of these surveys is to outline the needs for expanded testing capabilities.

If you have questions about the survey, please contact pema_gis@pa.gov. If you have questions about testing, please email DH-COVIDtesting@pa.gov.

 

 

Wednesday, May 20, 2020 – 8:43 p.m.

Today, the Department of Health confirmed 746 new positive cases of COVID-19 in Pennsylvania – an increase of 136 cases as compared to yesterday. This brings the statewide total to 64,412.

County-specific information and a statewide map are available here.

Interestingly, the DOH did not hold a media briefing today, citing “an issue with the statewide surveillance data system.”

A very important update:

DOH Public Reporting
Since the first batch of long-term care data was publicly reported by DOH yesterday afternoon, we’ve heard from dozens of members – including nursing homes, personal care homes and assisted living communities – regarding the significant inaccuracies and inconsistencies in the numbers. In some instances, the number of resident cases exceeded the number of residents in a facility.

We demanded a call with DOH and the Governor’s office, and that call was held this afternoon. We asked a few important questions:

  • Where did this data come from?
  • When will it be corrected?
  • Until it’s corrected, will it be taken down from public view?

The data was pulled from the ‘surveillance system’ which incorporates a great deal of reporting databases, and the Department is working to correct it as soon as they possibly can. But there is no plan to retract the incorrect data (as of now).

The new reporting system, Survey123, is the system they’d like to use, but only 500 of the 695 nursing homes have reported thus far. Additionally, AL/PC does not report to that system (yet).

The Department will be sending us a list of those nursing homes that have not submitted data to Survey123, and we’ll be reaching out to you directly. We have a call scheduled with DHS tomorrow to hear how this will affect our AL/PC members.

We understand the concern, panic and angst that this data has generated among your facility staff, residents and the family members and loved ones of those residents.

We have made our displeasure well-known to members of the media already, and we are currently reviewing our options to rectify this unfortunate situation.

In the meantime, we would encourage you to be transparent with the families and loved ones of your residents. Explain the information released, and answer any questions they may have.

If you are having difficulties with the Survey123 process, please reach out to PHCA, or email: RA-DHSNFQUESTION@pa.gov.

 

 

Tuesday, May 19, 2020 – 7:55 p.m.

Today, the Department of Health confirmed 610 new positive cases of COVID-19 in Pennsylvania – a decrease of 212 cases as compared to yesterday. This brings the statewide total to 63,666.

County-specific information and a statewide map are available here.

A few very important updates:

DOH Launches Public Reporting of COVID Info in Long-Term Care Facilities
Earlier today, the Department of Health released data on the number of COVID-19 cases and deaths in specific facilities across the state. The data is compiled on an Excel spreadsheet and includes three categories: Number Of Resident Cases, Number Of Employee Cases, and Number Of Deaths. If a facility has less than five of any of those data points, the information is redacted.

As we’ve examined today’s report, it is clear there are significant inaccuracies and inconsistencies. In some instances, the numbers are blatantly incorrect.

Since the data was reported, we’ve spoken with DOH leadership, and a call will be scheduled tomorrow. We have officially asked that the data be removed from the DOH website until it is corrected.

We apologize for the confusion this will likely cause your staff, as well as the family members of your residents.

These numbers may also result in inquiries from the media. We’ve created these talking points to help you with any questions you receive.

New DOH Testing Survey
Yesterday, the Department of Health released another new testing survey to all nursing homes asking for a response no later than Monday, May 25. The goal of the survey is to help the Department understand how many nursing facilities have already implemented or are pursuing testing for residents and staff. We believe the goal of the survey is to outline the needs for expanded testing capabilities.

If you have questions about the survey, please contact pema_gis@pa.gov. If you have questions about testing, please email DH-COVIDtesting@pa.gov.

Guidance Available for Employees Needing FBI Background Checks
DHS today released guidance for employees needing FBI criminal history background checks as a condition of employment while counties are operating under stay-at-home orders.

Individuals who are required to obtain an FBI background check are given additional time to meet this requirement if they are unable to complete their fingerprinting scan due to the COVID-19 pandemic. The extension for new hires to obtain the FBI background check lasts until 60 days following the expiration of the disaster emergency declaration issued by Governor Wolf, or December 31, 2020, whichever is sooner.

DHS has issued guidance so providers and potential employees understand what flexibility is available and how they can still receive fingerprinting services to obtain background checks now. FAQs are available here.

A map of all open IdentoGO locations is available here, and this map is updated as new offices begin to reopen. Anyone seeking fingerprinting services should call IDEMIA’s customer service at 844-321-2101 to ensure the location is still operating, schedule an appointment, and discuss necessary safety precautions.

CHC Webinar Announced for Thursday
The next Community HealthChoices (CHC) Third Thursday webinar will be held this Thursday, May 21 at 1:30 p.m.

Office of Long-Term Living (OLTL) Deputy Secretary, Kevin Hancock, will be providing updates on COVID-19.

To register, click here. After registering, you will receive a confirmation email containing additional details necessary to join the webinar.

 

 

Monday, May 18, 2020 – 7:40 p.m.

Today, the Department of Health confirmed 822 new positive cases of COVID-19 in Pennsylvania – an increase of 199 cases as compared to yesterday. This brings the statewide total to 63,056.

County-specific information and a statewide map are available here.

A few important updates:

Updates on DOH Universal & Recurring Testing Guidance
We continue to seek additional guidance and information related to the Department of Health’s universal testing directive released last Tuesday. DOH is now working on a formal plan to support the implementation of universal testing, and we may see updated language in the PA HAN 508 that was also issued last week.

Based on today’s calls with the Department, we believe the plan has already begun to take shape in northeast and southeast PA.

Note to nursing home providers: you may be contacted by representatives of PEMA, the DOH, the Hospital Association (HAP) or other entities to determine if your facility would like to be included in a testing ‘pilot program’. This program will include a site visit, walkthrough, review of infection control procedures and protocols, a review of testing protocols, and a final testing phase.

A few PHCA members have already been contacted, and have entered into the pilot program.

We should be receiving additional information on this program. Please contact Gail Weidman or Chris Fisher on the PHCA team if you have any questions.

We will update you as soon as the final plan and/or guidance is released.

New Nursing Home Reporting System Clarification
On Friday evening, we communicated that DOH would be requiring additional reporting for nursing home providers, similar to the information you already report to the CDC.

Now that the system is up and running, we’re receiving clarification on which information DOH needs. While this is a similar report to the NHSN reporting system, they are not the same.

This new system, Survey123, must be updated daily, while the NHSN system requires a weekly update.

We’re now being told that cumulative data should revert back to the beginning of the COVID-19 outbreak (January 1, 2020).

If you have questions, please reach out to us at PHCA, or contact: ra-dhSNFquestion@pa.gov.

We will continue to advocate for a single reporting system.

CMS Issues Guidance to States on Reopening Nursing Homes: Universal Testing Needed to Lift Visitation Ban

This afternoon, CMS released guidelines on reopening nursing homes, with parameters around testing requirements and visitation.

CMS announced that states have flexibility in deciding how the criteria in the guidelines should be implemented, given how the COVID-19 pandemic is affecting different communities.

This information is quickly developing. We will share additional information with you as we receive it.

Respirator Decontamination Program Available to All Long-Term Care Providers
In early May, Gov. Wolf announced a program to provide free N95 respirator decontamination for long-term care providers experiencing a shortage of respirators due to limited availability of PPE. You should have received information about this program from PEMA, the DOH and HAP.

PEMA is collaborating with Battelle Memorial Institute to deploy a decontamination unit in southeast Pennsylvania that has the capacity to sterilize up to 80,000 N95 respirators per day.

This service is available free of charge for skilled nursing facilities, assisted living communities and personal care homes. The only cost to providers is shipping costs to and from the decontamination site.

For more information about the program, click here.

 

Friday, May 15, 2020 – 8:14 p.m.

Today, the Department of Health confirmed 986 new positive cases of COVID-19 in Pennsylvania – an increase of 48 cases as compared to yesterday. This brings the statewide total to 60,622.

County-specific information and a statewide map are available here.

Additionally, Governor Tom Wolf announced 12 more counties will move to the ‘yellow phase’ of reopening on Friday, May 22. Those counties are: Adams, Beaver, Carbon, Columbia, Cumberland, Juniata, Mifflin, Perry, Susquehanna, Wyoming, Wayne, and York.

A few important updates:

A NEW Reporting Requirement from DOH: Due TOMORROW
We apologize for sending today’s update so late, but we have been fighting for clarification on the latest reporting requirement issued by the Department of Health. As you’re likely aware, this new order requires every nursing home to report COVID-specific information to the Department for their public reporting purposes.

The first report is due by 11:59 p.m. tomorrow (5/16).

Since the announcement was made earlier today, we had worked to obtain guidance on this order and delay its implementation.

However, less than 45 minutes ago, administrators should have received an email from the Department of Health, indicating the seriousness of this order as a ‘public health imperative’. There will be no delay in implementation – the information is due by midnight tomorrow.

Below, please find two documents that were distributed late this afternoon regarding this new reporting process:

If you are having difficulties compiling this data, or you’re experiencing technical difficulties, please email: RA-DHSNFQUESTION@pa.gov.

This new, duplicative requirement is extremely disappointing. Once again, the Department of Health has prioritized paperwork over patients.

PHCA will be responding accordingly.

Application Submission for Communicative Technology Now Open
We know many facilities are using iPads, tablets, webcams, etc. to keep residents in communication with their loved ones. Today, Pennsylvania received approval to use funds from Civil Monetary Penalties (CMPs) for technology that allows residents to engage in virtual social opportunities and telehealth visits.

If you are interested in taking advantage of this opportunity, please:

  • Review the Frequently Asked Questions for State Medicaid Agencies document.
  • Complete the electronic template application developed by CMS. The request must be for communicative technology, such as tablets and accessories including headphones and tablet protectors, for use by nursing homes, other healthcare providers, and state agencies.
  • Complete the Commonwealth of Pennsylvania General Invoice. Only those sections highlighted in Yellow need to be completed by the Nursing Facility. Please make sure that the description and costs of the communicative technology on the invoice and the CMS application match.

To submit the required forms by May 31 or for questions related to this program, email RA-PWCMPGRANTS@pa.gov.

CMS Issues Nursing Home ‘Best Practices’ Toolkit to Combat COVID-19
CMS has released a new toolkit intended to serve as a catalog of resources for nursing homes.

The goal of the toolkit is to outline best practices for a variety of subjects, ranging from infection control to workforce and staffing.

 

 

Thursday, May 14, 2020 – 8:24 p.m.

Today, the Department of Health confirmed 938 new positive cases of COVID-19 in Pennsylvania – an increase of 231 cases as compared to yesterday. This brings the statewide total to 59,636.

A few important updates:

‘Universal’ Testing
From the moment our Secretary of Health announced an initiative for universal testing for long-term care residents and staff (which took place only two days ago), we’ve attempted to gather information and guidance for you and your facilities.

How will facilities obtain testing kits? When should testing begin? How often should you test? What happens if the number of positive tests climbs exponentially?

We’ve asked these questions, and we continue to gather additional information about the testing plan, its implementation, and a potential webinar hosted by the Department of Health that will help to clarify guidance and move us forward.

Unfortunately, it appears as if there are very few specifics available. In fact, it’s difficult to tell if this is a mandate or a recommendation – or neither.

Please continue to reach out to us with questions, and we’ll get you information as quickly as possible. We hope to have clarification soon.

CMS Announces COVID-19 Data on Nursing Home Compare
Earlier today, CMS Administrator Seema Verma announced that newly required COVID-19 data compiled by the federal government will appear on Nursing Home Compare, with the first public information expected to be released by the end of this month.

As a reminder, the first round of data must be uploaded to the NHSN module by this Sunday, May 17.

DOH Releases Updated Guidance for Nursing Homes
Earlier today, the Department of Health released new interim guidance for nursing facilities. This guidance replaces the initial guidance issued on March 18 and provides greater detail regarding personnel allowed to access the facility amid visitor restrictions; health care personnel who become ill during their shift; admissions and readmissions for residents exposed to COVID-19; and testing for COVID-19 upon discharge from a hospital.

It also includes a new section around cohorting residents and Knowledge Center reporting.

If you have any questions, please don’t hesitate to reach out to Gail Weidman or Chris Fisher on the PHCA team.

PHCA COVID-Related Webinars Available
We understand how busy you are as you continue to respond to COVID-19, but we also know you and your staff are still in need of CEU credits. As such, all COVID-related webinars and associated credits will be free of charge for members and non-members. Our next webinar is:

COVID-19, the Courts, and Medicaid Eligibility: Navigating and Overcoming the Challenges
Thursday, May 21 – 2 p.m. to 3 p.m.
Skilled nursing administrators, business office managers, and business office staff are encouraged to register. Attendees are eligible to receive one CEU credit.
To register, click here.

 

 

Wednesday, May 13, 2020 – 7:33 p.m.

Today, the Department of Health confirmed 707 new positive cases of COVID-19 in Pennsylvania – a decrease of 130 cases as compared to yesterday. This brings the statewide total to 58,698.

The state is reporting an increase of 135 new deaths today, bringing the statewide total to 3,943 deaths in Pennsylvania. County-specific information and a statewide map are available here.

A few important updates:

AG Josh Shapiro Announces Criminal Investigations into Nursing Homes
Yesterday, Attorney General Josh Shapiro announced his office has opened criminal investigations into several Pennsylvania nursing homes, and he would investigate any nursing home engaging in criminal neglect of patients and residents.

The attorney general has shared no specific area of investigation with us, but the announcement seems to indicate the examination of our long-term care facilities is connected to negligent care provided during the COVID-19 pandemic.

As we have communicated publicly, this is a time when we need the state to partner with you on essential initiatives. We hope to work with the attorney general, his staff, and all levels of state government in partnership, rather than opposition, moving forward.

We’ll let you know when we learn more.

Wellness Wednesday Programming and Resources Available
Aegis, a PHCA business partner, has launched Wellness Wednesday, a new program for your staff to practice self-care during this stressful time. Each activity is designed to take about 10 minutes or less, and will walk you through an activity to support overall wellness.

Today’s Wellness Wednesday activity is Breathing Techniques for Beginners.

New PHCA Webinars: Stress Management and COVID-19
We understand how busy you are as you continue to respond to COVID-19, but we also know you and your staff are still in need of CEU credits. As such, all COVID-related webinars and associated credits will be free of charge for members and non-members.

Our upcoming webinars include:

Embrace the Glorious Mess That is You
Thursday, May 14 – 2 p.m. to 3 p.m.
All are encouraged to register and are eligible to receive one CEU credit.
To register, click here.

COVID-19, the Courts, and Medicaid Eligibility: Navigating and Overcoming the Challenges
Thursday, May 21 – 2 p.m. to 3 p.m.
Skilled nursing administrators, business office managers, and business office staff are encouraged to register. Attendees are eligible to receive one CEU credit.
To register, click here.

 

 

Tuesday, May 12, 2020 – 8:51 p.m.

Today, the Department of Health confirmed 837 new positive cases of COVID-19 in Pennsylvania – an increase of 294 cases as compared to yesterday. This brings the statewide total to 57,991.

The state is reporting an increase of 75 new deaths today, bringing the total to 3,806 deaths in Pennsylvania. County-specific information and a statewide map are available here.

A few important updates:

Funding News for ALL Long-Term Care Providers
Earlier today, the state Senate approved Senate Bill 1122, which originally contained $200 million in emergency funding for nursing homes.

However, I am pleased to report the bill was amended today to include additional monies for nursing homes, as well as our assisted living and personal care membership.

As it stands now, nursing homes are set to receive $245 million, and AL/PC providers will receive $50 million in state funds taken from the federal CARES Act.

Throughout the last three weeks, we have put a great deal of pressure on the Governor, his administration, and members of the General Assembly. This is a big result of that campaign.

The bill now goes to the House of Representatives, where we’ll continue to advocate for you.

We could not be more proud to report this news to you, and we’ll keep you updated.

DOH Releases Guidance on Universal Testing Strategy for LTC Residents, Staff
Earlier today, Department of Health Secretary Dr. Rachel Levine released new testing guidance for universal testing of long-term care residents and staff. This new guidance was released after weeks of urging and advocacy.

While we’re encouraged by the Department of Health’s announcement, we recognize there are a number of questions regarding the implementation and timing of this testing strategy. It’s also unclear if this guidance includes residents and staff in assisted living communities and personal care homes.

In the absence of additional information from the Department, we encourage you to contact DOH to seek information on preferred vendors, testing protocols, availability of tests and reimbursement for testing. You should also ask for more information related to documentation requirements should a resident – or staff member – refuse to be tested. Document, document, document all of your communications with the state health department and the steps you take as a result.

We hope to have true guidance soon, and we’ll update you as soon as we know more.

 

 

Monday, May 11, 2020 – 5:22 p.m.

Today, the Department of Health confirmed 543 new positive cases of COVID-19 in Pennsylvania – a decrease of 752 cases as compared to yesterday. This significant decrease in positive cases is likely a result of decreased reporting by independent labs over the weekend. This brings the statewide total to 57,154.

The state is reporting an increase of 200 new deaths today, bringing the total to 3,616 deaths in Pennsylvania. County-specific information and a statewide map are available here.

This morning, Governor Tom Wolf held a press conference in which he urged counties and businesses to follow the state’s COVID-19 mitigation efforts, or there would be consequences (withholding of federal funding, loss of business licenses, etc.).

In addition, Governor Wolf announced 13 additional counties will move to the ‘yellow’ phase of reopening this Friday. Those counties are Allegheny, Armstrong, Bedford, Blair, Butler, Cambria, Fayette, Fulton, Greene, Indiana, Somerset, Washington and Westmoreland.

A few important updates:

White House Recommends States Test All Nursing Home Residents & Staff
During a conference call today with state governors, Vice President Mike Pence strongly encouraged all states to focus their efforts on testing nursing home residents and direct care workers. White House coronavirus task force coordinator Deborah Birx, M.D., added that the federal government will help if necessary, but the administration’s position is that states must take the lead.

During this afternoon’s press conference, Department of Health Secretary Dr. Rachel Levine announced the department was working on plans to prioritize testing for nursing home residents and staff and would be releasing that plan later this week.

We’ll update you as soon as we know more.

NHSN COVID-19 Reporting: Accurately Reporting Staffing and PPE Shortages
NHSN COVID-19 mandated reporting for nursing homes has officially begun. AHCA recommends accurately reporting the staffing and PPE situation at nursing homes based on normal standards and guidance for PPE and staffing, not conservation guidance. Federal and state governments will use this data to hold nursing homes accountable for care and services provided and to identify who needs additional resources.

For Staffing, NHSN asks “Does your organization have a shortage of staff and/or personnel?” Answer YES if any of the following are occurring during the time period of reporting:

  • Staffing less than your facility needs or internal policies for staffing ratios prior to COVID or based on increased needs since COVID
  • Employing contingency or crisis strategies for staffing shortage
  • Using more agency staff than you used before the pandemic
  • Using volunteers for staffing needs more than what you may have used prior to the pandemic
  • Using any temporary positions per waiver allowances (such as temporary nurse aide or temporary feeding assistant)

For PPE, NHSN asks “Do you have enough for one week?” each for N95 masks, surgical masks, eye protection, gowns, gloves, alcohol-based hand sanitizer. Answer NO if any of the following are occurring during the time period of reporting:

  • Employing any conservation strategies for PPE use; if you are not able to use PPE per conventional transmission-based precautions in place before the pandemic you should answer NO.
  • Using alternative PPE such as cloth masks or other types of face coverings, clothing or other types of coverings instead of surgical gowns, or glasses for eye protection
  • Reusing any single-use supply item such as gown or masks
  • If additional residents in the next week will need to be placed on precautions, it will compromise your PPE supply
  • If additional staff in the next week will need to use PPE when returning to work, it will compromise your PPE supply
  • If visitors or contractors in the next week need to visit, it will compromise your PPE supply

New PHCA Webinars: COVID-19 Testing and Stress Management
We understand how busy you are, and we also realize you and your staff are still in need of CEU credits. As such, all COVID-related webinars and associated credits will be free of charge for members and non-members.

Our upcoming webinars this week include:

COVID-19 Testing – Clarifying the Options for Post-Acute Care
Wednesday, May 13 – 2 p.m. to 3 p.m.
To register, click here.

Embrace the Glorious Mess That is You
Thursday, May 14 – 2 p.m. to 3 p.m.
To register, click here.

 

 

Friday, May 8, 2020 – 6:04 p.m.

Today, the Department of Health confirmed 1,323 new positive cases of COVID-19 in Pennsylvania – an increase of 253 cases as compared to yesterday. This brings the statewide total to 54,238.

The state is reporting an increase of 200 new deaths today, bringing the statewide total to 3,616 deaths in Pennsylvania. County-specific information and a statewide map are available here.

A few important updates:

PHCA Testifies Before House Aging and Older Adult Services Committee
Earlier today, we testified again before Pennsylvania’s House of Representatives’ Aging and Older Services Committee.

Today’s testimony was similar to the sentiment we shared yesterday before the Senate Aging and Youth and Health and Human Services Committees.

We are proud to share your message with legislators, and we’ll continue to advocate for your needs as long as it takes.

Additional Resources Related to NHSN and Family Reporting Now Available
Below, you’ll find two documents that may be helpful for nursing home operators as we work toward compliance with the new CMS Interim Final Rule related to notification and reporting of COVID-19 cases:

Please note: If your nursing home has any resident and/or staff cases as of today (Friday, May 8) as described by CMS as ‘requiring notification’, the first notification is required to occur by tomorrow (Saturday, May 9) at 5 p.m. The notification is required if your nursing home had a single new COVID-19 case among residents or staff or three or more residents or staff who have new-onset respiratory symptoms within a 72- hour period.

NHSN Enrollment Delays and Tips
It is taking longer than anticipated for nursing homes to enroll in the CDC’s National Healthcare Safety Network (NHSN) due to high demand from the new CMS reporting requirements.

NHSN is providing two live Zoom sessions to address enrollment specific questions. After registering, you will receive a confirmation email containing information about joining the meeting:

Tuesday, May 12, 2020 – 1:00 PM
Register Here

Thursday, May 14, 2020 – 2:00 PM
Register Here

BHSL Provides New Resources on Abuse Training and Clarification Around Visitation Restrictions
Linked here are two new resources related to online training and clarification around visitation restrictions:

If you have any questions or if we can be of any assistance, please reach out to Gail Weidman or Chris Fisher.

PHCA Webinar: COVID-19 Testing – Clarifying the Options for Post-Acute Care
We want to continue to support your educational needs by providing webinar offerings related to the #COVID19 challenges you are facing.

Join us this Wednesday, May 13th for a webinar hosted by Medline: COVID-19 Testing – Clarifying the Options for Post-Acute Care. Webinar attendees will receive one CEU credit.

To register, click here.

 

Thursday, May 7, 2020 – 6:33 p.m.

Today, the Department of Health confirmed 1,070 new positive cases of COVID-19 in Pennsylvania – an increase of 182 cases as compared to yesterday. This brings the statewide total to 52,915.

The state is reporting an increase of 310 new deaths, bringing the statewide total to 3,416. This increase in reported deaths is a result of the ongoing reconciliation of data over the past several weeks. County-specific information and a statewide map are available here.

A few important updates:

PHCA Testifies Before Pennsylvania Senate on COVID-19
This morning, I was proud to testify before a joint committee hearing of the Pennsylvania Senate Aging and Youth and Health and Human Services Committees.

You can watch my testimony here.

The initiatives we shared with members of the state Senate include many of the points we continue to advocate for in PHCA’s Long-Term Care Plan for Pennsylvania, which outlines the critical need for emergency funding, priority testing, priority personal protective equipment, medical liability protections and collaboration with state government.

And our pleas for help are being answered. Today, we’ve received a number of calls from legislators who recognize the challenges you’re facing and want to help you and your residents. They’re asking what they can do, and what you need to be successful.

Tomorrow, we will be testifying before the House of Representatives and their Aging & Older Adult Services Committee.

CDC Releases New Resources Related to Reporting Module
During today’s provider committee call, our staff walked through resources from the CDC related to new reporting required for the NHSN COVID-19 module. This resource has been added to our online portal for your review and includes instructions for each of the four reporting modules: Resident Impact and Facility Capacity, Supplies and PPE, Staffing and Personnel Impact and Ventilator Capacity and Supply.

If you have any questions, please reach out to Gail Weidman or Chris Fisher on the PHCA team.

DOH Releases FAQ for Residents, Families and Staff
The Pennsylvania Department of Health has issued these frequently asked questions to address the concerns that families have raised with facilities throughout the last few weeks. If you have any questions, please don’t hesitate to reach out to PHCA staff.

DCED Approves Workforce Development Training Programs
Yesterday, the PA Department of Community and Economic Development (DCED) approved certain life-sustaining business workforce development training programs to resume, beginning tomorrow. This includes nurse aide and direct care training programs.

You can review the DCED FAQ resource regarding the guidance related to this approval here.

 

 

Wednesday, May 6, 2020 – 7:11 p.m.

Today, the Department of Health confirmed 888 new positive cases of COVID-19 in Pennsylvania – an increase of 23 cases as compared to yesterday. This brings the statewide total to 51,845.

DOH is also reporting an increase of 94 new deaths, bringing the statewide total to 3,106 in Pennsylvania. County-specific information and a statewide map are available here.

Before we dive into today’s updates, we want to take a moment to say thank you to all our nurses. National Nurses Week began today, and we’d like to recognize all of the tremendous work our nurses in long-term care have done, especially during the response to COVID-19.

Over the next several days, we’ll be recognizing a number of nurses from our member facilities who have gone to extraordinary lengths to support their fellow staff and care for their residents.

If you’d like to nominate a nurse to be featured during this week’s #NursesWeek2020 social media content, please email Shayna Varner, our Director of Communications, at svarner@phca.org. All submissions are welcome!

A few important updates:

Governor Wolf Issues Executive Order to Provide Liability Protections to Health Care Practitioners Only
This afternoon, Governor Tom Wolf issued an Executive Order granting civil immunity to individual health care practitioners.

Unfortunately, the order does not offer protections to health care providers and organizations, including nursing homes, assisted living communities, personal care homes and hospitals.

While today’s order recognizes the extraordinary efforts of individual caregivers and health care practitioners on the front lines, it simply failed to extend the same protections to providers, which still leaves members vulnerable to lawsuits.

Moving forward, we will continue our work with members of the General Assembly to ensure our member organizations receive the same protections already granted to providers in 13 other states across the country.

CDC Confirms NHSN COVID-19 Retrospective Reporting is Optional
There has been some confusion as to whether retrospective reporting in the NHSN COVID-19 module is required or not. AHCA has confirmed with the CDC that it is optional to submit data back to January 1, 2020. CMS has issued this memo to help answer questions that have been raised about the requirement, as well as the new resident, representative, and family notification requirement.

This memo contains a significant amount of information that we strongly encourage you to review.

As a reminder, the new rule requires reporting starting last Friday, May 1st, which must be done weekly. Friday, May 8th will mark the end of the first reporting period.

AHCA continues to advocate for CMS to allow a grace period from enforcement due to the length of time necessary for nursing homes to gain access to NHSN, as well as time needed to establish systems for reporting.

The CDC is offering several live Q&A sessions for nursing homes between May 6-14. Details can be found under the training section of the CDC NHSN website.

DHHS Clarifies CARES Act Provider Relief Fund Questions
Over the past several weeks, AHCA/NCAL has submitted an array of questions on the Provider Relief Fund.

Recently, the U.S Department of Health and Human Services (DHHS) staff has indicated they do not intend to recover Provider Relief Fund allocations unless:

  • DHHS identifies an overpayment associated with revenue calculations which were incorrectly based upon improper or incorrect information on the cost reports. DHHS also noted the Department is collecting tax filing information to be uploaded to verify the revenue. AHCA/NCAL recognizes the challenges associated with using tax filing information and is conveying those concerns to the Department; and
  • DHHS will pursue providers who cannot substantiate the costs/loss of revenue. AHCA/NCAL has developed a COVID-19 Loss/Cost Calculator (member login required).

DHHS will be issuing an FAQ to clarify the Tranche 1 and 2 payment concerns. We’ll be sure to provide that to you as soon as it is made available.

Governor Wolf Announces Program to Provide Free N95 Respirator Decontamination Units
Today, Governor Wolf announced a program to provide free N95 respirator decontamination to healthcare facilities, first responders, and other eligible organizations that may be experiencing a shortage of respirators due to limited availability through normal procurement channels.

The service is available free of charge for use by eligible organizations, including skilled nursing facilities and assisted living communities/personal care homes. The only cost to an eligible organization is for shipping to and from the site.

Information about the service is being distributed to potentially eligible organizations through the Pennsylvania Emergency Management Agency, the Pennsylvania Department of Health, the Hospital and Healthsystem Association of Pennsylvania (HAP), and other state agencies.

 

 

Tuesday, May 5, 2020 – 6:00 p.m.

Today, the Department of Health confirmed 865 new positive cases of COVID-19 in Pennsylvania – an increase of 40 cases as compared to yesterday. This brings the statewide total to 50,957.

The department also confirmed there have been 3,012 COVID-19-related deaths statewide.

In nursing homes and AL/PC communities, there are 9,625 resident cases, as well as 1,284 cases among employees. That’s a total of 10,909 cases at 495 distinct facilities.

A few important updates:

Update on NHSN Reporting Registration
It has been brought to our attention that there may be a 24-48 hour lag time between initiating registration to the National Healthcare Safety Network (NHSN) COVID-19 reporting module and completion of the registration process due to the number of facilities trying to gain access to the portal.

While waiting for the registration process to complete, you should download the four data collection pathway forms and accompanying instructions to start collecting the data that you will be uploading to NHSN once the registration process is complete.

It is extremely important to download and refer to the instructions page for each of the four data collection pathways.

The four data collection pathway forms are:

We’ll provide an update on this delay as we know more.

AHCA Releases New, Expanded Infection Preventionist Specialized Training
AHCA has released a new and expanded version of its popular Infection Preventionist Specialized Training that was first launched in 2017. AHCA recommends that each nursing facility train at least two Infection Preventionists through AHCA’s IPCO training program (should one Infection Preventionist leave the facility). The training is also highly recommended for assisted living communities.

Payment and registration are made online at ahcancalED.

New Resources Posted to Department of Health Message Board
The Department of Health has released two new pieces of guidance on the Message Board. These updates include:

  • PAHAN 504 – Interim Guidance on Discontinuing Non-Healthcare Isolation for Persons with COVID-19
  • Testing Survey – The Department of Health is asking all facilities to complete a short survey regarding COVID-19 specimen collection locations and laboratories. The purpose of the survey is to provide DOH with the information they need to better understand the need to increase specimen collection sites, the overall testing capacity, and barriers to testing. The Department is asking that one person from each facility complete the survey no later than Friday, May 8. 

Wellness Wednesday Programming and Resources Available
Aegis, a PHCA business partner, is launching Wellness Wednesday, a new program for your staff to practice self-care during this stressful time. Each activity is designed to take about 10 minutes or less and will walk you through an activity to support overall wellness.

Upcoming sessions include:

 

Monday, May 4, 2020 – 6:21 p.m.

Today, the Department of Health confirmed 825 new positive cases of COVID-19 in Pennsylvania – a decrease of 137 cases as compared to yesterday. This brings the statewide total to 50,092.

The department also confirmed there have been 2,458 COVID-19-related deaths statewide.

Over the last week, the Secretary of Health, Dr. Rachel Levine, has been asked repeatedly about long-term care facilities, as well as her Department’s response to providers throughout this epidemic, during her daily press conferences. The questions have revolved around funding, PPE availability and testing. During today’s press conference, Secretary Levine indicated the Governor’s Office and the Office of General Counsel are discussing civil immunity for health care providers – a key initiative we’ve endorsed since before the epidemic began.

Your advocacy and work has truly brought these issues to the forefront, and we won’t relent until we have answers, as well as real solutions.

A few important updates:

Update on FEMA PPE Supply to Nursing Homes
We now have word that FEMA will coordinate two shipments totaling a 14-day supply of PPE to nursing homes across the nation.

By the beginning of July, each facility will receive two separate packages containing a seven-day supply of eye protection, surgical masks, gowns, and gloves. Each facility will receive an allotment of all four items based on staff size.

The Level 1 medical gowns included in the shipments are intended for use in basic care settings for minimal risk situations. The gowns are durable and can be washed 30 to 50 times.

The first shipments will begin this week and will continue throughout May. Initial shipments will focus on metropolitan-area priority sites, such as New York City, Northern New Jersey, Boston, Chicago and Washington D.C. The second shipment of supplies will start at the beginning of June. We will continue to share more information as it becomes available.

New Resources Posted to Department of Health Message Board
Over the weekend, there were several new resources and updates added to the Department of Health Message Board. These updates include:

We’ve also updated our online portal to include a guidance wrap-up for the week ending Friday, May 1st.

Department of Health Releases Revised Guidance on Distribution of PPE
Earlier this afternoon, the Office of Long-Term Living shared revised guidance on the distribution of PPE from the Department of Health. This new guidance replaces the guidance that was sent via the ListServ email on Wednesday, April 8.

In other PPE-related news, Pennsylvania has entered into a consortium with six other states in a regional purchasing consortium for PPE and medical supplies. The other states are New York, New Jersey, Delaware, Massachusetts, Rhode Island and Connecticut.

The Governor’s Office and DCED will be leading this effort.

 

 

Friday, May 1, 2020 – 8:28 p.m.

Today, the Department of Health confirmed 1,208 new positive cases of COVID-19 in Pennsylvania – a decrease of 189 cases compared to yesterday. This brings the statewide total to 46,971.

The department also confirmed there have been 2,354 COVID-19-related deaths statewide.

During today’s press conference, Governor Tom Wolf announced the ‘reopening’ of 24 counties in the northwest and north-central regions of the state, beginning next Friday, May 8th.

Those counties are: Bradford, Cameron, Centre, Clarion, Clearfield, Clinton, Crawford, Elk, Erie, Forest, Jefferson, Lawrence, Lycoming, McKean, Mercer, Montour, Northumberland, Potter, Snyder, Sullivan, Tioga, Union, Venango, and Warren.

The counties were deemed ‘ready’ to reopen because of low per-capita COVID case counts, their ability to conduct contact tracing and testing, and appropriate population density to contain community spread.

As regions or counties move into the ‘reopening’ phase, some restrictions on work and social interaction will ease. Other restrictions, such as closures of schools, gyms and hair salons, as well as limitations around large gatherings, will remain in place.

A few important updates:

Changing the Perception of Long-Term Care and COVID-19
Since our PHCA Press Briefing on Monday, we’ve begun to change the narrative surrounding long-term care and COVID-19 in Pennsylvania. The critical support you need on the front lines – emergency funding, testing and personal protective equipment – is finally being addressed by reporters across the state. Frankly, these issues are too important to ignore.

Every day this week, we’ve participated in at least one critical interview. We’re working to get your message out, and to ensure your voice is heard.

This morning, we were on WITF Smart Talk with Scott LaMar – you can listen to our full interview here.

Nominate a Nurse for National Nurses Day!
This Wednesday, May 6th is National Nurses Day, and PHCA would like to express our gratitude to the nurses on the frontlines of the fight against COVID-19.

Throughout the day, we’ll be sharing stories on social media of individual nurses who have stepped up and stood out in the face of this epidemic.

If you’d like to nominate a nurse to be featured, please email Shayna Varner, our Director of Communications, at svarner@phca.org. All submissions are welcome!

CMS Issues Interim Final Rule with New Requirements for COVID-19 Reporting
Last night, CMS issued an interim final rule with comment period, which establishes reporting requirements for providers to report information related to COVID-19 cases among facility residents and staff.

Under this new requirement, nursing facilities must electronically report information regarding COVID-19 in a standardized format, which will rely on the CDC NHSN portal that went live on Wednesday with the new LTCF COVID-19 module.

In addition, providers must continue to comply with state and local reporting requirements as well. We will continue our efforts with state government to create a single reporting mechanism, rather than using duplicative processes.

This new requirement also requires that providers inform residents, their representatives and family members if positive COVID-19 cases occur in facilities.

Department of Health Releases New Resources on Message Board
The Department of Health has released a new resource on their Message Board, which provides information on who should wear PPE, how PPE is being prioritized, what strategy is being used to distribute PPE and who will be receiving PPE.

In addition, the Department has released additional information regarding the Educational Support and Clinical Coaching Program (ESCCP).

If you have any questions, please contact Gail Weidman or Chris Fisher on the PHCA team.

 

 

Thursday, April 30, 2020 – 8:00 p.m.

Today, the Department of Health confirmed 1,397 new positive cases of COVID-19 in Pennsylvania – an increase of 295 cases compared to yesterday. This brings the statewide total to 45,763.

The department also confirmed there have been 2,292 COVID-19-related deaths statewide.

A few important updates:

President Trump, CMS Announce the Formation of the Coronavirus Commission for Safety and Quality in Nursing Homes
In a press conference earlier today, President Trump announced a special nursing home task force that will convene in May to assess the response to COVID-19, identify best practices, and provide recommendations on protections for nursing home residents.

The Coronavirus Commission for Safety and Quality in Nursing Homes will include industry leaders, doctors, scientists, resident advocates, family members, and others.

Getting Started with NHSN Reporting on COVID-19
This week, the Centers for Disease Control and Prevention (CDC) released the National Healthcare Safety Network (NHSN) COVID-19 reporting module for long term care facilities. Centers who were not previously enrolled in NHSN will be required to go through an expedited enrollment process.

Daily reporting to NHSN provides the timeliest data which will be informative and provide situational awareness at both state and national levels. Data should be entered, at a minimum, at least once a week.

Data uploaded to NHSN can be done manually or through embedded import functions using CSV files. The COVID-19 module is divided into 4 separate reporting pathways which include:

  • Resident impact and Facility Capacity
  • Staff and Personnel Impact
  • Supplies and Personal Protective Equipment
  • Ventilator Capacity and Supplies

Centers can choose one person or multiple people within their center to access and upload information to NHSN.

CDC Webinar Training for LTCF COVID-19 Module: New Mandatory Reporting
CDC’s National Healthcare Safety Network has announced webinar trainings for the new LTCF COVID-19 Module, which is expected to be a new requirement by CMS.

The training webinars will be recorded and posted to the LTCF COVID-19 Module webpage with a PDF of the slide presentation.

We understand many members had difficulty gaining access to today’s webinar. We are hopeful tomorrow’s webinar login process will run much smoother.

Tomorrow’s Topic: COVID-19 Enrollment Guidance for Long-term Care Facilities
Friday, May 1, 2020 – 1:30 to 3 p.m.

Learn how to join this webinar on the CDC website.

 

 

Wednesday, April 29, 2020 – 7:30 p.m.

Today, the Department of Health confirmed 1,102 new positive cases of COVID-19 in Pennsylvania – a decrease of 112 cases compared to yesterday. This brings the statewide total to 44,366.

The department also confirmed there have been 2,195 COVID-19-related deaths statewide.

A few important updates:

Critical Emergency Funding for Nursing Homes: BIG News to Share
We are very proud to report that, earlier today, the state Senate Appropriations Committee amended a bill to include $200 million in funding for nursing homes.

Though the bill must still pass the full Senate, as well as the House of Representatives, this was a critical step in securing funding for PHCA providers.

Senators from both sides of the aisle spoke very highly of nursing homes and long-term care providers today. It proves that our advocacy, as well as the work you do every day, is making a difference,.

We will continue to work with members of the General Assembly, as well as the Wolf Administration, to ensure you receive the support you need. We’ll keep you updated as legislative talks progress.

CDC Webinar Training for LTCF COVID-19 Module: New Mandatory Reporting
CDC’s National Healthcare Safety Network has announced two upcoming webinar trainings for the new LTCF COVID-19 Module, which is expected to be a new requirement by CMS.

The training webinars will be recorded and posted to the LTCF COVID-19 Module webpage with a PDF of the slide presentation.

First Topic: COVID-19 Module Overview for Long-term Care Facilities  
Thursday, April 30, 2020 – 1:30 to 3 p.m.

Second Topic: COVID-19 Enrollment Guidance for Long-term Care Facilities

Friday, May 1, 2020 – 1:30 to 3 p.m.

Learn how to join these webinars on the CDC website.

New Resources on Nursing Home Surveys
Post & Schell, a trusted PHCA business partner, has developed this resource that pulls together information to support nursing home surveys during COVID-19.

This resource includes information that we hope will be helpful regarding DOH surveys:

  • Preparing for Infection Control Survey
  • Impact on Enforcement Actions
  • Impact on the Five-Star Quality Rating System
  • Posting of Nursing Home Staffing and DOH Minimum Staffing Requirements

The information has previously been distributed in separate emails and announcements – this document pulls the resources and information together in one place.

 

 

Tuesday, April 28, 2020 – 8:01 p.m.

Today, the Department of Health confirmed 1,214 new positive cases of COVID-19 in Pennsylvania – an increase of 329 cases compared to yesterday. This brings the statewide total to 43,264

The department also confirmed there have been 1,716 COVID-19-related deaths statewide.

A few important updates:

Your Voice Is Being Heard in Harrisburg!
Every day, we’re advocating in Harrisburg for critical emergency funding for long-term care. Funding that will help with staffing relief, PPE shortages and critical supplies for the duration of the COVID-19 response.

But we don’t advocate alone – over the last few weeks, you’ve made your voices heard as well. And we’re seeing results.

Late yesterday, we learned state Representative Gary Day, Chairman of the House Aging Committee, along with Reps. Brett Miller, Mark Gillen, Parke Wentling, Eric Nelson, Mike Jones and Frank Ryan sent a joint letter to Governor Tom Wolf, urging immediate emergency funding for long-term care providers.

This legislative support is critical, and it shows the power of your advocacy.

FEMA to Make Shipments of PPE to Nursing Homes in Early May
The White House Coronavirus Task Force announced yesterday that FEMA will be shipping every nursing home in the United States a supply of PPE (surgical masks, gowns, face shields and gloves) in early May and again in early June.

As we learn more about the arrival dates and amounts, we will keep you updated.

New Tool Available to Report Positive COVID-19 Cases to the Department of Health
In an effort to help streamline your reporting processes, PHCA has worked with the Department of Health to create this spreadsheet to report positive COVID-19 cases to your respective field office. This spreadsheet was developed to relieve some of the burden related to reporting individual cases.

Please note: nursing homes must report their first case in ERS and include in the documentation that ‘updates will be made via Excel spreadsheet to supervisor/designated surveyor’. This Excel spreadsheet is to be updated and sent to the field office daily.

If you have any questions, please reach out to Gail Weidman at gweidman@phca.org.

Temporary Nurse Aide Training Program Resources
Since announcing the approval of a temporary nurse aide (TNA) training program, we’ve received a number of questions from providers and potential nurse aides looking for additional information.

We’ve pulled together this resource to answer questions about the program, as well as a DOH-approved staffing tracker. Remember: TNA hours should be included in CNA hours with documentation of TNAs on the second tab of the worksheet.

 

Monday, April 27, 2020 – 7:49 p.m.

Today, the Department of Health confirmed 885 new positive cases of COVID-19 in Pennsylvania – a decrease of 231 cases compared to yesterday. This brings the statewide total to 42,050.

In addition, the department confirmed there have been 1,597 COVID-19-related deaths statewide. More than 60% of those deaths have, unfortunately, occurred in long-term care facilities.

A few important updates:

PHCA Updates the State Legislature on COVID-19
Two weeks ago, our membership sent more than 2,500 letters and emails to Governor Tom Wolf and the state House and Senate, urging them to prioritize emergency funding for long-term care.

And today, we held our first-ever PHCA Legislative Briefing conference call with every member of the general assembly. We spoke to the challenges you’re facing, the opportunities that exist, and the need for state government to work with providers – especially during the COVID-19 epidemic.

More than 120 legislators joined us, and we’ve heard from those legislators throughout the day. They want to help you and your residents. They’re asking what they can do, and what you need to be successful.

To download and listen to a recording of our briefing, click here.

After our Legislative Briefing, we held a Press Briefing for members of the media. We were joined by eighteen reporters from across the state who were able to hear, firsthand, the needs of providers and staff.

And our messaging is already paying dividends. You can read the first article written from our press briefing here.

PHCA Releases Long-Term Care Plan for Pennsylvania
Just over one week ago, Governor Tom Wolf released his ‘Plan for Pennsylvania’, which centered around the relief, recovery and reopening of Pennsylvania.

That plan, however, largely ignored the providers, workers and residents in long-term care. In fact, in the official 12-page plan, long-term care facilities are mentioned exactly twice.

The issues we’ve continued to advocate for – critical emergency funding for providers, prioritizing supplies of personal protective equipment for workers, addressing staffing shortages, protecting residents and granting civil immunity to the long-term care continuum – are simply too important to ignore.

Which is why, today, we released our own PHCA Plan for Pennsylvania that not only prioritizes long-term care providers, frontline workers and residents – it makes them the central focus.

You can take a look at the plan here.

AHCA/NCAL Grant and Loan Management Resource Guide Available
To aid members with managing the wide array of federal grants and loans available, AHCA/NCAL has developed a basic primer  (login required) for organizing oversight and day-to-day management of these emergency resources. The guidance includes federal cost reporting guidelines, as well as recommended financial management approaches for members.

To download the Resource Guide, log into the AHCA/NCAL website and go here.

Updated: Accelerated and Advance Payments FAQs 
The AHCA Medicare Accelerated and Advance Payment FAQs have been updated to reflect yesterday’s CMS announcement that it is reevaluating the amounts that will be paid under its Accelerated Payment Program to Part A facility-based providers (including SNFs) and suspending its Advance Payment Program to Part B suppliers effective immediately.

Tomorrow’s HealthCare™ Portal for AL/PC Providers
Earlier today, BHSL released additional information regarding the Learning and Support Network for COVID-19 through Tomorrow’s HealthCare™ web-based portal, as well as information on how to contact one of the health system partners in your county for additional one-on-one coaching.

If you have any questions, please contact Gail Weidman at gweidman@phca.org.

 

 

Friday, April 24, 2020 – 7:50 p.m.

Today, the Department of Health confirmed 1,599 new positive cases of COVID-19 in Pennsylvania – an increase of 230 cases compared to yesterday. This brings the statewide total to 38,652.

In addition, the department confirmed there have been 1,492 COVID-19-related deaths statewide. They are no longer including ‘probable’ COVID-19 cases in their overall count.

A few important updates:

Additional $20 Billion Distributed to Medicare Providers Today
HHS allocated another $20 billion today to all Medicare providers. Providers in PA may have received funds already…if not, you should expect them in the next week. HHS intends to send funds to Medicaid-only providers as well but is not doing so in this payment. We will continue to work with HHS to develop the system to get those funds distributed.

Combined with the first $30 billion in the CARES Act two weeks ago, HHS has now paid $50 billion total to Medicare providers.

HHS has developed an FAQ for the Provider Relief Fund with additional details. We will keep you updated with additional information as it is made available.

CMS Releases Guidance for Infection Control Protocols for Home Health Agencies
In March, CMS released guidance for infection control protocols for home health agencies. We wanted to share updated guidance which includes recommendations for home health care personnel who care for residents residing in residential care settings, such as assisted living and independent living.

If you have any questions, please don’t hesitate to reach out to Kevin CysykGail Weidman or Chris Fisher.

U.S. House Passes Interim Coronavirus Relief Bill
Late yesterday, the U.S. House of Representatives passed H.R. 266, the fourth stimulus bill aimed at providing relief to small businesses. The $484 billion deal refills the Small Business Administration’s depleted Paycheck Protection Program (PPP) by $310 billion and includes coronavirus testing funding ($25 billion).

Some PHCA members may qualify for this program. For more details, click here.

 

 

Thursday, April 23, 2020 – 6:40 p.m.

Today, the Department of Health confirmed 1,369 new positive cases of COVID-19 in Pennsylvania – an increase of 213 cases compared to yesterday. This brings the statewide total to 37,053.

In addition, the department confirmed today there have been 1,394 COVID-19-related deaths statewide. This decrease comes after the department determined it will no longer include ‘probable’ COVID-19 cases in their overall count.

A few important updates:

Our Advocacy Efforts Continue
Last week, we activated a robust advocacy campaign urging Governor Wolf and the General Assembly to prioritize emergency funding for long-term care. And since then, we’ve sent more than 2,500 letters and emails.

We continue to receive calls from concerned legislators, asking how they can help support you and the work you’re doing to protect your residents and fellow staff.

That’s why we’ve organized a PHCA Legislative Briefing this Monday, April 27th. We’ll be discussing the status of Pennsylvania’s nursing homes, personal care homes and assisted living communities and our response to the COVID-19 epidemic. And we’ll be speaking with every member of our state legislature.

There has already been an overwhelming response to Monday’s call, and we look forward to advocating on your behalf. We’ll report back after the call.

Preparing for Widespread COVID-19 Testing
Over the last several weeks, there has been an increased national focus on the need for priority testing of long-term care workers and residents, and we’ve been extremely vocal on this issue in our media efforts.

CMS has recently emphasized the importance of testing for COVID-19 in long-term care.

As a reminder: When accessing testing, AHCA/NCAL recommends providers ensure that tests are FDA approved PCR tests (versus Antibody/Serology tests) and that the lab will bill Medicare directly.

Providers should have a plan in place to isolate residents who test positive, and follow CDC guidance for staff that test positive. More information and guidance on preparing for widespread testing is available here.

HHS Releases COVID-19 Workforce Virtual Toolkit
HHS has developed this portal to provide a curated set of resources and tools for decision-makers managing healthcare workforce challenges in response to the COVID-19 emergency.

If you have COVID-19 practices, plans, tools, or templates to share, please visit the ASPR TRACIE Information Exchange COVID-19 Information Sharing Page (registration required) and place your resources under the relevant topic area.

Updated FAQs on Provider Relief Fund
AHCA/NCAL’s FAQs on the Provider Relief Fund has been updated to include information on the additional CARES Act funding to be released this week.  We will continue to update the FAQ, as an increase of $75 billion is expected to pass the House and be signed by the President soon.

 

 

Wednesday, April 22, 2020 – 8:29 p.m.

Today, the Department of Health confirmed 1,156 new positive cases of COVID-19 in Pennsylvania – a decrease of 140 cases compared to yesterday. This brings the statewide total to 35,684.

In addition, the department confirmed 58 new deaths among positive and ‘probable’ cases, bringing the statewide total to 1,622.

During this evening’s press conference, Governor Tom Wolf and Department of Health Secretary Rachel Levine outlined an initial plan for the regional re-opening of Pennsylvania, which will begin on Friday, May 8th. In order to qualify for this re-opening, a region’s population must reach a target goal of 50 positive cases per 100,000 individuals over the course of 14 days.

As part of this regional re-opening effort, regions or counties will be categorized into three different phases: red, yellow and green.

The red phase, which currently applies to the entire state, mandates strict social distancing, the closure of non-life sustaining businesses and building safety protocols.

As regions or counties move into the yellow phase, some restrictions on work and social interaction will ease while others, such as the closures of schools, gyms, and other indoor recreation centers, as well as limitations around large gatherings, remain in place.

The green phase eases most restrictions by lifting the stay-at-home and business closure orders to allow strategic reopening while prioritizing public health. This phase will facilitate a return to a “new normal”.

We’ll keep you updated on this plan as it progresses.

A few important updates:

More Federal Stimulus Funding Headed to Pennsylvania
Later this week, HHS will begin distributing the remaining funds from the federal CARES Act, or the second stimulus bill.

Many of our SNF providers received their first payment two weeks ago, which was based on 2019 Medicare billing.

This will be the second payment, which will be based on other factors (including Medicaid).

Funds will start going out as early as this Friday. Here is what we know:

  • SNFs are clearly part of a tranche of funds that HHS is using to pay providers based on their total revenue. It will distribute $20 billion of the overall $40 billion based on a percentage of providers total revenue. We do not know the exact formula yet, but providers who have a high level of Medicaid and/or Medicare Advantage will do proportionally better than those who do not.
  • HHS is also distributing $10 billion to those in COVID-19 hotspots. This may be for hospitals only, but that is being verified.

Knowledge Center Reporting Resource Guides
Last night, the Department of Health sent a letter to nursing home administrators, mandating reporting into the Knowledge Center portal.

Linked below are three resources and reference guides to help you answer the state’s request for information:

If you have questions, please email Dave Wojs, director of operations at the Knowledge Center.

We understand the frustration surrounding this new reporting requirement, and we are in communication with DOH regarding the rollout and implementation of this program. If you are unable to log in to the Knowledge Center and retrieve a username and password, simply email them and request it. And until you hear back, there is no need to submit anything.

It is our hope that the Knowledge Center will become the sole database for all reporting. We are advocating for this with state government, and we’ll keep you updated as those conversations progress.

PHCA Staffing Documentation Template for Easy Reporting
As a reminder: we received a waiver for staffing requirements from DOH and DHS if facilities are not able to meet minimums but are still providing quality care.

In light of this waiver, nursing home providers are being asked to document when staffing drops below the 2.7 PPD, the reason behind the decrease and how the facility is maintaining quality of care.

In order to offer consistency in reporting, PHCA staff has created this spreadsheet for members to use. Please feel free to make changes to this template to meet your specific needs.

Providers must forward this documentation to the appropriate department field office by the 10th of each month or until otherwise instructed by the Department.

If you have any questions, please reach out to Gail Weidman or Chris Fisher.

SEPTA Service in Philadelphia Area May Be Disrupted Tomorrow
For those providers in the Philadelphia area: SEPTA has advised there could be significant transit service disruptions tomorrow, April 23rd.

While SEPTA has not released details of this potential work stoppage, it is likely it will force the suspension of bus service within the city of Philadelphia. SEPTA is looking at all possible options for maintaining some core services, such as limited operations on the Market-Frankford and Broad Street Lines.

 

 

Tuesday, April 21, 2020 – 6:19 p.m.

Today, the Department of Health confirmed 1,296 new positive cases of COVID-19 in Pennsylvania – an increase of 348 cases compared to yesterday. This brings the statewide total to 34,528.

In addition, the department confirmed there have been 1,564 total COVID-19-related deaths statewide.

As a reminder, DOH has released a county-by-county breakdown of cases and deaths in long-term care facilities.

A few important updates:

Help Us Fight Back
On Friday afternoon, the New York Times, in an article regarding COVID-19 in long-term care facilities, called nursing homes ‘Death Pits’.

On Saturday morning, the Washington Post highlighted infection-control violations, rather than chronic Medicaid underfunding, inadequate PPE or lack of testing, as the primary reason for the spread of COVID-19 in our facilities.

Are you tired of the negative headlines? Fed up with the ‘blame’ our facilities and communities receive?

So are we.

In addition to digital and grassroots campaigns that launched late last week, PHCA is standing up for you. In newspapers. On local radio. On television. And we need your stories to help us tell ours.

Please forward this message to members of your staff, and reply to this email (or send to zshamberg@phca.org) with your stories of providing care in the midst of crisis. We want to know everything: your challenges, your hardships and those moments that have made it all worth it.

As we participate in interviews, contribute to stories and send out examples of quality care on social media, we want to help tell your story to the media, the legislature and the general public.

NEW: CMS Memo on Reporting Confirmed Cases
Late Sunday, CMS announced the agency will be releasing new requirements for reporting and notification of confirmed COVID-19 among residents and staff.

CMS will be issuing these requirements through rulemaking in the coming days.

As a reminder, current CDC guidance specifies that nursing homes notify state and local health departments about residents or staff with suspected or confirmed COVID-19, residents with severe respiratory infection resulting in hospitalization or death, or three or more residents or staff with new-onset respiratory symptoms within 72 hours of one another.

CMS & White House Task Force Want Public Reporting of COVID-19 Cases

Earlier today, we learned CMS and the White House may require public reporting of positive COVID-19 cases in nursing homes across the country. At this time, it is unclear how or in what format this data will be reported.

As we mentioned above, Pennsylvania is currently sharing a county-by-county breakdown of cases with the public – but not the specifics from each facility.

We will keep you updated as additional information is made available.

Continued Communications Strategies to Keep Families Up to Date
Effective communication with the family members and loved ones of your residents is critical – especially now. Family members want to know their loved one is safe, and that you and your staff are doing everything to protect them.

AHCA/NCAL has developed some recommendations to keep lines of communication open with family members during this time.

Hilton Hotels Donating Free Rooms to Frontline Workers
Hilton is donating 1 million hotel room nights across the U.S. to frontline staff leading the fight against COVID-19. Rooms are available free of charge to nurses, EMTs, doctors and other frontline staff who are AHCA members. And if you belong to PHCA, you’re a member of AHCA!

Rooms are now available through May 31. Click here to log in to AHCA/NCAL and be directed to the booking page for the program.

 

Monday, April 20, 2020 – 6:48 p.m.

Today, the Department of Health confirmed 948 new positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 33,232.

In addition, the department confirmed there have been 1,204 total COVID-19-related deaths statewide.

As many expected, Governor Tom Wolf officially extended the stay-at-home order until Friday, May 8th.

As a reminder, DOH has released a county-by-county breakdown of cases and deaths in long-term care facilities.

There has been a great deal of public and legislative pressure put on both DOH and our long-term care continuum to report positive cases and deaths in Pennsylvania. So far, we have been able to contain that pressure, and we will continue to push back on members of the media and the legislature.

A few important updates:

PA DOH Approves Temporary Nurses Aide Training Program
Last night, DOH approved our request for a temporary nurse aide training program for nursing home providers.

This free, eight-hour online training, in combination with on-site training provided at the facility, will prepare candidates to work as a temporary nurse aide, a position intended to address the current state of emergency and provide much-needed staffing relief in the midst of the COVID-19 epidemic.

Individuals wishing to complete the free online training can register for the course by clicking here. Please send this out to prospective employees.

CMS Issues New Guidance Requiring Providers to Communicate with Families, Residents of Positive COVID-19 Cases
In new regulatory requirements released last night, CMS will now require nursing home providers to inform residents, their families and representatives of COVID-19 cases in their facilities – as well as directly to the CDC.

The CDC will be providing a reporting tool to providers that will support federal efforts to collect nationwide data to assist in COVID-19 surveillance and response.

Over the past several weeks, we’ve strongly encouraged you to continue to communicate with your residents’ families as often as possible. To help with communication, AHCA/NCAL developed a sample letter for families and staff.

New Resources Available from our Partners at HAP
HAPevolve, a subsidiary of the Hospital & Healthsystem Association of Pennsylvania (HAP), has developed resources that may be helpful to providers. Please reach out to Larry Estes, senior director of business development at HAPevolve, for additional information.

  • Temporary Staffing – HAPevolve’s Endorsed Partner, Qualivis, has created a task force specific to addressing anticipated staffing challenges initiated by COVID-19.
  • PPE Supplies – HAP has worked to provide a list of atypical supply sources and it can be found here
  • PREP  Portable Response Emergency Plan
    HAPevolve’s emergency preparedness tool has been temporarily modified and provided at no cost for PA healthcare facilities for this emergent scenario to assist in distributing information and resources to their employees specifically regarding COVID-19 via a mobile application, whether iOS or Android.Before or after you download the application, click here for instructions on receiving the User Name and Password for yourself and others at your facility, as well as download instructions, if needed.

 

 

Friday, April 17, 2020 – 6:46 p.m.

Today, the Department of Health confirmed 1,706 new positive cases of COVID-19 in Pennsylvania – up 461 cases from yesterday. This brings the statewide total to 29,441.

In addition, the department confirmed there have been 756 total COVID-19-related deaths statewide.

DOH has also released a county-by-county breakdown of cases and deaths in long-term care facilities.

A few important updates:

PHCA Response to Gov. Tom Wolf’s “Plan for Pennsylvania”
Earlier today, PHCA released a statement in response to Governor Tom Wolf’s “Plan for Pennsylvania”, an outline intended to provide relief and recovery in the midst of the COVID-19 pandemic.

It is no secret that long-term care has become the epicenter of COVID-19 cases in PA and across the entire country.

Yet, in the entire “Plan for Pennsylvania”, long-term care seems to be an afterthought.

In the official 12-page planning document, which you can read here, long-term care is mentioned twice. And neither mention is noteworthy.

This is absolutely shameful. The Governor keeps reminding us to ‘hope’ during this crisis. ‘Hope’ will not bring you and your staff emergency funding, PPE or testing relief. ‘Help’ from state government will, and we need help now.

Please let us know how we can continue to help you.

Our Advocacy Efforts Continue…
We are proud to report that, over the last two days, you sent more than 1,500 letters to your elected officials regarding emergency funding for long-term care!

We want to thank you for your advocacy. But we need to keep the pressure on.

We know your time is extremely limited, so we made this as simple as possible. If you haven’t already, please take a minute to submit a letter to your hometown legislators.

While this advocacy push will focus on nursing home providers, we are actively working with AHCA/NCAL to get funding to our AL/PC members as well.

Reminder: CDC Guidance on Return-to-Work Criteria for Health Care Personnel
The CDC has released new interim guidance on return-to-work criteria for health care personnel (HCP) with confirmed or suspected COVID-19.

Please review, and let us know if you have any questions.

 

 

Thursday, April 16, 2020 – 6:28 p.m.

Today, the Department of Health confirmed 1,245 new positive cases of COVID-19 in Pennsylvania – up 100 cases from yesterday. This brings the statewide total to 27,735.

In addition, the department confirmed there have been 707 total COVID-19-related deaths statewide.

The Department of Health has also now released a county-by-county breakdown of cases and deaths in long-term care facilities.

A few important updates:

Our Advocacy Efforts Have Been Activated!
This morning, you received an email from PHCA, asking you to reach out to Governor Wolf, your state Senator and state Representative regarding emergency funding for long-term care.

I am proud to report that, in just over a few hours, you sent more than 1,000 letters to your elected officials!

I am also pleased to report that I received many calls from concerned legislators today. They want to know why we haven’t been prioritized as a funding source for these emergency dollars.

So we want to thank you for your advocacy. But we can’t stop now.

We know your time is extremely limited, so we made this as simple as possible. If you haven’t already, please take a minute to submit a letter to your hometown legislators.

In the coming days, we’ll be kicking off digital and social media campaigns that further underscore the critical need for funding.

While this advocacy push will focus on nursing home providers, we are actively working with AHCA/NCAL to get funding to our AL/PC members as well.

Important: Updates to Provider Relief Fund Website
The federal government has added an attestation portal to the CARES Act Provider Relief Fund website.

Providers who have been sent a payment from the initial $30 billion in CARES Act dollars must sign an attestation confirming receipt of the funds, and agree to the terms and conditions within 30 days of payment.

Additionally, the federal government has clarified that relief funds are available to all providers regardless of whether they have specifically treated COVID-19, noting that the government “broadly views every patient as a possible case of COVID-19.”

AHCA/NCAL has updated their FAQs on the Provider Relief Fund with this information.

CMS Extends Suspension of Standard Surveys
CMS announced on yesterday’s national call with nursing homes that the suspension of standard surveys will continue until further notice. This means the CMS guidance released on March 23 has been extended until CMS states otherwise. CMS will continue to conduct surveys for immediate jeopardy situations and additional infection control focused surveys using this tool.

You can find additional information to help you with AHCA’s Action Brief and on ahcancalED.

CMS Lessons from the Front Lines: COVID-19
The CMS Lessons from the Front Lines: COVID-19 call will take place tomorrow, April 17th from 12:30 – 2 pm. This call series is an opportunity to hear physicians and other clinical leaders share their experiences, best practices, strategies, and insights related to COVID-19.

Lessons from The Front Lines calls are held weekly on Fridays at 12:30 pm and specific topics vary. Dial in details are below:

Participant Dial-In: (877) 251-0301
Access Code: 8672948

Conference lines are limited, so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser.

Media Assistance: Call the PHCA Team
As a reminder: if your facility and/or community staff receive media calls regarding COVID-19 issues, please don’t hesitate to ask PHCA for help.

Our Director of Communications, Shayna Varner, can be reached at svarner@phca.org.

 

 

Wednesday, April 15, 2020 – 7:43 p.m.

Today, the Department of Health confirmed 1,145 new positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 26,490.

In addition, the department confirmed there have been 647 total COVID-19-related deaths statewide. New information indicates half of those deaths have been long-term care residents.

The Department of Health has also now released a county-by-county breakdown of cases and deaths in nursing homes.

A few important updates:

We Need Your Help! Advocacy for Emergency Funding Begins Tomorrow
Tomorrow morning, you’ll be receiving an email from PHCA, urging you to advocate for emergency funding for long-term care in the midst of the COVID-19 crisis.

In just a little more than two minutes, you can fill in your information and have emails sent to Governor Tom Wolf, your state Senator and state Representative.

Over the last few weeks, we have sent letters to the Governor and his administration, as well as members of legislative leadership, urging our elected officials to allocate federal Medicaid dollars to the group that needs them most: long-term care providers, staff and residents.

Now, we need your help. Please join us in this fight.

Again, you will receive an email tomorrow morning from PHCA, and just two minutes of your time will enable us to build support amongst the members of the PA legislature. And we’ll need that support to get critical dollars to you, your staff and your residents.

While this advocacy push will focus on nursing home providers, we are actively working with AHCA/NCAL to get funding to our AL/PC members as well.

Communication is Key
We cannot stress enough the importance of communication between providers, their staff members and the family members of their residents.

As a reminder, new guidance on notifying public health officials and stakeholders about confirmed cases of COVID-19 was released last weekend. This guidance reinforces much of what our members are already doing.

There is a push from our state legislature to require all providers to publicly report confirmed cases and deaths in facilities. We oppose this initiative, and we would encourage you to keep the channels of communication open between your staff, residents and their loved ones.

CMS Increases Medicare Payment for High-Production Coronavirus Lab Tests
Today, CMS announced Medicare will nearly double the payment for certain lab tests that rapidly diagnose large numbers of COVID-19 cases in an effort to expand testing to nursing home residents.

Medicare will pay the higher payment of $100 for COVID-19 clinical diagnostic lab tests making use of high-throughput technologies developed by the private sector. This is effective April 14 (yesterday), and will continue until the end of the COVID-19 crisis.

As testing availability continues to be an issue for providers in Pennsylvania, we will urge the Department of Health and the Wolf administration to prioritize any resources to frontline workers, staff and residents.

New OSHA Resources: Low/Unavailable PPE and Reporting Staff Cases
AHCA/NCAL released four new resources for guidance from OSHA and the CDC on critically low or unavailable Personal Protective Equipment. These new resources are applicable to all long term care providers. They are:

  • A form letter providers can fill in when responding to OSHA inquiries due to complaints regarding limited or unavailable PPE.
  • A document on OSHA guidance when PPE is critically low or unavailable, including steps providers can follow.
  • An explanation of OSHA and CDC guidance on N95 respirators that are critically low or unavailable.
  • A document with updated guidance from OSHA on employer recording and reporting requirements for COVID-19.

CMS to Hold COVID Stakeholder Engagement Call Tomorrow
Tomorrow, CMS will be hosting an “office hours” stakeholder engagement call on COVID-19 from 5 to 6 p.m. This call is the next in a series of opportunities for providers to ask questions of agency officials regarding CMS’s temporary actions.

The audio webcast link and registration can be found here. Dial-in info for the call is:

Dial-In: 833-614-0820
Event Plus Passcode: 6168487 

PA DOH Order Mandates Worker Safety Measures
Today, Department of Health Secretary Dr. Rachel Levine signed an order directing protections for critical workers who are employed at businesses that are authorized to maintain in-person operations during COVID-19.

Failure to comply with these requirements will result in an enforcement action that could include citations, fines, or license suspensions. Compliance with the order will be enforced beginning this Sunday, April 19 at 8 p.m.

 

Tuesday, April 14, 2020 – 7:10 p.m.

Today, the Department of Health confirmed 1,146 new positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 25,345.

In addition, the department confirmed there have been 584 total COVID-19-related deaths statewide.

It’s important to note that while there has been a decrease in cases over the last several days, this is most likely a result of limited testing capabilities and not indicative of a downward trend.

CARES Act Provider Funding FAQs
On April 10th, the U.S. Department of Health and Human Services released the first round of funding relief to nursing homes, hospitals and other health care providers. This funding can be used to support healthcare-related expenses or lost revenue attributable to COVID-19.

We were proud to fight for this funding at the federal level along with AHCA/NCAL.

They have developed FAQs specific to long-term and post-acute care providers regarding this funding.

If you have any additional questions, please reach out to PHCA.

 

Monday, April 13, 2020 – 7:15 p.m.

Today, the Department of Health confirmed 1,366 new positive cases of COVID-19 in Pennsylvania, a day-over-day increase of 188 cases. This brings the statewide total to 24,199.

In addition, the department confirmed there have been 524 total COVID-19-related deaths statewide. This is a day-over-day increase of 17 cases.

A few important updates:

CMS Issues New Cohorting and Transfer Guidance
Today, CMS released detailed guidance on long term care facility transfers. This matches the cohorting guidance that we shared with you previously.

To summarize: providers should make plans to cohort (or separate) residents before COVID-19 enters a facility. Cohorting is essential to controlling the spread of the virus.

PA Labor and Industry Launches COVID-19 Employment Portal
The Department of Labor and Industry has launched a new employment portal specific to businesses and sectors directly impacted by COVID-19. You can visit the portal here.

We believe this job portal will help connect providers with Pennsylvanians looking for work. We can potentially fill hundreds of critical roles.

But first: we need providers to sign up!

Please consider completing this Employer Intake Form and submitting it to the Department of Labor and Industry.

Staffing Shortage Relief and Flexibility
As a reminder: on March 16th, Governor Tom Wolf’s office approved our requests for staffing flexibility and relief. One of those requests was to waive the staffing requirements from DOH and DHS if facilities are not able to meet minimums but are still providing adequate quality of care to residents.

Specifically, the Governor’s Office told us that DOH will permit a facility to continue operations if the facility’s minimum number of nursing hours per resident per day (PPD) is below the required 2.7. Additionally, DHS will waive Personal Care Home and Assisted Living Residence staffing requirements if the facilities are not able to meet minimums but are still providing adequate quality of care to residents.

DHS will require notification at the time the staffing complement drops below the minimum level for monitoring purposes, and the facility should document the reasons for subsequent inspection.

Please: notify DOH or DHS and document if/when your staffing falls below the necessary number. If you experience any difficulty with a surveyor or particular field office during this process, please reach out to Gail Weidman, our Director of Policy and Regulatory Affairs, at gweidman@phca.org.

Temporary Nurse Aide Training Program
PHCA continues to advocate for the Temporary Nurse Aide Training program, which consists of 8 hours of online training and abbreviated on-site training. We believe this would help address critical staff shortages and get Pennsylvanians back to work.

We will keep you updated on the progress of this ‘ask’. It is currently with the Governor’s office and their legal team.

 

 

Saturday, April 11, 2020 – 6:55 p.m.

Today, the Department of Health confirmed 1,676 new positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 21,655.

In addition, the department confirmed there have been 494 total COVID-19-related deaths statewide.

A few important updates:

New Notification Guidelines for Confirmed COVID-19 Cases
Today, AHCA/NCAL released new guidance regarding necessary notification for providers when a case of COVID-19 is suspected and/or confirmed.

We are hopeful this reporting will allow DOH and CMS to target emergency shipments of PPE, testing and staffing resources to those facilities directly impacted by COVID-19 in Pennsylvania.

PA DOH Releases FAQs on Executive Order for PPE and Supplies
Given the strong reaction to Governor Wolf’s executive order earlier this week, which gave PEMA the authority to seize and redistribute PPE and other medical equipment to those facilities most in need, the Department of Health has released this FAQ document to help answer any questions you might have.

If you have additional questions, please don’t hesitate to reach out and let us know.

DOH, Bureau of Emergency Preparedness and Response to Offer PPE Training
The Department of Health and Bureau of Emergency Preparedness and Response will provide a series of PPE Training Sessions across the state. These online and in-person trainings will help attendees learn how to don and doff PPE appropriately.

There are approximately 350 open spots available in 7 locations throughout the state to administrator-level staff (limit 1 per facility).

Click here to see the letter that was sent to all facilities regarding this training. To register for the training, click here and search for course ID 1090851.

Please contact Chris Fisher at cfisher@phca.org or Gail Weidman at gweidman@phca.org if you have any questions.

 

 

Friday, April 10, 2020 – 8:14 p.m.

Today, Department of Health Secretary Rachel Levine confirmed 1,751 new positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 19,979.

In addition, Secretary Levine confirmed there have been 416 total COVID-19-related deaths statewide.

As you may know, we joined PennLive, the foremost news source in Harrisburg, yesterday afternoon for a Facebook Live townhall. We discussed the serious challenges facing long-term care facilities and frontline workers, including staffing, PPE shortages and funding.

Earlier today, PennLive released an editorial: State officials must do more to protect both patients and workers in nursing homes throughout Pennsylvania.

The Editorial Board ended the piece by saying, “…we know enough to ask state officials to take Shamberg’s concerns seriously and to immediately address the issues that are threatening the health and safety of thousands of Pennsylvanians.”

We couldn’t agree more. And we promise we’ll continue to fight for you, and make you, your staff and residents a priority to state government in the midst of this crisis.

A few updates:

HHS Begins Distributing Federal Stimulus Funding to Providers
We are thrilled to report that HHS is now distributing the first $30 billion of the healthcare stimulus fund that was included as part of the federal CARES Act.

A brief description of their process can be found here.

SNFs are included, and all Medicare providers will receive payments based on 2019 Part A and Part B billings. More information is coming, but it appears providers will receive roughly 6.2% of those billings.

This is in addition to the Accelerated Payment Program. Providers can participate in both.

The next distribution from the CARES Act will be $50 billion, and it will be more focused on Medicaid providers. HHS’s goal is to get that money out in the next 10 days.

We will continue to fight for more Medicaid funding, and we will continue to find funding solutions for our AL/PC members as well.

AHCA/NCAL Issues Guidance on Collaborating with Hospice
AHCA/NCAL worked with the National Hospice & Palliative Care Organization to develop joint guidance on the important role hospice can play as COVID-19 spreads.

Infection Control-Focused SNF Surveys 
CMS has announced federal and state surveyors will conduct targeted infection control surveys of providers, and they will base the survey on the abbreviated infection and prevention survey tool. AHCA developed an action brief to help you navigate the focused surveys, including implementation and preparation strategies.

DHS Launches New Learning and Support Network for COVID-19 Online Portal
In conjunction with DHS, the Jewish Healthcare Foundation has created an online portal – Tomorrow’s HealthCare™ online community. This network will allow you to participate in educational webinars, access past webinars, access guidelines, toolkits, and factsheets, and ask general questions about COVID-19 education or request educational resources. Webinars will be held on Tuesdays from 2 to 3 p.m.

For more information, click here.

 

Thursday, April 9, 2020 – 8:16 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 1,989 new positive cases of COVID-19, a day-over-day increase of 309, bringing the statewide total to 18,228 cases.

The department has reported a total of 338 COVID-19-related deaths statewide, up 28 from yesterday.

A few updates:

PHCA in the News on COVID-19
Over the last several weeks, we’ve been working hard to get the word out on the challenges you’re facing: the need for critical emergency funding, PPE, staffing issues, and more.

Here’s a small overview of some of the coverage we’ve secured:

In addition, Steve Tack, owner of Quality Life Services and a PHCA Board member, submitted his own letter to Governor Tom Wolf to request emergency funding and support for our sector. Tonight, Steve filmed an interview with a Pittsburgh-area news station, and we hope more reporters will reach out to hear his story.

Now is the time to share your story as well. If you’d like to take part in a letter or public statement, please let us know.

The groundswell of support is building, but we need your help.

AHCA/NCAL Provides Update on PPE
There are no quick fixes to the national PPE shortage. One coalition, Project N95, has formed to help link PPE suppliers with health care providers in need. More information on PPE availability, conservation, and what to do when you are running low are available here from AHCA/NCAL.

We will keep you apprised of any new developments with the national PPE supply as these details become available.

COVID-19 Testing Vendors for Long-Term Care Providers
On Monday, AHCA/NCAL provided a summary of the challenges LTC providers are facing in gaining access to COVID-19 testing.

We, along with our national organization, have been seeking companies who can provide testing for LTC providers with reasonable turnaround times, and have put together a list of credible vendors here.

This list will be continuously updated as more vendors are found. If you know of any vendors that should be added to this list, please contact COVID19@ahca.org.

No-Interest COVID-19 Financial Support Available
The CMS COVID-19 Accelerated Payment Program is a streamlined version of existing policy that allows Medicare Administrative Contractors (MACs) to issue no-interest short term loan payments in certain circumstances, including national emergencies.

AHCA members and Independent Operator Council co-chairs Sarah Schumann and Mark Traylor, who submitted requests for and quickly received the accelerated payments, have the following recommendations for their peers:

“We strongly recommend that SNF operators take full advantage of the CMS COVID-19 Accelerated Payment Program.  It’s a simple 5-10-minute process to complete and submit the application for an interest-free loan to assure adequate cash-flow during these challenging times.  Since it must be paid back later, we suggest setting this advance into a separate reserve account to use as an emergency fund.” 

Providers can learn more details in the AHCA Accelerated and Advanced Payments FAQ document here.

Pennsylvania Licensing Waivers
Since March 17, the Pennsylvania Department of State has issued 30 licensing waivers to allow licensed professionals, facilities and trainees to respond to COVID-19.

The Department of State website will be updated regularly as additional requirement waiver information becomes available. Licensees with questions should contact their state licensing board via the email addresses on the Department of State website.

OSHA Expands Temporary Enforcement Guidance on Fit-Testing
OSHA has issued new enforcement guidance for enforcing annual fit-testing requirements of the Respiratory Protection standard as a result of supply shortages of N95s or other filtering facepiece respirators. This guidance now includes healthcare as well as all other workplaces covered by OSHA where there is required use of respirators.

Reminder: Social Media Best Practices
Many of our members have turned to social media to make sure the loved ones of residents are able to stay engaged while restricted visitation policies remain in place.

To ensure the privacy and dignity of patients and residents, consider these best practices before posting to your facility’s social media channels. If you have any questions, please reach out to Shayna Varner, our Director of Communications, at svarner@phca.org.

 

 

Wednesday, April 8, 2020 – 7:50 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 1,680 new positive cases of COVID-19, a day-over-day increase of 101, bringing the statewide total to 16,239 cases.

The department has reported a total of 310 COVID-19-related deaths statewide, up 70 from yesterday.

A few updates:

PHCA Sends Letter to Governor Wolf for Funding and Civil Immunity 
As the number of positive COVID-19 cases rise in nursing homes, personal care homes and assisted living residences across the state, we have identified two actions that Governor Tom Wolf must take immediately to get much-needed support to our providers, staff and residents.

Earlier today, we partnered with LeadingAge PA and sent a joint letter to the governor, reiterating the importance of emergency funding to help providers cover increased costs due to staffing, PPE and supplies.

We also urged the governor to take the important step that many of his colleagues have already taken across the country, including in New York, New Jersey, Connecticut and Vermont: issue an executive order granting civil immunity to health care providers.

You and your staff are doing all you can to protect your residents. You should not have to worry about the threat of lawsuits.

We will keep you updated on these requests, and we’re hopeful that Governor Wolf will act in the coming days.

Governor Wolf Signs Executive Order to Redistribute PPE Based on Provider Need
Today, Governor Wolf announced an executive order giving the Pennsylvania Emergency Management Agency (PEMA) and the Department of Health authority to seize and redistribute PPE to meet the surge of COVID-19 cases across the state.

The executive order will give PEMA the authority to reimburse facilities for PPE and equipment seized as part of the redistribution effort and will arrange for supplies to be allocated where they are needed most.

Please note: we are opposed to any decree that allows state government to take PPE from your facility or community and distribute it elsewhere. We have calls with DOH and DHS tomorrow and will seek clarification on this order.

New Resource: When COVID-19 Gets into Your Facility
According to federal guidelines, steps should be taken now to limit the spread of COVID-19 amongst staff and residents in your facility.

AHCA/NCAL has compiled this resource to outline key steps you can take to protect residents in your care.

AHCA/NCAL Offers Guidance in Response to OSHA Communication on Lack of PPE
Are you receiving letters from OSHA regarding the lack of PPE in your facility? AHCA/NCAL is recommending preparing a plan with the following information:

  • If you are running low on PPE, follow the CDC guidance and guidance from your local health department.
  • Have a plan that deals with potential exposure to COVID-19 for employees.
  • Communicate this plan to all staff often and have it available to review.

Update on Recording Workplace COVID-19 Exposures to OSHA
OSHA recordkeeping requirements at 29 CFR Part 1904 mandate covered employers record certain work-related injuries and illnesses on their OSHA 300 log. While these requirements exempt recording of the common cold or flu, COVID-19 is a recordable illness when a worker is infected on the job if the following criteria are met:

  • Case is confirmed COVID-19
  • The case is work-related as defined by 29 CFR 1904.5 and
  • The case involves one or more of the general recording criteria set forth in 29 CFR 1904.7

For more information, click here to visit OSHA’s injury and illness recordkeeping reporting requirements page.

 

 

Tuesday, April 7, 2020 – 7:38 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 1,579 new positive cases of COVID-19, bringing the statewide total to 14,559 cases.

The department has reported a total of 240 COVID-19-related deaths statewide.

All 67 counties in Pennsylvania now have reported cases of COVID-19.

A few updates:

Update: Federal FMAP Dollars and Advocacy
Yesterday, I gave you an update on our advocacy efforts to secure more funding in the midst of this crisis.

Last night, we sent a plea to every member of our state House and Senate, urging their support for you, your staff and your residents.

And today, our ask was formally printed in the Pennsylvania Capital-Star, the go-to source for the state legislature in Harrisburg: Here’s how Wolf, lawmakers can help our nursing home heroes.

Again, we know how busy you are, and we’re not asking you to step away from the care you’re providing. But if you know your state Representative or Senator, and you’ve spoken with him or her about funding before, now is the time to remind them how urgent it is to prioritize long-term care in the state capitol.

And help us make sure we get the word out about the work you’re doing on social media.

Be sure to send us your videos, testimonials, pictures, etc. in which you ask your legislator for help. Send all videos to Shayna Varner, our Director of Communications, at svarner@phca.org.

Pennsylvania Health Alert Network Releases Guidance on Providing Documentation
We’ve heard from providers looking for additional guidance on when to provide documentation to patients and residents as they await a COVID-19 test, and what they should do while they wait. See below for links to more helpful information:

U.S. Senators Bob Casey and Pat Toomey Request Guidance from CMS on Special Focus Facility (SFF) Program
Last night, U.S. Senator Bob Casey reached out to let us know he and his colleague, Senator Pat Toomey, sent a letter to CMS commending the dedicated health care workers in long-term care facilities during the response to COVID-19.

In addition, the senators requested information on how the agency is working with nursing homes affiliated with the Special Focus Facility (SFF) program to slow the spread of COVID-19. You may recall this has been a focus of the Senators since early last year.

 

 

Monday, April 6, 2020 – 8:13 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 1,470 new positive cases of COVID-19, bringing the statewide total to 12,980 cases.

The department has reported a total of 162 COVID-19-related deaths statewide.

As you’ve likely seen in nightly news reports – or you’re experiencing it in your own facility or community – many of the positive cases are now in our nursing homes. And while the total is only approximately 15% of our population, and the numbers pale in comparison to New York and New Jersey, we know you and your staff are doing anything and everything to mitigate the impact of the virus.

So, please continue to ask us questions. Reach out for clarification. And let us know how we can help. With open lines of communication to DOH, DHS, the hospital systems, the Managed Care Organizations and members of the legislature, we’re here to help you.

Know that we are proud to fight alongside you. And we’ll continue to support you in any way we can.

A few updates:

Federal FMAP Dollars and Advocacy
Since the COVID-19 epidemic began here in Pennsylvania, we have been asking Governor Tom Wolf for help.

Two weeks ago, we, LeadingAge PA and the healthcare unions sent a letter to the Governor, making our case for more funding in the midst of this crisis. And since then, we’ve advocated on your behalf with every member of legislative leadership.

Tonight, we sent a plea to every member of our state House and Senate, urging their support for you, your staff and your residents.

Republican, Democrat – it doesn’t matter. Supporting long-term care should be a bipartisan issue.

We know how busy you are, and we’re not asking you to step away from the care you’re providing. But if you know your state Representative or Senator, and you’ve spoken with him or her about funding before, now is the time to remind them how urgent it is to prioritize long-term care in the state capitol.

And let’s make sure we get the word out about the work you’re doing on social media. Be sure to send us your videos, testimonials, pictures, etc. in which you ask your legislator for help. Send all videos to Shayna Varner, our Director of Communication, at svarner@phca.org.

IHME COVID-19 Projections and Resources
IHME has created a model to forecast COVID-19 projections, cases and the demand for hospital services in each state. This model integrates a number of different data sources into one tool to best predict hospital utilization.

You can click on a Pennsylvania-specific model to see our predicted apex, numbers and projections over the course of the next few weeks.

DHS Offering COVID-19 Education and Support Network Webinar
The DHS Bureau of Human Services Licensing has partnered with the Jewish Healthcare Foundation to create a COVID-19 education and support network using Tomorrow’s HealthCare™, a web-based portal, to provide support to personal care homes and assisted living residences.

The introductory webinar will be hosted tomorrow, April 7 from 2:00 – 3:00 pm. Click here to register. The webinar will be recorded, and the recording and materials will be available afterward.

CMS: Medicare Accelerated and Advanced Payments 
As a reminder: CMS has announced that it will expand its accelerated and advance payment program for Medicare providers during COVID-19. These payments provide emergency funding and address cash flow issues based on historical payments when there is a disruption in claims submission and/or claims processing.

To qualify for accelerated or advance payments, a provider must:

  • Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s request form;
  • Not be in bankruptcy;
  • Not be under active medical review or program integrity investigation; and
  • Not have any outstanding delinquent Medicare overpayments.

CMS anticipates that the payments will be issued within 7 days of the provider’s request. See this informational fact sheet on the accelerated and advance payment process and how to submit a request.

CMS guidance on provider eligibility and submission processes from today’s announcement differ from those found in the Medicare Financial Management Manual (Section 150). Providers should contact their MACs directly to understand how the MAC will be operationalizing CMS’s guidance.

The MAC regional coverage map can be found here.

Communication with Families and Residents
It is important to keep families and staff informed if you do have a confirmed case of COVID-19 in your facility. To help with communication, AHCA/NCAL has developed a sample letter for families and staff and talking points for the media and broader public.

We would ask you to also reach out to Shayna Varner at svarner@phca.org to help with media inquiries and public statements.

 

 

Saturday, April 4, 2020. – 6:18 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 1,597 new positive cases of COVID-19, bringing the statewide total to 10,017 cases.

The department has reported a total of 136 COVID-19-related deaths statewide.

A few additional updates:

Updated Guidance from AHCA/NCAL
AHCA/NCAL has updated this resource as COVID-19 spreads across the country and impacts nursing homes and AL/PC communities. Due to the rapid progression of the virus, providers should now assume it is already present in the surrounding community – and even in their facility. This resource outlines four action steps.

In addition, AHCA/NCAL has updated this cohorting consideration guide, as CMS released new guidance last week.

All providers should make plans for cohorting residents now, even if there are no positive cases (per CMS guidance). Cohorting is imperative in helping to control the spread of the virus.

Pennsylvania Primary Election
The Pennsylvania Primary Election, originally scheduled for April 28, has officially been postponed to Tuesday, June 2nd.

Thanks to new election law, voters in PA now have the ability to vote by mail under any circumstance. You can apply for mail-in ballots online, by mail, or in person, until one week before the election.

This was a necessary change PHCA advocated for so that more residents and staff could take part in the electoral process.

To request your mail-in ballot for the upcoming primary election, click here.

 

 

Friday, April 3, 2020 – 4:44 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 1,404 new positive cases of COVID-19, bringing the statewide total to 8,420 cases.

The department has reported a total of 102 COVID-19-related deaths statewide.

A few additional updates:

New Guidance from CMS for Skilled Nursing Facilities
Late yesterday, in consultation with the CDC, CMS issued new recommendations to state and local governments, as well as nursing homes, to help mitigate the spread of COVID-19. The recommendations include the following:

  • Nursing homes should immediately ensure they are complying with all CMS and CDC guidance related to infection control, particularly focusing on consistent hand washing and changing and removing of PPE based on preliminary data from infection control focused surveys.
  • CMS/CDC urges State and local leaders to consider the needs of long term care facilities with respect to supplies of PPE and COVID-19 tests.
    • Medicare is now covering COVID-19 testing when furnished to eligible beneficiaries by certified laboratories.  These laboratories may also choose to enter facilities to conduct COVID-19 testing.
  • Nursing homes should immediately implement symptom screening for all staff, residents, and visitors – including temperature checks.
    • An exception to this is EMS workers responding to an urgent medical need.
    • Facilities should limit access points and ensure that all accessible entrances have a screening station.
    • Patients and residents who enter facilities should be screened for COVID-19 through testing, if available.
  • Nursing homes should ensure all staff are using appropriate PPE when they are interacting with patients and residents, to the extent PPE is available and per CDC guidance on conservation of PPE. The recommendations provide NEW detail on steps to take including:
    • All long-term care facility personnel in the country should wear a facemask while they are in the facility.

FAQs re: Alignment of Isolation Waivers, MDS and Payment Policies
AHCA has developed a FAQ document to help providers navigate how the various CDC and CMS COVID-19 guidance and Section 1135 waivers interact with current MDS-RAI coding guidance and payment models, specifically for situations when it is determined that a resident requires isolation related to COVID-19.

This guidance is intended to provide context to help guide provider decisions and will be updated as necessary as new policies are issued.

PHCA Develops COVID-19 Cost Calculator
During this week’s PHCA SNF COVID-19 Committee call, the topic of tracking increased staffing and equipment costs related to COVID-19 was discussed. The committee asked if we could create a tracking tool to calculate a basic PPD cost increase.

So, that’s exactly what we did. We’ve uploaded this tracker to our COVID-19 portal.

Note: This tracker is a basic template. We’ve also added blank cells with formulas for you to populate with any expenditures not captured.

If you have any questions, please reach out to Chris Fisher, Gail Weidman or Zane Barrick to discuss. Special thanks to the PHCA team for creating this resource.

Provider Civil Immunity During COVID-19
As of today, eight states across the country, including New York and New Jersey, have implemented civil immunity for healthcare providers and workers during the COVID-19 emergency via either gubernatorial executive order or statute passed by the legislature.

We are currently working with Pennsylvania’s other healthcare providers, including hospitals and physicians, to achieve the same civil immunity for you.

 

 

Thursday, April 2, 2020 – 8:06 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 1,211 new positive cases of COVID-19, bringing the statewide total to 7,016 cases in 62 counties.

The department has reported a total of 90 COVID-19-related deaths statewide.

A few additional updates:

PHCA Requests Regulatory Flexibility for Providers and COVID-19 Patients
As our long-term care continuum responds to the growing number of COVID-19 positive patients, our rules, regulations and guidelines must inevitably change.

And this will almost certainly require coordination between various departments in state government.

That’s why, earlier today, we sent a joint letter to Governor Tom Wolf, the Department of Health, the Department of Human Services and the Department of Aging to request coordination, collaboration, flexibility and clear guidelines regarding COVID-19.

We were proud to partner with LeadingAge PA and PALA on this important initiative. This applies to all our members, including nursing homes, personal care homes and assisted living residences.

We’ll continue to work every day to ensure you are part of the solution during this crisis. And to do that, we’ll need state government to do their part.

AHCA/NCAL Releases New Guidance to Prevent Transmission of COVID-19
Every person-to-person interaction inevitably increases the risk of spreading COVID-19. Today’s guidance from AHCA/NCAL offers ideas on how to limit interactions with your residents while still providing the highest level of quality and compassionate care.

CMS Reports Frequent Incorrect Use of PPE
According to CMS, a common theme of COVID-19 infection control-focused surveys has been the incorrect use of PPE, including donning and doffing procedures. Surveyors are now asking staff to demonstrate handwashing, as well as the donning and doffing of PPE.

We encourage you to review the appropriate way to apply and remove all PPE, including gloves, gowns, masks, and eye protection.

  • These documents can be printed and posted to ensure your staff is aware of how to appropriately don PPE.
  • These documents can be printed and posted to ensure your staff is aware of how to appropriately doff PPE.
  • The following video explains hand hygiene and donning/doffing of PPE appropriately.

Update: Suspension of Professional and Practical Nursing Laws and Regulations
The Pennsylvania Department of State has continued to issue updates on a series of licensure waivers to provide additional flexibility to licensed health care providers under the State Board of Nursing.

To learn more, visit the Department of State’s Waived and Suspended Licensing Regulations page for information on all waivers. This page will be updated continuously as additional waivers are approved.

We have received questions regarding the licensing process for out-of-state RNs and LPNs wishing to assist in Pennsylvania’s COVID-19 response. Those individuals should:

  • Apply for a temporary practice permit and license at www.pals.pa.gov.
    • Use the Application Checklist and answer the questions to apply for Licensure by Endorsement.
    • In the Application, select YES to the question asking, “Do you want to obtain a Temporary Practice Permit?
    • Upon evaluation of your application, a Temporary Practice Permit will be emailed.
  • A criminal background check will only be required prior to the issuance of a license.

Since some English language proficiency examinations have become unavailable due to the COVID-19 emergency, the requirement for English language proficiency testing for RNs and LPNs licensed out of state has been temporarily waived.

Individual applicants should send any questions to the State Board of Nursing’s resource account at ST-NURSE@pa.gov.

DCED Waiver Request Deadline is TOMORROW: Friday, April 3
Tomorrow marks the DCED waiver deadline to provide continuing training for professionals in essential services, including nurses.

For nursing facilities that conduct their own in-house CNA training programs, you may request a waiver to maintain CNA training operations and continue to develop an adequate supply of nurse aides.

The Commonwealth has made the following resources available for providers to request waivers:

  • ra-dcedcs@pa.gov– A resource account to send questions about whether businesses need to close.
  • RA-dcexemption@pa.gov– A resource account if businesses want to apply for a waiver and want information on the process.

This waiver process pertains to an already-approved nurse aide training program.

Please note that Pearson VUE is closed until mid-April and no nurse aide competency exams will be scheduled until Pearson VUE opens. For additional information on the nurse aide competency exam, please go to https://home.pearsonvue.com/pa/nurseaides.

PHCA is awaiting official word from DOH as to whether the 120-day requirement for CNAs having completed their training to complete their CNA test will be waived, pending the opening of testing.

PHCA Partners with Harrisburg University to Provide 3D-Printed PPE
Yes, you read that right.

Today, Harrisburg University of Science and Technology announced a partnership with PHCA to provide workers on the frontlines with 3D-printed face shields amidst a statewide shortage of PPE.

The first batch of 12 face shields will be delivered to Providence Place Senior Living in Dover, PA. We anticipate many more to come!

Suppliers with Available PPE and Other Resources
Many of our existing business partners – as well as new organizations – have stepped up to provide you with a number of resources including additional supply needs, PPE and other educational opportunities.

To make it easy and accessible for you, we’ve created a new page on our online portal, PHCA COVID-19 Resources. This will serve as an up-to-date list of PPE suppliers and other resources that may be helpful as your facility or community responds to COVID-19.

 

 

Wednesday, April 1, 2020 – 9:11 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 962 new positive cases of COVID-19, bringing the statewide total to 5,805. This is the highest daily number to date.

The department has reported a total of 74 COVID-19-related deaths statewide.

In addition, Governor Wolf has expanded his stay-at-home order to include all Pennsylvania counties. This stay-at-home order is in place until Thursday, April 30.

A few updates:

AHCA/NCAL: Effects of COVID-19 on Residents, Families and Staff
Long-term care providers and staff should prepare for COVID-19 entering a facility. As we saw in Washington state, and as we’re seeing (and experiencing) now across Pennsylvania, the virus affects everyone differently.

Residents and staff may become ill. Hospitalizations will likely occur. And, unfortunately, we’ve already seen residents in our facilities succumb to the virus.

These are difficult situations, but we need to be prepared.

Our national organization, AHCA/NCAL, has prepared the following steps to help you and your staff get ready for what’s ahead.

BHSL Issues New Collective Guidance
Late yesterday, BHSL issued new collective guidance related to infection control protocols, PPE and staffing, as well as additional resources from the CDC, CMS and the PA Department of Health. This guidance has also been added to our online portal: phca.org/COVID19.

In addition, BHSL is looking for ways to help AL/PC providers address existing and emerging staffing issues.

If you have any suggestions, please reach out to Gail Weidman, Director of Policy and Regulatory Affairs, at gweidman@phca.org and Kevin Cysyk, Director of Assisted Living and Personal Care, at kcysyk@phca.org.

Suppliers with Available PPE and Other Resources
Over the last few weeks, we’ve been in search of alternative sources of PPE across the state – and even across the country.

Many of our existing business partners – as well as new organizations – have stepped up to answer our call.

To make it easy and accessible for you, we’ve created a new page on our online portal, PHCA COVID-19 Resources. This will serve as an up-to-date list of PPE suppliers and other resources that may be helpful as your facility or community responds to COVID-19.

Honor our Healthcare Heroes
As a reminder: we’ve already asked you to send us heartwarming pictures, messages and stories about the residents in your facilities and communities. And we’re continuing to broadcast those incredible stories every day on social media.

But we cannot forget about you and your staff. You are heroes, in every sense of the word.

As this crisis worsens, and our direct care workers continue to risk their health and safety to protect their residents, we believe it’s our duty to share this story with state government, elected officials and the general public.

So film a quick video. Take a selfie. And help us show the world the good work you’re doing. You can send everything to Shayna Varner, our Director of Communications, at svarner@phca.org.

 

 

Tuesday, March 31, 2020 – 8:03 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 756 new positive cases of COVID-19, bringing the statewide total to 4,843 in 60 counties.

The department has reported a total of 63 COVID-19-related deaths statewide.

In addition, Governor Wolf has expanded his stay-at-home order to include Cameron, Crawford, Forest, Franklin, Lawrence, Lebanon and Somerset counties. More than half of Pennsylvania’s 67 counties are now included in the stay-at-home order.

Some additional updates:

CMS Issues Blanket Regulatory Waivers
Yesterday, CMS issued several blanket waivers for long term care providers that will apply across the United States. The waivers have a retroactive effective date of March 1st and will last through the end of the emergency declaration.

We were thrilled to see CMS finally remove some of the ‘road blocks’ that might prevent providers from creating standalone COVID-19 floors, wings or facilities.

Because of these waivers, providers can now transfer patients within facilities, or to other facilities, solely for the purposes of cohorting and separating residents with and without COVID-19.

CMS also approved the temporary certification of non-skilled nursing facilities to be used as emergency COVID-19 care sites, as well as waiving certain conditions of participation and certification requirements for opening a nursing facility if states identify a need for a new site to open quickly. We might begin to see schools, dorm rooms and convention centers open up as COVID sites.

Additionally, operators can also now use a variety of non-resident rooms, including dining rooms, activity areas, and conference space, to provide care on a temporary basis to help with surge capacity.

The updated guidance also waives certain training and certification requirements for nurse aides in an attempt to ease the workforce strain on operators.

Most of this is likely in response to New York’s decision to prevent operators from rejecting residents solely based on a COVID-19 diagnosis, or requiring a test as a condition of admission.

Additionally, PHCA will be submitting a waiver request to CMS to seek more relief for providers. We’ve heard from our members on the front lines regarding many issues, and we can’t afford to wait for this relief any longer.

DOH Recommending ‘Universal’ Masking
During today’s post-acute provider call, the Department of Health recommended universal, around-the-clock masking for health care providers in facilities.

While that sounds fine, we had a simple question: where are the masks?

We’re acutely aware of the need for PPE in facilities across the state, and every conversation with DOH, DHS, the Governor’s office and the legislature includes talk of more PPE for long-term care providers.

For now, universal masking is simply a recommendation, not a mandate.

Suppliers with Available PPE
Speaking of masks…

Over the last few weeks, we’ve been in search of alternative sources for PPE across the country. And as that search yields results, we’ll share it with you in our daily update.

Here is an additional option for sourcing masks and/or gowns:

NorthCape, a major outdoor furniture manufacturer based in Alsip, Illinois, has transitioned its production and distribution functions to produce and distribute hospital-approved and nurse-designed fabric masks and nurse gowns. They are currently producing these products, and have the capacity to increase output. For pricing and ordering information, click here.

Combating the Trial Bar
It’s important for you to be aware: in the midst of our membership risking it all on the front lines of the COVID-19 epidemic, not all advocacy groups seem to be supporting you in Harrisburg.

Late last week, the PA trial bar and trial attorneys sent a letter to the state Supreme Court, asking for the ability to continue to drag long-term care providers into court for discovery proceedings and civil cases.

Their reasoning? Trial attorneys are struggling, too.

Let me be clear: while PHCA may be focused on the regulatory and policy issues affecting providers during this crisis, we’ll never lose sight of the big picture. And we’re never too busy to stand up to the trial bar.

Yesterday, associations representing healthcare providers and workers sent a letter to the Supreme Court, asking for a delay in all court proceedings. We were proud to sign on to that letter.

Please know: we’ve got your back, no matter the issue or enemy.

 

 

Monday, March 30, 2020 – 7:18 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 693 new positive cases of COVID-19, bringing the statewide total to 4,087 in 59 counties.

The department has reported a total of 49 COVID-19-related deaths statewide.

In addition, Governor Wolf has expanded his stay-at-home order to include Carbon, Cumberland, Dauphin and Schuylkill counties.

This stay-at-home order, as well as school closures and the closure of all non-life-sustaining businesses, has been extended through Thursday, April 30. 

Some additional updates:

Ongoing Discussions with Federal and State Officials
Earlier today, PHCA participated in discussions with federal and state officials to share the significant challenges facing Pennsylvania’s long-term care providers during the COVID-19 crisis. We spoke with U.S. Senator Bob Casey, as well as the northeast PA Legislative Caucus, regarding critical PPE shortages, staffing challenges and much-needed state and federal funding.

Additionally, we shared our concerns related to any state mandate requiring nursing homes and long-term care facilities (including AL/PC) to accept all discharged hospital patients, including those who have tested positive for COVID-19.

Both conversations yielded positive support, and we will continue to work with our federal and state legislators to ensure you are not faced with mandatory admissions.

CMS Moves to Increase Hospital Capacity
In an effort to combat the lack of hospital beds nationwide, CMS today issued guidance to allow healthcare systems and hospitals to provide services in locations beyond their existing walls.

Under CMS’s temporary new rules, hospitals will be able to transfer patients to outside facilities, such as ambulatory surgery centers, inpatient rehabilitation hospitals, hotels, and dormitories, while still receiving hospital payments under Medicare.

And ambulatory surgery centers can contract with local healthcare systems to provide hospital services, or they can enroll and bill as hospitals during the emergency declaration as long as they are not inconsistent with their State’s Emergency Preparedness or Pandemic Plan. CMS waivers will also permit doctor-owned hospitals to increase their number of beds without incurring sanctions.

AHCA/NCAL Releases New Guidance on Hospital Transfers 
Our national organizations are working on the very same issue. Today, they released new guidance for long term care facilities on accepting admissions from – and transferring patients to – hospitals during COVID-19.

These revisions are based on new evidence from the CDC, which found that 57% of elderly residents who tested positive for COVID-19 did not have symptoms, but shed the virus at levels that made them infectious to others.

Based on this new CDC data, unless a person has tested negatively for COVID-19 before admitting them to your building, you should assume the person has COVID-19 regardless of them having or not having symptoms.

New Suppliers Producing PPE for Pennsylvania
If state government won’t help us, we’ll have to find it ourselves.

Over the next few days, you can count on our daily updates including alerts on alternative sources of PPE in Pennsylvania (and across the country).

For the last few weeks, we’ve been in search of those alternative sources, and we’ve located a few. For example:

RCJ Global Enterprises, an organization run by Roberto Clemente, Jr., has identified a source of personal protective equipment in western Pennsylvania. The manufacturer has complete certifications and is used across the globe for medical supplies. For more information, please email rcjglobalenterprises@gmail.com. You will receive additional information about purchase minimums and other details for placing an order.

In addition, The Beistle Company, a Pennsylvania medical device manufacturer, has retooled its manufacturing capabilities to make plastic face masks. These masks are currently in production. While not yet FDA or ASTM approved, they would still be effective during a shortage. For more information, please contact Doug Holdren at dmholdren@beistle.com or 717-532-2131, ext. 324.

Updated Contact Information for Nursing Facility Field Offices
Outlined below are the email addresses for the nursing facility field office supervisors. Any waiver/exception request should be sent directly to the supervisor of the appropriate field office:

 

 

Sunday, March 29, 2020 – 6:39 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 649 new positive cases of COVID-19 in Pennsylvania, bringing the statewide total to 3,394 covering 58 counties. The department has reported a total of 38 COVID-19-related deaths statewide.

During a press conference early this afternoon, DOH Secretary Dr. Rachel Levine spoke about prevention measures in nursing homes, assisted living communities and personal care homes. She also indicated that 5% of nursing homes in Pennsylvania are currently treating COVID-19 positive cases, with the majority of cases identified in the southeast.

In the last two days alone, there have been dozens of news articles and television segments devoted solely to positive cases in nursing homes across the state. We are working with the Governor, his administration and the Department of Health to respond to these cases, and to mitigate the impact of the virus.

A few additional updates:

CMS: Medicare Accelerated and Advanced Payments 
CMS announced yesterday that it will expand its accelerated and advance payment program for Medicare providers during COVID-19. These payments provide emergency funding and address cash flow issues based on historical payments when there is a disruption in claims submission and/or claims processing.

To qualify for accelerated or advance payments, a provider must:

  • Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s request form;
  • Not be in bankruptcy;
  • Not be under active medical review or program integrity investigation; and
  • Not have any outstanding delinquent Medicare overpayments.

Medicare will start accepting and processing the accelerated and advance payment requests immediately. CMS anticipates that the payments will be issued within 7 days of the provider’s request. See this informational fact sheet on the accelerated and advance payment process and how to submit a request.

CMS guidance on provider eligibility and submission processes from today’s announcement differ from those found in the Medicare Financial Management Manual (Section 150). Providers should contact their MACs directly to understand how the MAC will be operationalizing CMS’s guidance. The MAC regional coverage map can be found here.

Department of Labor Guidance on ‘Health Care Provider’ Definition
At the urging of AHCA/NCAL and PHCA to include nursing home, assisted living and personal care staff in their definition of “health care provider”, the U.S. Department of Labor has published guidance to address exemptions and employer requirements to the expanded Family Medical Leave Act and sick leave benefits included in the recently passed Families First Coronavirus Response Act.

The Department’s exemptions FAQ (see #56) states that the “health care provider” exemption to these new leave requirements applies to “anyone employed at any… nursing facility, retirement facility, nursing home, home health care provider… This includes any permanent or temporary institution, facility, location, or site where medical services are provided that are similar to such institutions.”

Additionally, our friends at Post & Schell, P.C. have conducted their own thorough analysis and are extending it to our membership. Click here for their analysis, which can also be found on our online portal: phca.org/COVID19.

New State Guidance for AL/PC Providers
After a great deal of work, PHCA has learned that the Office of Long-Term Living (OLTL) has suspended, with conditions, specific license regulations for personal care homes and assisted living residences. In addition, OLTL has imposed restrictions on visitations and temporarily suspended annual inspections.

We’ve highlighted some of the provisions you’ve specifically asked about below:

  • Criminal history checks and hiring policies shall be in accordance with the Older Adult Protective Services Act: a facility may extend a provisional hire for the sole reason that FBI clearances/checks are not available. The facility must document the reason why the FBI clearance/check was not available. Providers shall obtain the FBI clearances/checks within 60 days from the date the suspension of the regulation is lifted. This only relates to licensing requirements and does not change any other law.
  • Direct Care Staffing: providers shall notify their Bureau of Human Services Licensing (BHSL) regional office via email of any anticipated or actual staff shortages and of their plan to mitigate the staff shortage for approval by the regional director for BHSL.
  • Annual Trainings: all the annual trainings required under these regulatory provisions are provided a 90 grace period. The training shall be completed within 90 days from the date the suspension of the regulations is lifted.
  • Fire Drills: the requirement of an unannounced fire drill at least once a month is being suspended. The suspension shall be lifted upon the date the Disaster Proclamation is lifted by the Governor. In addition, the annual requirement of a fire safety inspection and fire drill conducted by a fire safety expert is being suspended.  The annual fire safety inspection and fire drill must be completed within 60 days of the date the Disaster Proclamation is lifted by the Governor.
  • DME- Medical Evaluations: if the resident’s primary care physician determines that the medical evaluation can be conducted at a later date, then the facility can postpone the medical evaluation to the date determined by the physician; provided that, the medical evaluation must be performed no later than 90 days after the Emergency Declarations is lifted. The facility shall document the primary care physician’s determination in the resident’s record for subsequent review.
  • Medication Administration Training: staff who have been previously trained may continue to administer oral; topical; eye, nose and ear drop prescription medications; and epinephrine injections for insect bites or other allergies for up to 90 days beyond the staff’s training renewal date. Staff who have been previously trained may continue to administer insulin injections for up to 90 days beyond the staff’s training renewal date.

There are a number of other regulatory provisions that are being suspended. Please review this document for the full list. If you have any questions, please reach out to Gail Weidman, Director of Policy and Regulatory Affairs, at gweidman@phca.org or Kevin Cysyk, Director of Assisted Living & Personal Care, at kcysyk@phca.org.

 

 

Saturday, March 28, 2020 – 7:27 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 533 new positive cases of COVID-19 in Pennsylvania, bringing the statewide total to 2,751. The department has reported a total of 34 COVID-19-related deaths statewide.

In addition, Governor Wolf has expanded his stay-at-home order to include three additional counties: Beaver, Centre and Washington.

Federal Funding Update
Last week, Congress passed the Families First Coronavirus Response Act, which granted a 6.2% FMAP (Federal Medicaid match) increase to all 50 states. That 6.2% increase equates to $1.5 billion in Medicaid dollars for Pennsylvania.

Additionally, President Trump has signed the CARES (Coronavirus Aid, Relief, and Economic Security) Act. This package, which has reached upwards of $2 trillion total, will include a temporary suspension of the 2% Medicare sequestration cut and $100 billion for health care providers (including nursing homes, hospitals, etc.).

State Funding Update 
Given the $1.5 billion in FMAP dollars, PHCA is asking the Governor and General Assembly for a 3% rate increase for providers, plus a $290 million supplemental that will be paid to help combat increased costs due to COVID-19.

There is also $50 million in emergency funding available for Pennsylvania to purchase medical equipment and supplies for nursing homes, hospitals and emergency workers. We’ll be told how those dollars are being allocated in the next two or three days.

Mandatory(?) SNF Admissions from Hospitals
By now, you’ve likely seen the news out of New York state, as nursing home operators have been told they will be required to accept patients infected with COVID-19 who are discharged from hospitals. This is being done in an effort to make hospital beds available to new COVID-19 patients.

Other states are facing this mandate as well. Michigan, Ohio…the list will surely grow in the coming days.

Yesterday, SNF providers were sent guidance from DOH regarding admissions. I do not believe what you received yesterday was a mandate to accept any and all COVID-19 positive residents. And that was corroborated by DOH this morning.

But I do think you need to be ready for the very real possibility of accepting these patients very soon. And we may be on the cusp of ‘containment centers’, or entire facilities that house only COVID-19 positive residents.

And if it’s not an entire facility, it might be a dedicated floor or wing.

And if it’s not one of our facilities, it might be a hotel, convention center or a school.

Please know that this is the topic at the national level. Earlier today, Mark Parkinson, President & CEO of AHCA and Dr. David Gifford, Chief Medical Officer, released a statement addressing state orders directing nursing homes to accept all hospital patients.

To be clear, I think what New York did was wrong. I think it was unjustified. And I don’t want that to happen here in Pennsylvania.

But this is an extraordinary time, and we need to be ready. So, in an effort to make things easier for you, we’ve consolidated all the guidance surrounding new admissions, including additional resources offered by the CDC, into a one-stop resource.

This resource has also been added to the phca.org/COVID19 portal as well.

As this issue continues to be debated across the country and in PA, know that we’re on your side. We’ll share more as soon as we have additional information.

CMS Guidance for Implementing Telehealth in Long-Term Care Facilities
CMS recently issued an electronic toolkit regarding telehealth and telemedicine for long-term care providers.

As you know, CMS has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel.

We highly recommend utilizing telemedicine in your facility. If you have any questions, please let us know.

Weekly Statewide Call for Providers
The weekly statewide COVID-19 call for post-acute care providers hosted by HAP and the Pennsylvania Department of Health Bureaus of Epidemiology and Emergency Preparedness & Response has been moved from Wednesdays at 1 pm to Tuesdays at 1 pm.

These calls will help infection prevention and control staff, hospital communicators, and frontline staff coordinate your facility’s coronavirus preparedness and response.

To call in, dial 929-436-2866. The meeting ID is 621414465#.

Pennsylvania Offers Temporary Licensing Waivers for Health Care Professionals
The Department of State has announced a series of temporary licensing waivers for health care professionals and others during the COVID-19 disaster declaration.

To learn more, click here.

 

 

Friday, March 27, 2020 – 8:15 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there were 531 new positive cases of COVID-19 in Pennsylvania, bringing the statewide total to 2,218.

In addition, Governor Wolf has expanded his stay-at-home order to include nine additional counties: Berks, Butler, Lackawanna, Lancaster, Luzerne, Pike, Wayne, Westmoreland and York counties.

Before we provide a few updates, a note of appreciation:

Thank You
As another week comes to a close, we want to say ‘thank you’.

Thank you for the time you’ve spent, the dedication you’ve shown, and the support you’ve given to your residents, your colleagues and the team here at PHCA.

As you’ve spoken with family and friends about COVID-19 and your profession throughout the last few weeks, I’m sure you’ve heard the following sentiment:

“You didn’t sign up for this”.

Even I, the president of PHCA, have heard this from many colleagues in Harrisburg. “This isn’t why you took this job.”

But in talking to our membership, whether it’s one of our Board members, committee members, an administrator, executive director, front line staff, housekeeper, etc., every single person tells me the same thing: “No, this is exactly what I signed up for. This is why I chose to do what I do.”

Please know that rings true for me. It rings true for the PHCA team. And I’ve seen it ring true for every one of our members.

So I’ll say it again: thank you. Thank you for choosing this path, this profession, and for caring for our most vulnerable. Because there are not many people who can do what you do, especially in these circumstances.

It has been an absolute honor to serve this membership. And we will continue to do that, each and every day (including nights, weekends, etc.).

If you need anything, let us know. And please continue to visit phca.org/covid19 for up-to-date information.

A few additional updates:

Draft Letter to Request Administrative Relief from MCOs
Over the last few days, the Managed Care Organizations (MCOs) have requested providers take on additional administrative tasks during this epidemic. We know that your ability to take on this additional workload is incredibly limited, and we highly encourage you to complete and send this template letter to your MCOs to request relief on any and all administrative burdens that pull valuable staff time and resources away from the resident bedside.

If you have any questions, please contact Gail Weidman, Director of Policy and Regulatory Affairs, at gweidman@phca.org.

CDC Preparedness Checklist for Nursing Homes and other Long-Term Care Settings
As the number of positive cases of COVID-19 increase in hospitals, and our facilities are asked to accept transfers of those individuals, it is very important to review this preparedness checklist from the CDC to ensure you and your staff are ready.

This checklist should be used as a tool to develop a comprehensive COVID-19 response plan, including plans for:

  • Rapid identification and management of ill residents
  • Supplies and resources
  • Sick leave policies and other occupational health considerations
  • Education and training
  • Surge capacity for staffing, equipment and supplies

For guidance from the CDC on steps to take when there are cases in your facility, click here.

License Renewal Deadlines for Administrators, Nurses Extended
The Department of State has extended the occupational licensure renewal deadline for nurses, graduate medical trainees, nursing home administrators and other professionals. The April, May and June license renewal deadlines have been extended to July, August and September. For more, click here.

Third Federal Stimulus Package Signed into Law
Today, the U.S. House passed and the President signed into law the third stimulus bill, the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Of particular note to skilled nursing facilities and assisted living facilities it includes the following provisions:

  • A temporary suspension of Medicare sequestration cut
  • $100 billion fund for eligible health care providers
  • $200 million in funding to prevent, prepare for, and respond to coronavirus
  • Childcare support for health care sector employees

As we learn more about the funding, and exactly how the $100 billion fund for health care providers will be divided, we will let you know.

 

 

Thursday, March 26, 2020 – 5:26 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there are 560 new positive cases of COVID-19 in Pennsylvania, bringing the statewide total to 1,687 in 48 counties.

To date, more than 170 individuals who have tested positive for COVID-19 have required hospitalization. Of those hospitalized, 56 of these individuals have required intensive care and 32 of those patients have required the use of ventilators. More than 40 percent of those requiring hospitalization have been over the age of 65.

In addition, the department also reported five new deaths, bringing the statewide death total to 16.

Yesterday, Governor Wolf expanded his stay-at-home order to include Lehigh and Northampton counties. The stay-at-home order now covers Allegheny, Bucks, Chester, Delaware, Erie, Lehigh, Monroe, Montgomery, Northampton, and Philadelphia counties.

We strongly encourage you to visit phca.org/covid19 for up-to-date information from AHCA/NCAL, DOH, the CDC and CMS. Please use these resources, and let us know how we can help.

A few additional updates:

U.S. Senate Passes Coronavirus Aid Relief, and Economic Security Act (H.R. 748)
Yesterday, the U.S. Senate passed the CARES (Coronavirus Aid, Relief, and Economic Security) Act, which now heads to the House of Representatives for consideration. Of note to skilled nursing facilities and AL/PC, the stimulus includes:

  • A temporary suspension of Medicare sequestration cut
  • $100 billion fund for eligible health care providers
  • Deferral of 6.2% payroll tax
  • $200 million in funding to prevent, prepare for, and respond to COVID-19
  • Childcare support for health care sector employees
  • New loan program for certain employers
  • Funding for housing for the elderly and disabled

We expect the House will pass the bill tomorrow. We can then offer a more detailed summary of the various provisions specific to long-term care providers and workers.

Governor Wolf Announces $50 Million in Emergency Funding To Purchase Medical Equipment and Supplies for Nursing Homes, Hospitals and Emergency Workers
Today, Gov. Wolf announced the availability of $50 million in state funding to purchase medical equipment and supplies for nursing homes, hospitals and emergency medical services to meet urgent patient and staff needs to address COVID-19.

This was done in conjunction with the members of the state House and Senate.

While this certainly does not solve the problem, it is a step in the right direction for providers and workers. We were proud to work alongside the legislature and administration to secure these funds.

DHS Portal Offers Searchable List of Child Care Providers Approved to Operate During COVID-19 Emergency
DHS has added a searchable portal to help health care workers identify child care providers who have been approved to operate during COVID-19. To find a child care provider in your area, click here.

Please note that this list may change as providers may make the decision to close at any time. DHS is working to keep this list as up-to-date as possible.

HCC Asks Providers to Update Facility Information in Knowledge Center
In an effort to increase awareness and manage emergent concerns, the Pennsylvania Health Care Coalitions (HCC) and the Department of Health will be asking post-acute facilities to begin inputting facility-specific information into the Knowledge Center multiple times per day.

Additional information will be released soon; however, we strongly encourage all members to begin the registration and logging process. If you are not yet set up with an account for the Knowledge Center, please email kchelp@haponline.org with a request to join and include your title and facility name.

REMINDER: CDC Strategies to Optimize PPE and Equipment
As a reminder, the CDC issued guidance last week regarding the use and reuse of masks, gowns and face shields. We know many of you have already taken steps to significantly conserve masks and gowns and extend the availability of your remaining PPE and we encourage you to continue these practices as supply improves.

If you are in need of PPE, contact your regional Health Care Coalition. The Coalition will deploy a quick response team, which includes an epidemiologist, to your facility to assess the situation and provide emergency PPE based on the level of risk identified in your community.

 

 

Wednesday, March 25, 2020 – 12:15 p.m.

Today, the Pennsylvania Department of Health released new COVID-19 numbers: there are 276 new positive cases of COVID-19 in Pennsylvania, bringing the statewide total to 1,127 cases. This is the largest one-day increase of reported cases.

In addition, Governor Wolf has added Erie County to his stay-at-home order.

Please remember: PHCA is here to help during this time. We’re here to support you and your staff, to help with media response, and to mitigate the impact of this virus on your community.

We would encourage you to visit phca.org/covid19 for daily information from AHCA/NCAL, DOH, the CDC and CMS. Please use our resources, and let us know how we can help.

A few additional updates:

Update on Federal Stimulus Package
Late last night, the White House and Congress reached an agreement on a $2 trillion stimulus funding package to address growing economic challenges during the COVID-19 outbreak. Elements of the proposal include $250 billion for direct payments to individuals and families, $350 billion in small business loans, $250 billion in unemployment insurance benefits and $500 billion in loans for distressed companies.

There is also $130 billion included in the package for healthcare providers. The media may be reporting this will all be paid to hospitals; however, it appears as though this will be divided among all healthcare providers, including long-term care.

PHCA will fight to secure every single dollar for long-term care providers in Pennsylvania.

Retired Health Care Professionals and COVID-19 Response
This morning, Governor Tom Wolf formally suspended several regulations related to the state boards of Medicine, Osteopathic Medicine, Nursing and Pharmacy for the duration of the COVID-19 emergency.

These new suspensions will increase the number of available and qualified health care practitioners in Pennsylvania by allowing retired practitioners to re-enter their field without paying reactivation fees:

  • State Board of Medicine licensees who are inactive/retired status for less than four years can apply for reactivation of their license. This measure allows these practitioners’ licenses to become active unrestricted until Dec. 31, 2020.
  • Medical Doctors (MDs) and certain allied health professionals integral to providing care during this state of emergency, whose licenses are expired/inactive for less than four years, may apply for reactivation of their licenses. This measure allows retired/inactive MDs, physician assistants, respiratory therapists and perfusionists to become active until December 31, 2020.
  • State Board of Osteopathic Medicine licensees who are inactive/retired status for less than four years can apply for reactivation of their licenses. This measure allows retired/inactive Doctors of Osteopathic Medicine (DOs) to become active unrestricted until Oct. 31, 2020.
  • DOs and certain allied health professionals integral to providing care during this state of emergency, whose licenses are expired/inactive for less than four years, can apply for reactivation of their licenses. This measure, which applies to retired/inactive DOs, physician assistants, respiratory therapists and perfusionists, allows those individuals to become active until October 31, 2020.
  • Registered Nurses (RNs), Clinical Nurse Specialists (CNSs), and Certified Registered Nurse Practitioners (CRNPs) whose licenses are expired/inactive for less than five years can apply for the reactivation of their licenses.
  • Pharmacists whose licenses are expired/inactive for less than four years can apply for reactivation of their licenses.

This was a consistent talking point for PHCA and our messaging to state government, and we were thrilled to see it was approved this morning.

PHCA to Launch ‘Connect Communities’, an Easier Way to Share Information
Information sharing has never been more important – especially during the COVID-19 epidemic. That’s why we’ve created a forum for you to share information in real-time between you and your colleagues across the state.

We are proud to announce the launch of two new private online community discussion groups, which are available to all PHCA members. These groups, called ‘Connect Communities’, are available for two groups (for now): PHCA Skilled Nursing and PHCA Assisted Living and Personal Care. Access to these online communities is included as part of your PHCA membership.

Later this week, administrators and executive directors will receive an email from the American Health Care Association (AHCA) with usernames and passwords, as well as additional information on how to use the community.

Be on the lookout for additional information in the near future, and let us know if you’d like to join.

 

 

Tuesday, March 24, 2020 – 8:35 p.m.

Today, Department of Health Secretary Rachel Levine confirmed 207 new positive cases of COVID-19 in Pennsylvania, bringing the statewide total to 851 cases. This is the largest one day increase of reported cases.

Seven deaths in the Commonwealth have been attributed to COVID-19.

Additionally, it is our understanding that there are positive cases in Pennsylvania nursing homes. While this is certainly unfortunate, it is not entirely unexpected.

As positive cases do arise, know that PHCA is here for you. We’re here to support you and your staff, to help with any media response, and to mitigate the impact of this terrible virus on your community.

We would encourage you to visit phca.org/covid19 and download the PHCA COVID-19 Toolkit: Preparing for Positive Cases, which is located at the top of the page. Not only will it help you prepare, but it provides valuable steps to take if/when a case is confirmed.

Additionally, our COVID-19 page contains daily information from AHCA/NCAL, DOH, the CDC and CMS. Please use our resources, and let us know how we can help.

A few additional updates:

CDC Call on PPE Strategies
Tomorrow afternoon, the CDC will host a Clinician Outreach and Communication Activity (COCA) call that will focus on PPE optimization strategies.

The call will take place tomorrow, March 25th from 2 to 3 pm. Presenters will discuss strategies for facilities to optimize PPE supplies, such as eye protection, isolation gowns, facemasks, and N95 respirators. Advanced registration is not required.

Due to the high demand, we are encouraging participants to also consider viewing the call on Facebook Live. If you are unable to attend, the call will be available for viewing on COCA’s Facebook page a few hours after the live event ends. If you have questions or would like to learn more, email coca@cdc.gov.

CHC-MCOs to Host Webinars to Discuss Changes re: COVID-19
As a reminder, the Community HealthChoices Managed Care Organization (CHC-MCO) Coalition will be hosting one more webinar for all nursing facilities to discuss changes and updates occurring as a result of COVID-19. This webinar is scheduled for this Thursday, March 26th from 10 to 10:30 am.

You can register for this session here. Your confirmation email will include details for the webinar.

New Hospital to Post-Acute Care Facility Transfer Form
PHCA has been working with the Hospital and Healthsystem Association of Pennsylvania, LeadingAge PA and other stakeholders to create a consistent, streamlined transfer form to be used when a resident is admitted or re-admitted to your facility or community from a hospital. The revised and most up-to-date form can be downloaded here.

DOH to Expedite TB Testing Requirements
PHCA has also been in communication with DOH regarding the relaxation of the two-step TB testing requirement for new hires. As a result, any nursing facility that wishes to seek an exception should submit a request to their respective field office supervisor and include which part of the regulation they are seeking an exception for, as well as updated policy and procedures the nursing facility will follow if the exception is granted. By providing this information, DOH can expedite the process for review and approval of the exception.

If you have any questions related to this process, please reach out to Gail Weidman, our Director of Policy and Regulatory Affairs, at gweidman@phca.org.

 

 

Monday, March 23, 2020 – 7:43 p.m.

Today, Department of Health Secretary Rachel Levine confirmed 165 new positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 644 cases covering 34 counties.

Governor Tom Wolf also announced a stay-at-home order beginning tonight at 8 p.m. and lasting two weeks for those residing in Allegheny, Bucks, Chester, Delaware, Monroe and Montgomery counties.

The Governor extended statewide school closures for two more weeks as well. This extended closure will now continue through Friday, April 10.

We recognize this new stay-at-home order, as well as the extended school closures, will impact the available workforce in your facilities and communities. We continue to work with the Wolf Administration to find opportunities for flexibility in the DHS daycare requirements and the DOH staffing requirements.

PHCA, LeadingAge PA, SEIU, UFCW and AFSCME Join Forces
Earlier today, PHCA sent an urgent letter, co-signed by LeadingAge PA, SEIU Healthcare, UFCW 1776 and AFSCME District 1199, to Governor Wolf, his senior staff and the Department of Human Services regarding critical Medicaid funding for long-term care providers.

You can read the letter here.

Last week, Congress passed the Families First Coronavirus Response Act, which (among other things) granted a 6.2% FMAP (Federal Medicaid match) increase. That 6.2% increase equates to $1.5 billion in Medicaid dollars for Pennsylvania.

We believe there are no providers more deserving of these dollars than those working in long-term care in Pennsylvania today. So we are advocating for a 3% rate increase, plus $290 million derived from the $1.5 billion that will be paid to providers to help combat increased costs due to COVID-19.

We’re hopeful the Governor will respond favorably to our request, and we’ve already begun to reach out to his administration and members of the legislature.

PHCA Roundtable with Senator Bob Casey
This afternoon, PHCA leadership held a virtual roundtable discussion with U.S. Senator Bob Casey regarding the COVID-19 epidemic and ways in which the Senator and his colleagues can support our sector throughout this crisis.

With no deal on a new federal stimulus package, members of Congress are currently negotiating the terms and structure of federal legislation designed to aid healthcare providers, working families and those directly impacted by COVID-19.

As more information becomes available, we will keep you updated.

CHC-MCOs to Host Webinars to Discuss Changes re: COVID-19
As a reminder, the Community HealthChoices Managed Care Organization (CHC-MCO) Coalition will be hosting two webinars for all nursing facilities to discuss changes and updates occurring as a result of COVID-19. These webinars are scheduled for:

Tuesday, March 24, 2020 – 10 a.m. to 10:30 a.m.
Thursday, March 26, 2020 – 10 a.m. to 10:30 a.m.

Register for the session of your choice here. Your confirmation email will include details for the webinar.

New Waiver Process for Child Care Centers
The Office of Child Development and Early Learning (OCDEL) has developed a waiver process for child care centers that support essential service employees, which includes health care workers, to allow the center to continue to operate. A child care center that serves the children of essential service employees can apply for a waiver using this form. The form should be completed and submitted to the following RA account: ra-pwdracert@pa.gov.

 

 

Sunday, March 22, 2020 – 6:29 p.m.

Today, Department of Health Secretary Rachel Levine confirmed 108 new positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 479 cases.

Governor Wolf also reiterated his mandate for all non-critical businesses across the Commonwealth to close. Enforcement will begin at 8 a.m. tomorrow morning.

Philadelphia Mayor Jim Kenney also issued his own mandate to begin at 8 a.m. tomorrow morning: a stay-at-home order for the entire city. The order will prohibit public and private gatherings outside a single household, with certain exceptions.

DOH Long-Term Care Toolkit
Earlier today, the Department of Health released a long-term care toolkit to help providers prepare for COVID-19. This toolkit includes:

  • an abbreviated preparedness assessment,
  • active screening checklist for residents,
  • a compilation of CDC guidance for long-term care communities,
  • a symptomatic line list template,
  • a list of EPA’s registered antimicrobial products for use against COVID-19,
  • a template letter to be sent to families should a case of COVID-19 be confirmed in your facility or community,
  • healthcare facility COVID-19 exposure tracking log,
  • a step-by-step guide to conduct contact tracing for COVID-19 cases, and
  • ten steps to consider should a case of COVID-19 be confirmed in your community.

This toolkit can be downloaded here. The link will take you to a zip folder containing all nine documents.

Guidance on Communication after a Confirmed Case
It’s important to keep families and staff informed if you do have a confirmed case of COVID-19 in your facility. To help with communication, AHCA/NCAL has developed a sample letter for families and staff and talking points for the media and broader public.

We would ask you to also reach out to Shayna Varner, our Director of Communications, at svarner@phca.org to help with media inquiries and public statements.

Honor our Healthcare Heroes
We’ve already asked you to send us heartwarming pictures, messages and stories about your residents, and how staff is helping them communicate with family, friends and loved ones during this crisis.

But we cannot forget about your staff. They are heroes, in every sense of the word.

As this crisis worsens, and our direct care workers continue to risk their health and safety to protect their residents, we believe it’s our duty to share this story with state government, elected officials and the general public.

When you see something like this, tell us. Because it’s a message that must be delivered.

 

 

Saturday, March 21, 2020 – 3:53 p.m.

Today, Department of Health Secretary Rachel Levine confirmed 103 additional positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 371 cases.

Additionally, the Secretary announced that a second Pennsylvanian has died as a result of COVID-19.

Staffing
Throughout the last few weeks, PHCA has urged the Department of Health, as well as the Departments of State and Education, to relax certain licensing requirements for our direct care workers – especially nurses.

During today’s press conference, Secretary Levine announced an initiative to do just that.

The following requirements for nurses have been changed to help combat COVID-19:

  • Temporary nursing practice permits and graduate permits will be extended beyond one year and extension fees will be waived.
  • Registered Nurses will not have to apply for extensions of their RN graduate or temporary permits. All temporary and graduate permits that would normally expire during the next 90 days will be automatically extended for an additional 90 days.
  • Practical Nurses will not have to apply for extensions of their PN graduate or temporary permits. All temporary and graduate permits that would normally expire during the next 90 days will be automatically extended for an additional 90 days.
  • Registered Nurses, Certified Registered Nurse Practitioners (CRNPs) and Certified Nurse Specialists (CNS) can continue to care for patients if their licenses are currently “in renewal” and set to expire on April 30, 2020. These licenses will be extended for an additional three months until July 31, 2020.
  • Nursing school graduates who have been issued “Authorizations to Test” by the board, and have been unable to sit for the licensure examinations due to cancellation of the examinations because of COVID-19, and do not already have a graduate permit, can immediately apply for a graduate permit so they can assist in the COVID-19 response. Note: This graduate permit authorizes graduate nurses to practice under the supervision of a registered nurse until they can take the examinations. The permits expire if the graduate permit holder fails the examination.
  • More than 14,000 CRNPs can practice to their full capabilities and assist in the COVID-19 response without the usual requirement that they practice within a specific clinical specialty. They also are allowed to prescribe drugs outside the established formulary.
  • On a CRNP’s initial application for prescription-writing authority, the State Board of Nursing will require only one collaborative physician and one substitute physician, rather than the entire list of substitutes.
  • In the event that board-recognized national CRNP certification examinations become unavailable during the coronavirus emergency, CRNPs will not have to hold national certification in a particular specialty.
  • Out-of-state applicants for certification as a CRNP by endorsement in Pennsylvania, who are active licensees of other states and have national certification, will not have to meet the educational equivalence requirement.

COVID-19 in Long-Term Care
Last night, we learned a Sodexo employee working at the Allentown campus of Cedarbrook Senior Care and Rehabilitation has tested positive for COVID-19. An investigation determined the employee had no direct contact with residents.

Earlier today, Philadelphia Health Commissioner Thomas Farley announced the first confirmed case of COVID-19 in a city nursing home.

We are working to obtain additional information on these cases, and we’ll keep you updated as we learn more.

Update on PPE
PHCA has reached out to other associations whose membership has also been impacted by COVID-19. We’ve asked them to consider donating any PPE supplies that aren’t immediately needed – especially gowns, masks, gloves and goggles (whether they are surgical, N95 or other) – to help our caregivers on the front lines who are protecting Pennsylvania’s most vulnerable population. We have received an overwhelmingly positive response.

If you are in dire need of PPE supplies, please reach out to Shayna Varner, our Director of Communications, at svarner@phca.org. She will be coordinating to make sure supplies are distributed to our provider communities most in need.

Honor our Healthcare Heroes
We’ve already asked you to send us heartwarming pictures, messages and stories about your residents, and how staff is helping them communicate with family, friends and loved ones during this crisis.

But we cannot forget about your staff. They are heroes, in every sense of the word.

As this crisis worsens, and our direct care workers continue to risk their health and safety to protect their residents, we believe it’s our duty to share this story with state government, elected officials and the general public.

When you see something like this, tell us. Because it’s a message that must be delivered.

 

 

Friday, March 20, 2020 – 4:48 p.m.

Today, Department of Health Secretary Rachel Levine confirmed 83 additional positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 268 cases.

In keeping with Governor Wolf’s mandatory closure of all non-life-sustaining businesses, we have been forced to close the PHCA office in Harrisburg. However, our team is working remotely, and we stand ready to help you any way we can.

Update on PPE
PHCA has reached out to other associations whose membership has also been impacted by COVID-19. We’ve asked them to consider donating any PPE supplies that aren’t immediately needed – especially gowns, masks, gloves and goggles (whether they are surgical, N95 or other) – to help our caregivers on the front lines who are protecting Pennsylvania’s most vulnerable population. We have received an overwhelmingly positive response.

If you are in dire need of PPE supplies, please reach out to Shayna Varner, our Director of Communications, at svarner@phca.org. She will be coordinating to make sure supplies are distributed to our provider communities most in need.

Clarification on Restricted Visitation Policies and Ancillary Services
While restricted visitation policies do limit visitation for all volunteers, non-essential health care personnel and others, these restrictions do not include:

  • Home-health and dialysis services;
  • the Department of Aging/Area Agency on Aging and the Department of Human Services where there is a concern for serious bodily injury, sexual abuse, or serious physical injury;
  • or hospice services offered by licensed providers within the nursing home facility.

If you have any questions, please don’t hesitate to reach out to Gail Weidman, Director of Policy and Regulatory Affairs, at gweidman@phca.org.

Interim Guidance on SNFs Accepting Patients from Hospitals
AHCA has issued interim guidance to help skilled nursing facilities when accepting hospital discharges during the COVID-19 pandemic. This guidance will likely change as the prevalence of COVID-19 varies in communities and hospital surge increases. This guidance is designed to help reduce the risk of admitting someone with COVID-19 into your facility, along with the steps you should take to prevent spread.

We strongly urge SNFs to begin creating separate wings, units and/or floors by moving current residents to handle admissions from the hospital and keep current residents separate, if possible. 

BHSL Releases New Guidance for AL/PC Members
Earlier today, BHSL released new guidance for assisted living residences and personal care homes, with the exception of the requirement to accept new admissions. Although this document mentions nursing facilities specifically, it applies to AL/PC as well. AL/PC communities are encouraged to accept new admissions but are not required to do so. However, you must continue to receive current residents from hospitals or nursing facilities if they are ready to be discharged and can be served in the home, including stable patients who have had the COVID-19 virus. Please send any questions to RA-PWARLHEADQUARTERS@pa.gov or contact your regional office.

DOH Outlines Quick Response Team Notification Process
The Department of Health Departmental Operations Center (DOC) is closely monitoring the changing conditions within the Commonwealth’s post-acute and long-term care facilities as it relates to COVID-19. Facilities with individuals who have been identified as presumed positive should report their status to the Bureau of Emergency Preparedness and Response through their Regional Healthcare Coalition (HCC)/HAP Regional Manager. The QRT notification process is outlined here.

CHC-MCOs to Host Webinars to Discuss Changes re: COVID-19
The Community HealthChoices Managed Care Organization (CHC-MCO) Coalition will be hosting two webinars for all nursing facilities to discuss changes and updates occurring as a result of the novel coronavirus (COVID-19) situation. These webinars are scheduled for:
Tuesday, March 24, 2020: 10 a.m. to 10:30 a.m.
Thursday, March 26, 2020: 10 a.m. to 10:30 a.m.
Register for the session of your choice here. Your confirmation email will include details for the webinar.

Online Certification for CNA Now Available
The National Association of Health Care Assistants is now offering free COVID-19 training for Certified Nursing Assistants and anyone else that would like to take the course. We understand you are extremely busy; however, this course is available to any staff who may benefit from the training. To register and complete the online certification, click here.

Reminder: Our AL/PC Summit is Postponed
As a result of the COVID-19 pandemic, PHCA will not be hosting our annual AL/PC Summit this Tuesday, March 24.

We had hoped to offer the Summit sessions via webinar; however, we have made the decision to postpone all educational opportunities until a later date. We will be issuing full refunds for all attendees and sponsors. If you have questions about your Summit refund, please contact Beth Graham at bgraham@phca.org.

 

 

Thursday, March 19, 2020 – 6:06 p.m.

Today, Department of Health Secretary Rachel Levine confirmed 52 additional positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 185 cases.

As a result of this rapid increase, as well as continued non-compliance with previous requests to close non-essential store locations, Governor Wolf has ordered the closure of all non-life-sustaining businesses in Pennsylvania as of 8 p.m. today, March 19, to slow the spread of COVID-19. Enforcement actions against businesses that do not close their physical locations will begin at 12:01 a.m. Saturday, March 21.

In addition, the White House announced this morning the number of positive COVID-19 cases has surpassed 10,000, doubling over two days as states across the country expand testing.

Here are other relevant updates:

Recommendations for Patient Transfers
In keeping with visitation restrictions in your communities, we strongly recommend you apply these same restrictions when arranging for patient transfers. The shortage of PPE also exists within the ambulance and transport community. If you need to transport a patient using these services, we strongly recommend you make arrangements to do so in the lobby or at the front door of your facility in an effort to reduce the opportunity for COVID-19 to enter.

Make sure you have the appropriate equipment to transport a bed-bound patient to the lobby or the entrance of your facility. If you do not, ask your transport provider NOW if there are extra stretchers available to give you time to sanitize and clean the equipment before use.

New Hospital to Post-Acute Care Facility Transfer Form
We have partnered with the Hospital and Healthsystem Association of Pennsylvania and LeadingAge PA to create a consistent, streamlined transfer form to be used when a resident is admitted or re-admitted to your facility from a hospital. You can download this form here.

#PHCACares Initiative
Yesterday, we launched #PHCACares on our social channels to encourage Pennsylvanians to share messages of encouragement, love and support to the residents of Pennsylvania’s long-term care communities.

We’re asking you to visit phca.org/PHCACares and share letters, drawings, photos and videos with our state’s long-term care residents – and their providers of care. We’ll send these well wishes to your facilities, and we’ll be featuring submissions on our Facebook page.

And if you’re posting on social media, please use #PHCACares so we can share your wishes with residents near you.

 

 

Wednesday, March 18, 2020 – 6:24 p.m.

Today, Department of Health Secretary Rachel Levine confirmed 37 additional positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 133 cases.

The numbers are beginning to rise more rapidly as more testing is being conducted across the state, both by the Department of Health and commercial laboratories.

Additionally, late this afternoon, Governor Tom Wolf confirmed the state’s first COVID-19-related death.

A few relevant updates:

New CDC Guidance on PPE
This morning, the CDC issued new guidance on the use and reuse of masks, gowns and face shields. We strongly urge you to begin taking steps today to significantly conserve masks and gowns and extend the availability of your remaining PPE until the supply improves, or we are able to obtain masks and gowns from our association partners.

At this time, the Department of Health has stated that any emergency supply of PPE will only be provided should an active case of COVID-19 occur within a facility.

Congress Passes Families First Coronavirus Response Act – HR 6201 
Late today, the U.S. Senate passed a multibillion-dollar emergency aid package to confront the economic impacts of the coronavirus. The bill will now go to President Trump for his signature.

Among other things, the bill increases the federal Medicaid match (FMAP) by 6.2%. This will bring an additional $1.5 billion to Pennsylvania.

States will be required to use these funds for COVID-19 related expenses. Keep in mind: the enhanced FMAP does not result in automatic rate increases for our sector. It’s up to each state to decide how to spend the funds, which means we’ll need to advocate for our fair share – and we will need your help.

Congress will begin working on another bill this week to provide further stimulus to the economy. We will be seeking funding in that bill as well.

Share Your Positive Stories!
Today, ABC27 (the ABC affiliate here in Harrisburg) aired a story highlighting the good work an IntegraCare community, the Woods at Cedar Run, has been doing for their residents during this trying time.

And yesterday, Carbondale Nursing and Rehabilitation Center was featured on ABC16 for their dedication to their residents.

We need more stories like this!

We’d love to showcase these efforts and highlight the good work you’re doing on our social media channels. Please share photos, videos and other anecdotes with Kara Barmoy, our Digital and Social Media Manager, at kbarmoy@phca.org. Remember: every story is worth sharing.

And if you share on social media, please use #PHCACares in your post!

 

 

Tuesday, March 17, 2020 – 5:31 p.m.

Today, Department of Health Secretary Rachel Levine confirmed 20 additional positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 96 cases.

A few additional updates:

Governor Wolf Approves Staffing Requests
Earlier today, we shared that Governor Tom Wolf, the Department of Health and Department of Human Services approved three of our four requests for emergency regulatory and staffing relief. A formal announcement will be forthcoming, but we are proud to advocate on your behalf for these much-needed steps in support of your facilities and communities.

Townhall with U.S. Senator Pat Toomey
This morning, we joined a healthcare provider townhall conference call with U.S. Senator Pat Toomey (R-PA) to share policy and regulatory concerns related to COVID-19 response efforts. Senator Toomey offered an update on congressional activity pertaining to COVID-19 and discussed the Families First Coronavirus Response Act, federal legislation aimed at helping workers and businesses through these turbulent times. Senator Toomey also recognized the PPE shortages and challenges existing in Pennsylvania and across the country.

The federal legislation has passed the U.S. House of Representatives and is awaiting a vote in the Senate.

U.S. Senator Bob Casey sends letter to Trump Administration
We received word today that Sen. Bob Casey (D-PA) has sent a letter to Vice President Mike Pence, asking for additional information on the Administration’s efforts to protect nursing home residents, staff and their families.

We will be participating in a roundtable discussion with Senator Casey this Friday regarding COVID-19 and much-needed support for long-term care facilities.

CMS
As a reminder: CMS is waiving 42 CFR 483.20 to provide relief to SNFs on the timeframe requirements for Minimum Data Set assessments and transmission. If you have any questions, please contact PHCA staff.

Share Your Positive Stories!
Throughout the last few days, we’ve received pictures, videos and stories from member facilities and communities regarding the innovative ways in which they’re keeping residents engaged with family members and each other – whether through messages on social media, Facetime calls or video-conferencing.

We’d love to showcase these efforts and highlight the good work you’re doing on our social media channels. Please share photos, videos and other anecdotes with Kara Barmoy, our Digital and Social Media Manager, at kbarmoy@phca.org. Remember: every story is worth sharing.

 

 

Tuesday, March 17, 2020 – 11:21 a.m.

Late last night, we received updated guidance from the Wolf Administration in response to our joint letter with LeadingAge PA requesting emergency regulatory and staffing relief to ensure you are prepared to combat COVID-19 in your facilities. A formal announcement will be forthcoming, but we wanted to get this information to you right away as you plan daily operations.

Governor Wolf has agreed to grant three of our four requests:

  • We asked for a waiver or temporary relief from staffing requirements if facilities are not able to meet minimums but are still providing adequate quality of care to residents.
    • The Governor will be GRANTING this request. DOH will permit a facility to continue operations if the facility’s minimum number of nursing hours per resident per day (PPD) is below the required 2.7. DHS will waive Personal Care Home and Assisted Living Residence staffing requirements if the facilities are not able to meet minimums but are still providing adequate quality of care residents. DHS will require notification at the time the staffing complement drops below the minimum level for monitoring purposes and the facility should document the reasons for subsequent inspection.
  • We asked to allow for flexibility in the individuals that perform certain activities with proper abbreviated training.
    • The Governor will be GRANTING this request. DHS and DOH will provide flexibility for individuals to perform certain tasks with abbreviated, focused training. This does not extend to permit the performance of licensed functions without a license or to provide services beyond the scope of the license. Adequate documentation is required.
  • We asked for temporary Pennsylvania licensure to physicians, nurses and nursing assistants licensed in other states who can help providers here and now.
    • The Governor will be GRANTING this request. For nurses specifically, temporary permits for nurses licensed in other states can be issued immediately upon application, with the Board waiving the administrative paperwork requirements by verifying licensure in the other state through NURSYS (a national database of nurses provided by the National Council of State Boards of Nursing).
  • We also asked to allow for flexibility in Department of Human Services daycare regulation requirements so that long term care providers with space can allow workers to bring their children to these settings.
    • At this point, the Governor will NOT be granting this request. The Governor is committed, however, to working through alternative solutions to accommodate long-term care provider staff without the arrangement being on site.

We are grateful for the emergency regulatory and staffing relief promised by Governor Wolf, the Department of Health and the Department of Human Services to help our long-term care providers as they navigate the emerging impacts of COVID-19 and continue their tireless efforts to protect Pennsylvania’s most at-risk and vulnerable population: those in long-term care facilities.

This additional flexibility will allow our providers to continue providing the best possible care for residents while also helping to address some of the acute workforce challenges facing the long-term care sector and the unique challenges of this virus.

 

 

Monday, March 16, 2020 – 8:48 p.m.

Earlier today, Governor Wolf and Department of Health Secretary Rachel Levine confirmed 13 additional positive cases of COVID-19 in Pennsylvania. This brings the statewide total to 76 cases.

In addition, Governor Wolf announced mitigation (or ‘quarantine’) efforts have been expanded to include the entire state. These efforts include the recommended closure of all non-essential stores. Restaurants and bars will be open for takeout and/or delivery only. Grocery stores, pharmacies, gas stations and medical facilities will remain open.

This statewide mitigation effort will be in place for the next two weeks.

President Trump Remarks
Late this afternoon, President Donald Trump offered the federal government’s take on the COVID-19 outbreak, advising that Americans should avoid social gatherings involving groups of 10 or more.

Early news reports indicated the White House was considering imposing curfews and a national quarantine, but that was proven to be untrue (for now).

CMS
We wanted to ensure you received this important update: to aid skilled nursing facilities in addressing the COVID-19 outbreak, CMS is waiving both the 3-Day Stay and Spell of Illness requirements.  

This means that skilled nursing facility care without a 3-day inpatient hospital stay will be covered for beneficiaries, regardless of whether there is COVID-19 present in the hospital or not.

CMS also is utilizing the authority under section l8l2(f) providing renewed SNF coverage to beneficiaries without starting a new spell of illness and allowing them to receive up to an additional 100 days of SNF Part A coverage.

 

 

Sunday, March 15, 2020 – 6:36 p.m.

Earlier today, the Pennsylvania Department of Health confirmed 16 additional positive cases of COVID-19. This brings the statewide total to 63 cases.

It’s worth noting there have been 446 patients to date who have been tested or are in the process of being tested. 205 of those tests were negative; 63 have been confirmed, and 183 patient samples are either at the lab for testing or on their way to the lab.

PPE (Personal Protective Equipment)
As we told you yesterday, we have received many questions and concerns from providers across the state regarding shortages of masks, gowns, gloves, goggles and hand sanitizer.

We recommend initiating as many conservation approaches as you possibly can at this time. If you are imminently (within 3-4 days) about to exhaust specific PPE supplies, you should take these steps in this order:

CMS and the Federal Government
As a reminder: Late Friday, CMS released new guidance directing all skilled nursing facilities to cancel all group activities and communal dining, and implement active screening of residents and healthcare personnel for fever and respiratory symptoms based on the newest recommendations from the Centers for Disease Control and Prevention.

Implementing this will be a challenge for providers, and will likely require changes in staffing patterns. How this is implemented must be viewed on a facility-by-facility and day-to-day basis, depending on your physical plant, staff availability, and resident needs.

Please review this recommended approach on how to implement social distancing in your dining practices.

 

 

Saturday, March 14, 2020 – 3:22 p.m.

Today, Governor Tom Wolf and Department of Health Secretary Rachel Levine announced there are now 41 “presumptive positive” cases and 6 confirmed cases of COVID-19, including 2 new cases in Allegheny county.

In addition, Governor Wolf expanded county-specific quarantine restrictions to Chester and Bucks Counties, which requires the closure of all non-essential public spaces.

As a reminder: all public schools will close starting this Monday, March 16th until Friday, March 27.

Staffing
We recognize these new quarantine restrictions, as well as the impending school closures, will dramatically impact the available workforce in your facilities and communities.

We continue to put pressure on the Wolf Administration and DOH for guidance on proactive regulatory and staffing relief for providers as we navigate the emerging impacts of COVID-19.

Yesterday, we sent a joint letter with LeadingAge PA to the Governor, his senior staff and the Department of Health. We have received confirmation they are reviewing, and we hope to have guidance for providers soon.

PPE (Personal Protective Equipment)
We have received many questions and concerns from providers across the state regarding shortages of masks, gowns, gloves, goggles and hand sanitizer.

Late last night and this morning, we engaged in conversations with members from the Hospital and Healthsystem Association of PA, the PA Chamber, the PA Food Merchants Association and other stakeholders to see if supplies could be diverted from public stores to the healthcare providers who need them most. We will continue to work with our partners in Harrisburg on ways to get you supplies.

CMS and the Federal Government
Late yesterday, CMS released new guidance directing all skilled nursing facilities nationwide to restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as end-of-life.

This guidance also directs nursing facilities to cancel all group activities and communal dining, and implement active screening of residents and healthcare personnel for fever and respiratory symptoms based on the newest recommendations from the Centers for Disease Control and Prevention.

Because assisted living and personal care communities are regulated at the state level, this CMS guidance does not directly apply to AL/PC; however, the risk to our population in assisted living and personal care is just as serious. Unless we hear otherwise, these visitation guidelines should be applied throughout our entire continuum of care.

Additionally, both President Donald Trump and CMS Administrator Seema Verma have stated publicly that they are suspending the Medicare three-day stay requirement before a SNF admission. We have not yet seen an official CMS waiver for this, so please don’t assume this rule is in effect until we have received formal confirmation.

For More Information
We will continue to share updates via email and on our social media channels. Please follow PHCA on Facebook and Twitter for the most up-to-date guidance and resources for long-term facilities from federal and state partners.

 

Friday, March 13, 2020 – 5:58 p.m.

This afternoon, Governor Tom Wolf and Department of Health Secretary Rachel Levine announced there are now 35 “presumptive positive” cases and 6 confirmed cases of COVID-19, including cases in three new counties: Cumberland, Bucks and Washington.

In addition, Governor Wolf expanded county-specific quarantine restrictions to Delaware County.

And perhaps most important: all public schools will close starting Monday, March 16th until Friday, March 27.

We recognize these new quarantine restrictions, as well as the impending school closures, will dramatically impact the available workforce in your facilities and communities.

Earlier today, we sent a joint letter to Governor Wolf, co-signed by LeadingAge PA, urging him and his administration to provide proactive regulatory and staffing relief for long-term care providers as we navigate the emerging impacts of COVID-19.

Based on the strong recommendations and learned best practices from our counterparts in other states, including Washington, we have requested an executive order that provides for the following:

  • Granting temporary relief or waivers from the staffing requirements issued by DOH and DHS;
  • Allowing for staffing flexibility for ancillary or administrative staff to perform certain resident-specific activities after the proper, abbreviated training;
  • Allowing for flexibility from DHS daycare regulation requirements so long-term care providers with space can allow workers to bring their children to these settings;
  • Immediately granting temporary Pennsylvania licensure to physicians, nurses and nursing assistants licensed in other states to help providers here and now.

We await additional guidance from the Wolf Administration and DOH on these recommendations.

In Washington, D.C., CMS Administrator Seema Verma said the agency would be ratcheting up restrictions on nursing home visitors in soon-to-be issued guidance. We will keep you updated as soon as we know more.

 

 

Friday, March 13, 2020 – 2:50 p.m.

Yesterday, the Department of Health (DOH) issued guidance on Visitation in Nursing Facilities due to COVID-19. The Department of Human Services, Office of Long-Term Living is asking that all Personal Care Homes and Assisted Living Residences adopt and implement the guidance attached.

Information will continue to be shared and disseminated going forward to address questions and concerns that have been brought to our attention. We continue to monitor information from the Pennsylvania Department of Health and the U.S. Centers for Disease Control and Prevention. Guidance developed by DHS will be centrally located on this page, which will be updated as additional guidance becomes available. We encourage you to continue to consult these resources for updates on COVID-19, information on staying healthy, and updates on the situation in Pennsylvania.

 

 

Thursday, March 12, 2020 – 6:10 p.m.

As a result of our meeting with the Department of Health earlier this week, we have received interim guidance from the state that takes into account our input as it relates to visitation policies for skilled nursing providers during the response efforts to COVID-19.

The Department is currently advising the following:

  • If a nursing facility is located in an area in which there are known cases of COVID-19, the Department recommends a no visitor policy in nursing facilities, except in instances of end-of-life events that require visitation from immediate family members, friends, and religious leaders.
  • This is immediately applicable to homes in Montgomery County and any bordering counties.
  • If a nursing facility is not located in a county or area in which there are known cases of COVID-19, but assesses a ‘no visitor’ policy to be in the best interest of residents, the Department supports that step at this time.
  • Nursing facility staff and administrators should use screening protocols per their Emergency Preparedness and Infection Control Plan, and any health care providers who have signs or symptoms of a respiratory infection should not report to work.

This interim guidance from DOH can be found here.

We would urge you to continue to over-communicate with residents, staff and family members.

We will continue to share updates via email and on our social media channels. Please follow PHCA on Facebook and Twitter for the most up-to-date guidance and resources for long-term facilities from federal and state partners.

 

 

Thursday, March 12, 2020 – 2:57 p.m.

This afternoon, Governor Tom Wolf and Department of Health Secretary Rachel Levine announced 22 individuals have tested “presumptive positive” for COVID-19 in Pennsylvania. There are currently 81 tests pending.

During the press conference, Governor Wolf issued the following guidance for Pennsylvania and Montgomery County specifically:

Statewide

  • The Wolf Administration discourages individuals from traveling to recreational activities like gyms, movie theaters and shopping malls.
  • The Wolf Administration encourages religious leaders to exercise discretion in order to mitigate the spread of illness.

Montgomery County

  • A ‘no visitor’ policy will be implemented for nursing homes, and others to be evaluated.
  • Schools in Montgomery County will be closed starting tomorrow, as will child care centers licensed by the Commonwealth.
  • Adult daycare centers will be closed.
  • Freedom of travel will remain, but the Governor and the Commonwealth ask all people to refrain from non-essential travel.
  • Essential services will be available: police, fire, and emergency medical services, essential services for vulnerable populations.
  • Supermarkets, pharmacies, and gas stations will remain open. The Governor and the Commonwealth recommends that non-essential retail facilities close.
  • AMTRAK will begin operating a reduced schedule and the Ardmore stop will close to AMTRAK trains for two weeks, beginning tomorrow. The Wolf Administration is also working directly with SEPTA to evaluate potential impacts and will continue to provide service updates as things evolve.

Commonwealth Employees

  • The Commonwealth is authorizing a 10 workday paid absence for individuals who don’t have telework capabilities.
  • Facilities that are in Montgomery County that are Commonwealth facilities and provide essential services will remain open.
  • Facilities that are administered by Montgomery County will follow the same procedures as the county.

State correctional facilities and veterans homes have already introduced a statewide visitor ban to ensure the safety of inmates, residents, staff and visitors.

We will continue to share updates via email and on our social media channels. Please follow PHCA on Facebook and Twitter for the most up-to-date guidance and resources for long-term facilities from federal and state partners.

 

 

Tuesday, March 10, 2020 – 5:48 p.m.

Earlier today, Department of Health Secretary Rachel Levine announced there are now 12 total ‘presumptive positive’ cases of COVID-19 in Pennsylvania.

Late yesterday, the Centers for Medicare and Medicaid Services (CMS) issued revised guidance for skilled nursing facilities in order to prevent the spread of COVID-19. The guidance focused on limiting visitors to your facilities, and that can be found here.

The revised CMS guidelines are similar to those provided by AHCA/NCAL yesterday afternoon; however, there are a few very slight variations in how the guidance documents are written. Both aim at controlling or mitigating the spread of the virus. Here is a side-by-side comparison.

We would strongly encourage you to implement a visitation policy at your facilities or communities at this time. Though the AHCA/NCAL recommendations differ slightly from CMS, we must work to ensure the safety of our residents and staff. If you’re unclear on any of these policies or need a recommendation, please reach out to PHCA as soon as possible.

As you’re communicating with families of residents, AHCA/NCAL has prepared a template document for providers to help explain the need for restricting visitors.

A few state updates:

  • Tomorrow morning, PHCA will be meeting with Department of Health leadership to discuss specific guidance for providers. Following the meeting, we will send you pertinent updates.
  • PHCA has been invited by U.S. Senator Bob Casey to participate in a Congressional COVID-19 roundtable next Friday, March 20. We will share the results of that meeting as well.

 

 

Monday, March 9, 2020 – 9 p.m.

The Centers for Medicare & Medicaid Services (CMS) has released additional requirements and detailed guidance on the screening, treatment and transfer procedures healthcare workers must follow when interacting with patients to prevent the spread of COVID-19. CMS is also issuing additional guidance specific to nursing homes to help control and prevent the spread of the virus.

To view, CMS’s guidance for nursing homes, click here.

 

Monday, March 9, 2020 – 6:18 p.m.

Earlier today, Department of Health Secretary Rachel Levine announced there are now 10 total ‘presumptive positive’ cases of COVID-19 in Pennsylvania. There is currently one case in Delaware County, one case in Monroe County, one case in Wayne County and seven cases in Montgomery County. Three of these individuals are currently hospitalized. DOH expects to see an increase in the number of COVID-19 cases in the coming weeks.

As you continue to implement heightened preventative measures and review infection control protocols to reduce risk within your communities, please consider the community visitation guidance (below), which has been issued by AHCA/NCAL:

These recommendations go above and beyond the CMS guidance issued last Wednesday, but are consistent with the guidance and regulations to restrict persons entering the building who may pose a health risk to our residents.

To reflect this new guidance, AHCA/NCAL has also created a screening checklist for SNF visitors.

You’re likely hearing concerns from residents, staff, family members and ancillary companies about this virus, and how best to handle a single confirmed case – or an outbreak.

If you have not done so already, please begin to compile family contact information for proactive communication in the event a single confirmed case – or an outbreak – occurs in your community.

It is critical to communicate with your residents’ families as quickly and as often as possible.

As a reminder: in the interest of long-term care operators and direct care workers across the state, we have opened our online resource on the PHCA website to both members and non-members.

If you have any questions, please don’t hesitate to contact staff at PHCA:
  • For regulatory questions, please contact Gail Weidman, Director of Policy and Regulatory Affairs, at gweidman@phca.org.
  • For quality questions, please contact Chris Fisher, Director of Quality Initiatives, at cfisher@phca.org.
  • For communications or questions related to responding to media inquiries, please contact Shayna Varner, Director of Communications, at svarner@phca.org.

 

Monday, March 9, 2020 – 12:33 p.m.

Today, the Pennsylvania Department of Health announced a Montgomery County resident is a presumed positive case for COVID-19. Pennsylvania now has seven presumptive positive cases of coronavirus, five in Montgomery County, one in Delaware County and one in Wayne County.

This individual, an adult, is in the Hospital of the University of Pennsylvania in critical condition, where they are being cared for under proper precautions to protect other patients and hospital staff. They tested presumptive positive after known international exposure.

For the most up-to-date information on the coronavirus, please visit here.

 

 

Sunday, March 8, 2020 – 6:09 p.m.

Today, the Pennsylvania Department of Health announced two additional patients have tested presumed positive in Montgomery County.

These two individuals, both adults, have mild symptoms and are isolated at home. They tested presumptive positive after known international exposure. This brings the total of Pennsylvania presumptive positive cases to six.

 

 

Saturday, March 7, 2020 – 5:40 p.m.

Governor Tom Wolf has confirmed two new presumptive positive cases of 2019 Novel Coronavirus (COVID-19) in Pennsylvania. Both individuals are from Montgomery County, have mild symptoms, are in isolation at home and were exposed to an area of the United States where COVID-19 is present.

According to a press release issued by the governor’s office, the Wolf Administration has been “coordinating with legislative leaders from both parties, and we have agreed to immediately work toward a package that would provide resources to ensure we are aggressively mitigating the spread of COVID-19.”

These resources will help mitigate the spread and strengthen state and local efforts by:

  • Supporting county and municipal health departments;
  • Securing necessary equipment and personnel;
  • Securing personal protective equipment (PPE);
  • Disseminating public health messaging; and
  • Supporting care for seniors, the most at-risk population.

“While we anticipate that there will be more Pennsylvanians with COVID-19 in the coming days and weeks, it is important for residents to know the commonwealth is prepared and that they should be, too,” Sec. of Health Dr. Rachel Levine said. “We are working with the health care community and local community leaders across Pennsylvania to keep them informed, consult on patient testing and ensuring they have the resources they need to care for patients. We are prepared to mitigate the spread of this virus in Pennsylvania.”

All are reminded to:

  • Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.
  • Cover any coughs or sneezes with your elbow, not your hands.
  • Clean surfaces frequently, such as countertops, light switches, cell phones and other frequently touched areas.
  • Contain if you are sick, you should stay home until you are feeling better.

 

 

Friday, March 6, 2020 – 4:18 p.m.

Pennsylvania Department of Health Secretary Rachel Levine hosted an afternoon briefing to provide stakeholders with additional guidance and information following this morning’s press conference indicating there are two “presumptive positive” cases of COVID-19 in Pennsylvania.

During the call, Secretary Levine shared the following information:

  • Both cases will remain “presumptive positive” until test results are confirmed by the CDC. One individual is an adult from Wayne County (international exposure); the other is an adult from Delaware County (exposure from another state).
  • At this time, these cases are not a result of community transmission as defined by public health criteria.
  • Both individuals have been quarantined in their homes and are being monitored closely by the Department of Health via phone calls and are in close communication with their respective physicians.
  • The state public health laboratory in Exton has expanded its ability to test for COVID-19. By this weekend, the state public health laboratory will be able to complete up to 125-150 tests per day.
  • Following this morning’s press conference, Governor Tom Wolf issued an emergency disaster declaration, providing more support to state agencies involved in the response to COVID-19.
  • Five schools in Central Bucks County School District were closed out of an abundance of caution related to an out-of-state exposure. These closures were not a result of the presumptive positive cases in Wayne and Delaware counties. This decision was made in conjunction with the superintendent and local health departments.
  • COVID-19 is spread and/or transmitted through air droplets (coughing and sneezing), close personal contact (touching or shaking hands) and through touching surfaces that may have come into contact with the virus. Individuals are encouraged to reduce the risk of spreading of the virus by taking the following precautions:
    • Washing your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.
    • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
    • Clean surfaces frequently, including countertops, light switches, cell phones and other frequently touched items.
    • If you are sick, stay home and avoid contact with others.
  • Pennsylvania is monitoring travelers as per CDC guidelines. Travelers returning from impacted countries are subject to a 14-day quarantine.
  • The Department of Health continues to collaborate with federal, state and local partners to protect public health.

Secretary Levine also provided additional guidance and information related to:

TESTING
If you are ill and feel you may have been exposed to COVID-19, call 877-724-3258. You can speak directly with a state epidemiologist or contact your health care provider to discuss symptoms and potential exposure to determine if a test is needed. If a test is needed, you will be referred to have testing done. After a specimen is gathered, it will be sent to the state public health lab. The test takes about four hours to complete. At this time, there is no backlog of tests at the state public health laboratory. Testing at the state public health laboratory or the CDC testing is free – it is covered by state and federal government. The Department of Health is in discussions with DHS and Pennsylvania Insurance Department to make sure there are no economic disadvantages caused as a result of COVID-19 testing.

ADDITIONAL PRECAUTIONS FOR GENERAL PUBLIC
At this time, there are no additional precautions necessary for the general public. The general public should refrain from purchasing masks or gloves. We need to make sure those are available for health care providers. To reduce the risk of contracting COVID-19, wash your hands frequently and use hand sanitizer.

DOMESTIC TRAVEL RECOMMENDATIONS
There are no domestic travel recommendations at this time. If you feel you have been exposed to someone in another state that may have also had exposure to COVID-19, call your local health department. If a state has a widespread community transmission, it is possible there may be some level of travel restrictions put in place; however, none have been discussed at this time.

PROJECTED INCREASE IN CONFIRMED CASES
The Department of Health expects to see more confirmed cases of COVID-19 in Pennsylvania. There has been community spread, as defined by the public health criteria, in California, Washington state among others. The Department of Health will be monitoring the potential for this spread extremely carefully with county partners and other stakeholders and are prepared to address as necessary.

GUIDANCE FOR SCHOOLS
The Department of Health is working with superintendents and school personnel in conjunciton with the Department of Education to talk about school guidelines and the potential need for closures. Based on what is known about COVID-19, young people don’t seem to be as at risk for this virus but the department is planning to take all necessary precautions with schools.

CLEANING
The CDC recommends frequently deep cleaning surfaces in high traffic areas with ammonia-based cleaning supplies. COVID-19 can live on surfaces. It is important for businesses, restaurants and other crowded areas routinely clean frequently touched surfaces including work stations, countertops, doorknobs, etc. No additional disinfection is necessary.

We’ll continue to send you emails with updates and disseminate our information on our social media channels.

 

 

Friday, March 6, 2020 – 1:59 p.m.

The following documents have been posted to the Department of Health message board:

  • State Registrar Notice
    The Bureau of Health Statistics (BHSR) is awaiting formal detailed guidance from CDC’s National Center for Health Statistics on the reporting of deaths where Coronavirus Disease 2019 or COVID-19 has caused or is assumed to have caused or contributed to the death of a decedent. This document provides interim guidance that has been developed for medical professionals to be followed in reporting these deaths until further information is available.
  • Long-Term Care Facility (LTCF) Visitation Guidance
    This visitation guidance is provided to prevent the spread of COVID-19 and are many of the same strategies used every day to detect and prevent the spread of other respiratory viruses like influenza.

 

 

Friday, March 6, 2020 – 1:12 p.m.

Following the reports this week that COVID-19 is spreading in some communities and has impacted a nursing facility in Washington state, we feel it is necessary for AHCA/NCAL to cancel the 2020 Quality Summit and Independent Owner Conference next week (March 9-13) in Grapevine, Texas.

After carefully evaluating this situation, we have no doubt that this decision is in the best interest of our residents and our caregivers. Traveling across the country to attend a conference could slightly increase the risk that professionals who work in our long term care centers every day may become infected. We know that the frail and elderly residents in our care are the most vulnerable to this virus and we need to do everything we can to minimize every risk, no matter how small. We simply cannot take any action that puts our residents, our staff and their families at a higher risk for illness. The safety and well-being of our residents and staff come first.

We also hear from our members that they have a singular focus on the steps they need to take to provide high-quality care during this time: preparing our staff and buildings, following strict infection prevention and control procedures, reassuring our residents, and communicating with families. We also know that many of our members are struggling to fill supplies of masks and other protective equipment. Canceling our meetings next week ensures our focus is where it should be—with our residents.

We will continue to provide educational materials, tools and other resources as well as regular updates about COVID-19. You can find daily updates on our website at www.ahcancal.org/coronavirus.

Registered attendees of the Quality Summit and Independent Owner Leadership Conference will be issued a registration refund by Monday, March 9, 2020. Once the refund is processed, you will receive an email notification. We are working with the hotels now to determine the best way to cancel the reservations. We will send you a notification later today on the process.

We appreciate your understanding and wish you good luck as you prepare for the worst and hope for the best.

 

 

Friday, March 6, 2020 – 11:43 a.m.

Following a press conference announcing the first two presumptive positive cases of coronavirus, known as COVID-19, Governor Tom Wolf today signed an emergency disaster declaration to provide increased support to state agencies involved in the response to the virus.

The disaster declaration follows the Department of Health’s activation of its Department Operations Center at the Pennsylvania Emergency Management Agency’s headquarters to conduct public health and medical coordination for COVID-19 throughout the commonwealth and the governor’s announcement earlier this morning about two presumptive positive cases in Pennsylvania. One individual is an adult from Wayne County; the other is an adult from Delaware County.

To date the Wolf Administration has:

  • Activated of the Department of Health’s Emergency Operations Center to allow for enhanced response coordination;
  • Began testing for COVID-19 at the state laboratory;
  • Maintained communication and outreach with federal, state and local partners;
  • Provided symptom monitoring for residents returning from areas impacted by coronavirus;
  • Provided health care providers, businesses and education providers with information;
  • Reviewed and adapted current pandemic flu plans to prepare for spread of COVID-19;
  • Increased testing capacity to test 20-25 individuals a day;
  • Purchased equipment to increase testing capacity to 125-150 individuals within a day.

 

 

Friday, March 6, 2020 – 10:10 a.m.

Just this morning, Governor Tom Wolf and Department of Health Secretary Rachel Levine hosted a press conference in which they confirmed two presumed positive cases of COVID-19 – one in Delaware County and one in Wayne County. The cases will remain presumed positive until test results are confirmed by the CDC. Both individuals have been quarantined in their homes.

The Pennsylvania Department of Health is working with county and municipal health department partners to continue testing individuals who meet the criteria to be tested for COVID-19.

Later today, DOH will be holding a briefing call to provide additional guidance. We will provide any and all information updates with you as quickly as possible following this briefing.

As additional information is made available from our federal and state partners, we will continue to update this online portal. And we’ll continue to send you emails and disseminate our information on our social media channels.

Don’t forget – we’ve developed an online resource available only to PHCA members. Visit phca.org/COVID19 today to learn more.

We’ll continue to send you emails and disseminate our information on our social media channels.

If you have any questions, please don’t hesitate to contact staff at PHCA:

  • For regulatory questions, please contact Gail Weidman, Director of Policy and Regulatory Affairs, at gweidman@phca.org.
  • For quality questions, please contact Chris Fisher, Director of Quality Initiatives, at cfisher@phca.org.
  • For communications and questions about responding to media inquiries, please contact Shayna Varner, Director of Communications, at svarner@phca.org.

 

 

Thursday, March 5, 2020 – 4:45 p.m.

With last weekend’s news out of Washington state regarding COVID-19 (coronavirus), a great deal of media attention has been placed on long-term care providers across the country.

As of this email, there have been 13 states with either confirmed or presumptive positive cases of the virus (as reported to CDC).

You’re likely hearing concerns from residents, staff, family members and ancillary companies about this virus, and how best to handle a single confirmed case – or an outbreak.

PHCA is here to help you, every step of the way, and our team will ensure you receive all appropriate guidance to combat this virus in your communities.

As additional information is made available from our federal and state partners, we will continue to update this online portal. And we’ll continue to send you emails and disseminate our information on our social media channels.

While there have been no confirmed cases of COVID-19 here in PA, it’s critical we continue to plan ahead. Here are a few tips to consider:

  • Communicate frequently with staff to keep them informed on the expectations for prevention steps;
  • Review with staff potential situations that could interrupt their work schedule, like closed schools, daycare, illness, etc. and help them plan their steps;
  • Use CDC infographics for sharing information quickly and help staff to take action;
  • Maximize your front line defenses: implement a system for simple screening questions for visitors and staff before they are in contact with residents.

The CDC expects an increase of confirmed COVID-19 cases in the coming days and weeks and is relying on health care providers to take action and help prevent the spread of the virus.

If you have any questions, please don’t hesitate to contact staff at PHCA:

  • For regulatory questions, please contact Gail Weidman, Director of Policy and Regulatory Affairs, at gweidman@phca.org.
  • For quality questions, please contact Chris Fisher, Director of Quality Initiatives, at cfisher@phca.org.
  • For communications and questions about responding to media inquiries, please contact Shayna Varner, Director of Communications, at svarner@phca.org.

 

 

Wednesday, March 4, 2020 – 4:55 p.m.

The Centers for Medicare & Medicaid Services (CMS) issued two new Quality, Safety and Oversight memos today about COVID-19 – two apply to nursing homes and a third to hospitals that are listed below. We strongly encourage you to review:

  1. QSO 20-14-Nursing Homes (NH) at https://www.cms.gov/files/document/qso-20-14-nhpdf.pdf
  2. QSO 20-12-ALL at https://www.cms.gov/files/document/qso-20-12-allpdf.pdf-1

The first memo (QSO 20-14-NH) provide NEW and helpful guidance on:

  • Screening visitors and who should be restricted;
  • Screening employees and contractors and who should be asked to stay at home;
  • When patients should be managed in the facility vs sent to the hospital;
  • What to do when transferring residents with suspected COVID-19, and;
  • What criteria to use in accepting patients from the hospital with COVID-19

The second memo (QSO 20-12-ALL) announces that CMS will re-prioritize surveys to conduct focus surveys about infection control for facilities that have had an infection control deficiency in the past to assure that they are in compliance with the new regulations. Specifically:

  • Surveys of facilities/hospitals that have a history of infection control deficiencies at the immediate jeopardy level in the last three years, and;
  • Surveys of facilities/hospitals/dialysis centers that have a history of infection control deficiencies at lower levels than immediate jeopardy.

The Agency also provided a copy of the critical elements pathway in QSO-20-12-ALL that will be used by the surveyors to assess compliance with current regulations. We encourage you to review and use these guidelines in your facility as a self-assessment tool.

We encourage all members to review closely the State Operating Manual’s guidance for F-880 related to infection control and take steps to assure consistent hand washing (or use alcohol hand gels) and contact precautions for residents with respiratory infections.

 

 

Wednesday, March 4, 2020 – 3:36 p.m.

The recording to AHCA/NCAL’s COVID-19 webinar on March 3 is now available here. Please note that there are two versions, depending on which web browser you are using.

This is a critical issue for long term care as evidenced by the more than 13,000 people who participated in the webinar.

Please continue to check AHCA/NCAL’s website for the latest information and resources that AHCA/NCAL has to share about COVID-19. Please email COVID19@ahca.org with any additional questions regarding this virus.

Thank you for everything you are doing to keep our residents, families and staff safe.

 

 

Tuesday, March 3, 2020 – 8:30 a.m.

The CDC expects an increase of confirmed COVID-19 cases in the coming days and weeks, and is relying on health care providers to take action and help prevent the spread of the virus. Due to the rapidly changing nature of the spread of COVID-19 around the world, it is important for families to be prepared.

But don’t panic! There are ways you can protect yourself at work and at home – and help prevent the spread of the virus in your area. Please consider the following information and resources to help you prepare.

Protect yourself at work:

  • Advise all staff to wear PPE when appropriate. At this time, the CDC does not recommend the use of PPE for workers who are not providing direct patient care.
  • When appropriate, use social distancing from anyone who may be displaying symptoms.
  • Wash and/or sanitize your hands after every interaction with a resident or visitor.
  • If you have reason to suspect a possible COVID-19 case, please follow these more stringent standards:
    • droplet precautions for the resident;
    • full PPE for all staff within a six-foot radius;
    • N95 masks;
    • isolation gowns;
    • and face/eye protection.
  • If you suspect a possible COVID-19 case, please report it to the Department of Public Health.

 Protect your building: 

  • Consider adding additional resources regarding COVID-19 at your entrance signs, such as warning signs in bold letters asking visitors having flu and/or respiratory symptoms to temporarily refrain from visiting the facility – even if they do not have travel history.
  • Encourage all staff to self-isolate at home if they display symptoms of the flu, especially if they have received the flu vaccine.
  • Take precautionary removal of care staff who identify as suspected cases. Ask them to self-isolate at home as well.
  • Prohibit staff from reporting to work if they are sick until cleared to return.
  • Consider restricting admissions or heightened screening of admissions.
  • Environmental cleaning: At this time, retrain to and follow these guidelines from the CDC about infection control and cleaning.
  • Post visual alerts that remind everyone to wash their hands and cover their coughs.

Protect yourself at home and in the community:

  • Practice social distancing, when possible. Stay away from anyone coughing or sneezing – particularly, if you do not know the person.
  • Practice good hand washing and cough etiquette.
  • If you are sick, have flu symptoms or a fever: Stay home and self-isolate.
  • Prepare for schools to close.
  • If you are sick, call your physician, clinic or hospital before you visit them. Do not go to a clinic or hospital with symptoms without calling first – they will instruct you on the proper procedures.

The CDC has offered strategies for health care providers on how to optimize supplies of N95 respirators in the face of decreasing supply, which can be found here. These strategies include minimizing the number of health care professionals who need to use respiratory protection, use alternatives to N95 respirators, such as facemasks where feasible, and prioritize the use of N95 respirators for those with the highest risk of acquiring an infection or experiencing complications from an infection.

You can learn more about the CDC’s strategies for optimizing the supply of PPE here. If you are having difficulty meeting PPE requests, please contact your local and state health departments.

While we are still taking a “wait and see” approach, the above-mentioned information can be used to minimize any potential impact or spread of the COVID-19 virus. As the situation evolves, it’s important to remember the most accurate and timely information regarding this outbreak is available through the Pennsylvania Department of Health as well as the CDC’s website and social media channels.

Providers are also reminded their emergency preparedness plans are required to address emerging infectious disease protocols. It is recommended all providers review their emergency plans to ensure their plan includes protocols and policies regarding emerging infectious diseases and to ensure all staff is trained on the appropriate steps to put into place if the situation should arise.

Partner spotlight

As a leading pharmacy provider to long-term care and post-acute care facilities, PharmScript partners with healthcare organizations across 16 states and delivers medications to thousands of residents and patients. Founded in 2009 with the goal of providing a seamless pharmacy experience, PharmScript is committed to helping providers deliver patient-centered care with high-quality service, accuracy, timeliness, and cost containment.

Learn more about our business partners
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