Changes with the end of the PHE for Nursing Homes WITH LINKS

 

To: NHA, DON, IP  From: Health Facilities – Nursing Facilities Section   Attached are two QSO Memos from CMS regarding nursing home testing requirements and QSO 20-39-NH REVISED nursing home visitation requirements with the end of the PHE. This memo also contains updated information regarding the vaccination of staff and residents. Please also refer to the updated CDC guidance regarding COVID vaccination, masking, and infection prevention practices.   Chapter 2 of the Colorado licensure regulations has been updated to reflect the state requirements for an infection prevention officer, infection treatment plans, and reporting criteria. This can be found in 6CCR 10-11-1 Chapter 2 Part 11.   Please let us know if you have any questions regarding this updated guidance.

May 17, 2023— Stakeholder Meeting Concerning The House Bill 1294 Health Facilities Funding

 

To: All Licensed Facility Stakeholders  From: Health Facilities and Emergency Medical Services Division (HFEMSD)   The HFEMSD is holding a series of 1294 Stakeholder Forum meetings to discuss a model for sustainable licensing funding to support the regulatory work the division is statutorily charged with. It has been a number of years since the division has requested fee increases and as a consequence, the present budget is insufficient to support the ongoing work of the division. Historically the division has increased fees through individual provider group stakeholder negotiations followed by formal requests for the adoption of new fees through the Board of Health. Additional increases have also periodically occurred with small incremental increases which were capped under the Denver, Aurora, and Lakewood consumer price index (CPI). The path for future funding is geared towards a more sustainable and predictable path for ongoing funding through a balance of recurring annual facility licensure fees offset by continued general fund support.  HFEMSD looks forward to working closely with you and encourages your participation to help develop a mutually supportable long-range budget solution.  Meetings for this important work will be held virtually each Wednesday during May, 2023 and may be extended into June, 2023 as necessary. The dates and times of the scheduled meetings are as follows:  Wednesday, May 17th 3:30pm - 5:00pm Wednesday, May 24th 3:30pm - 5:00pm Wednesday, May 31st 3:30pm - 5:00pm The 1294 Stakeholder Forum was established in statute as a result of House Bill 12-1294, which directs licensed provider facilities be afforded opportunities to promote dialogue and transparency for issues of interest and concern to all licensed healthcare facilities. This forum is statutorily required for such purpose Members of this group are encouraged to continue these discussions through the re-establishment of the HB 12-1294 Stakeholder Forum. Pursuant to C.R.S 25-3-113, the Stakeholder Forum consists of representatives from various types of provider facilities licensed by the department along with consumers, consumer advocates, ombudsmen, and other interested parties which meet at least four times each year for the Department to discuss and take into consideration the concerns and issues of interest to the forum members and other attendees regarding the development and implementation of rules and other matters that affect all licensed health care facilities. Resources:    ● HB 1294 Stakeholder Forum Website (includes meeting information  and invite/communication sign-up)  ● Agenda Item Request Form  If you have any further questions or comments prior to the meeting please contact Rachel Bader at rachel.bader@state.co.us

End of the federal Public Health Emergency for COVID-19

 

To: Residential & Long-Term Care Facilities   From: CDPHE Infection Prevention Program   The U.S. Department of Health and Human Services will end the federal Public Health Emergency for COVID-19 at the end of the day May 11, 2023. Visit the link to the Colorado Department of Public Health and Environment’s COVID-19 federal public health emergency FAQ for additional information. Monitor the department’s communication channels, including newsletters and calls, during the upcoming weeks for additional information and tools to assist with the transition. If you have additional questions, email cdphe_covid_infection_prevention@state.co.us.

LTC Newsletter Week ending 5/5/23

 

Attached is the most recent LTC newsletter for the week ending 5/5/2023.      https://drive.google.com/file/d/1F9VB66R4UDik0QKQRcWaSOmezQpxqEMD/view?usp=share_link     If you have any questions about the content, contact the CDPHE IP Program cdphe_covid_infection_prevention@state.co.us

Join NHSN Colorado Group Office Hour on 4/5/2023

 

Please join us at our National Healthcare Safety Network (NHSN) Colorado Group Office Hour webinar on Wednesday, April 5, 2023 from 1:00 – 1:30 MST.   The Colorado Department of Public Health and Environment (CDPHE), Healthcare-Associated Infections and Antimicrobial Resistance Program, offers NHSN Colorado user group office hours every two months via webinar to provide updates and training related to NSHN. Staff will provide a brief presentation followed by a question and answer session. The office hours are not required but are an opportunity for your facility to ask questions about reporting requirements in Colorado and request NHSN technical support. If you need assistance on NHSN errors or have any other NHSN related questions, please help us maximize the NHSN office hours and feel free to stop by for any amount of time you like.   Intended audience: Acute Care Hospitals, Critical Access Hospitals, Long-Term Acute Care Hospitals, Inpatient Rehab Hospitals and Ambulatory Surgery Centers reporting to NHSN   Agenda for April 5th office hour: ·         Colorado HAI/AR program update. ·         Antimicrobial Stewardship and the NHSN AUR Module. ·         Discussion.   Please register in advance for this webinar: https://zoom.us/meeting/register/tJYvdOGgrzIoHNSn42ftzmaQx22ol-YFVP2F   After registering, you will receive a confirmation email containing information about joining the webinar.   Please let us know if there are any specific topics or content you would like to see in our next office hour webinar planned for June 7, 2023.   For comments, concerns, or questions, please contact Lynda Saignaphone at lynda.saignaphone@state.co.us.

Proposed Changes to 6 CCR 1009-1

 

To: Healthcare Stakeholders    From: Chris Czaja, Medical Epidemiologist, Program Manager    Please see the attached information. Announcing another opportunity to review and provide feedback to the proposed Board of Health rules for communicable disease control.  Memo 6 CCR1009-1 Draft rule text only 6 CCR 1009-1

Residential and Long-Term Care Newsletter: March 8, 2023

 

To: Residential care facilities (Nursing Homes, Assisted Living Facilities, Group Homes, and Intermediate Care Facilities) From: CDPHE Residential Care Strike Team & Infection Prevention Program A new Residential and Long-Term Care Facility Newsletter is out this week. This issue covers preparing for the end of federally funded facility testing, rapid test auto shipments, and educational opportunities. The newsletter is a collaboration between CDPHE’s Residential Care Strike Team and Infection Prevention program. Email questions and content suggestions to or cdphe_covid_infection_prevention@state.co.us. Residential and Long-Term Care Facility Newsletter - March 8, 20

Residential and Long-Term Care Facility Call Slides 2/15/2023

 

To: Residential care facilities (Nursing Homes, Assisted Living Facilities, Group Homes, and Intermediate Care Facilities)   From: CDPHE Residential Care Strike Team & Infection Prevention Program   The slides from the February 15, 2023, Nursing Facilities and Intermediate Care Facilities call can be accessed at the following link.

Resources to Help Providers Plan for the End of the COVID-19 National Emergency Declarations

 

To: All Health Care Providers From: Greg Schlosser, Branch Chief, Health Facility Education and Quality On January 30, 2023, the Biden-Harris Administration announced its intent to end the national emergency and public health emergency (PHE) declarations related to the COVID-19 pandemic on May 11, 2023. To help you prepare for the end of the PHE and the flexibilities enabled during the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) has resources available, some of which have been updated based on recent action by Congress.  The following materials reflect recent changes and are currently available on the CMS Emergencies Page: Provider-specific fact sheets for information about COVID-19 Public Health Emergency(PHE) waivers and flexibilities: https://www.cms.gov/coronavirus-waivers CMS 1135 Waiver / Flexibility Request and Inquiry Form: https://cmsqualitysupport.servicenowservices.com/cms_1135 Acute Hospital At Home: https://qualitynet.cms.gov/acute-hospital-care-at-home Please note that two programs initiated during the PHE have been extended through 2023, thanks to Congress’s passage of the Consolidated Appropriations Act for Fiscal Year 2023: these extensions include the major telehealth waivers and the Acute Hospital Care at Home (AHCaH) individual waiver that was initiated during the PHE. CMS will continue to provide updates in upcoming months, and we encourage you to regularly visit the CMS Emergencies Page for the most up-to-date information. If you have any questions, please contact Melanie.Roth-Lawson@state.co.us.

Reducing Barriers to COVID-19 Vaccination: Sub-Provider Agreements

 

To: Residential Care Facilities (nursing homes, assisted living facilities, group homes and intermediate care facilities)   From: CDPHE Residential Care Strike Team and CDPHE Immunization Branch   Body of message:   January 10, 2023,   Dear long-term care partners,   On December 16, 2022, Centers for Disease Control and Prevention (CDC), the U.S. Department of Health and Human Services (HHS), and other partner organizations announced a national effort aimed at reducing barriers to COVID-19 vaccination for residents of long-term care facilities (LTCFs) by providing flexibilities in vaccine administration, increasing communications, and encouraging jurisdictions to use “strike teams” for intensive facility-level efforts. Specific actions under this national initiative include:  COVID-19 vaccine sub-provider agreements allowing LTCFs that are not directly enrolled as providers in the CDC COVID-19 Vaccination Program to access COVID-19 vaccine doses through enrolled pharmacy providers for direct administration by the LTCFs to their residents and staff. See Long Term Care Facilities Enrolling in CDC COVID-19 Vaccination Program | CDC for more information.  Use of single-dose vials: HHS approved the use of single-dose vials of Pfizer COVID-19 vaccine for enrolled LTC pharmacy partners in order to improve access.  Even though HHS is granting a 90-day temporary waiver of data reporting requirements to the state/local immunization information system (IIS), this waiver is not available in Colorado. That’s because Colorado law requires immunizing providers to report all doses administered to the Colorado Immunization Information System (CIIS).   The Colorado Department of Public Health and Environment (CDPHE) has many resources to ensure the success of LTCFs across the state. Read this letter in its entirety to learn how CDPHE can help your facility be successful in protecting your residents and staff from COVID-19.     Educational sessions tailored to LTCFs   CDPHE’s Immunization branch created just-in-time virtual educational sessions that complement existing resources to assist your facilities as you prepare to administer COVID-19 vaccines. Topics include: vaccine storage and handling, temperature excursions, vaccine administration, and reporting to CIIS. To request an educational session for your LTCF, email cdphe_covidvax@state.co.us.    Storage and handling supplies Implementing best practices for vaccine storage and handling is key to ensuring that every dose given is viable and effective. Storing vaccines in pharmaceutical-grade storage units and monitoring temperatures with a certified, calibrated continuous temperature monitoring device or digital data logger (DDL) are best practices for all vaccines. CDPHE can reimburse the purchase of an approved pharmaceutical-grade storage unit and provide free DDLs to facilities that enroll as a CDC sub-provider or as a Colorado COVID-19 vaccine provider.   ●    Pharmaceutical storage unit reimbursement CDPHE offers enrolled COVID-19 vaccine providers a total reimbursement of up to $3,500 to cover the cost of an approved, new pharmaceutical-grade refrigerator. Review the COVID-19 Vaccine Storage Unit Reimbursement Policy for additional information and email the COVID-19 Vaccine Program at cdphe_covidvax@state.co.us for additional information.    ●    Free digital data loggers All units that store COVID-19 vaccines must be monitored with a calibrated DDL that has a buffered probe and the ability to record and store temperature data. If your current data logger does not have the ability to record, store, and print a report of all temperature readings, complete the COVID-19 Program Supply Order Request Form. CDPHE will mail you a compliant data logger, free of charge, to install in your unit immediately upon receipt. The data loggers provided will be a VFC400 or a TRED30-16R model. Order one DDL for each storage unit that will hold COVID- 19 vaccine. If you have any questions about completing the request form, email the COVID-19 Vaccination Program at cdphe_covidvax@state.co.us.   Vaccine data reporting in CIIS All vaccine doses administered must be reported in CIIS within 14 days for manual reporters or within 7 days for electronic reporters to prevent over-vaccination of patients and to assure patient safety if any issues are identified with particular vaccine lot numbers. In addition, all immunizing providers are required by law to report patient-level immunization data to CIIS per §25-4-2403, C.R.S.   There are several ways that a LTCF can report doses administered to CIIS, as required by statute.   ●    Manual entry ○     IZ Quick Add - This is a process by which you can upload information about vaccines administered for multiple patients during a larger clinic within CIIS. The doses are then processed overnight and reflected on patient records in CIIS the next day. ○     Individual Patient - This is a process that you will follow if you are manually reporting a vaccine administered to a patient directly into the CIIS web application one at a time. ○     Historical Entry - This is a process you will follow if you have to add a historical vaccine not given by your facility or for which administrative information like lot number, body site, etc. do not exist to a patient’s record in CIIS.   ●    Electronic reporting ○     Option #1: Develop an electronic interface Organizations using an Electronic Health Record (EHR) that do not currently have an electronic interface with CIIS may be able to develop an electronic interface to report data to CIIS. If you are interested in electronically reporting data to CIIS, email Kim Gulliver at kim.gulliver@state.co.us. ○     Option #2: PrepMod system PrepMod is a mass vaccination scheduling and vaccine administration system that allows staff to set up virtual clinics and track all vaccines administered. Vaccine administration data entered into this system gets sent electronically to CIIS. There is no cost to use it. If you are interested in using this system, email the PrepMod Help Desk at cdphe_prepmod@state.co.us or complete the PrepMod Interest Form. ●    CIIS notification and opt-out requirements CIIS is an opt-out system, which means that patients have the right to not have their immunization information displayed in CIIS. Any organization reporting vaccination information to CIIS is required to have a notification method in place and understand the opt-out procedure. More information is available at the links below. ●    CIIS Notification Information ●    Opt-Out Information If you need assistance with any of the resources above, email the Colorado Immunization Information System Help Desk at cdphe.ciis@state.co.us.   Reminder: Vaccine data reporting in NHSN and EMResource CMS-certified nursing homes are required to report resident and staff vaccination data to CDC’s National Healthcare Safety Network (NHSN) each week. More information related to this reporting can be found at LTCF | Weekly HCP & Resident COVID-19 Vaccination |NHSN | CDC.   Public Health Order 20-20 sets requirements for long-term and residential care facilities to prevent the spread of COVID-19. It requires these facilities to provide COVID-19 testing and vaccinations for their staff and residents. It also requires facilities to make and maintain COVID-19 prevention and response plans. Additionally, the order requires facilities to submit data to CDPHE about their capacity, staffing, personal protective equipment, and other information. Facilities are still required to report all resident and staff COVID-19 vaccine doses to CDPHE through the Juvare/EMResource reporting system. Here’s how: ●    Juvare/EMResource reporting periods are twice monthly. ●    The first report shall occur during the reporting period one, which is defined as the first (1st) day through the fourteenth (14th) day of the month. ●    The second report shall occur during the reporting period two, which is defined as the fifteenth (15th) day through the last day of the month. ●    Multiple reports received during a reporting period shall be counted for that reporting period only. ●    However, facilities are required to report resident and staff vaccine doses into Juvare/EMResource when changes occur and as soon as possible after vaccine doses are completed. ○     The EMResource Access form can be completed here for first- time users in EMResource or for access changes for current users (complete one form for each team member that needs access). ○     Login through the EMResource login page. ○     Retrieve your username. ○     Reset your account password. ○     Training/support materials by facility type is outlined in the EMResource Guidance Document. ○     Access EMResource through Google Chrome and a computer (non-mobile device), if possible. EMResource questions? Email residentialcarestriketeam@state.co.us. 

Upcoming COVID-19 residential and long-term care facility call cancelled 10/19/22

 

To: Residential care facilities (Nursing Homes, Assisted Living Facilities, Group Homes, and Intermediate Care Facilities)    From: CDPHE Residential Care Strike Team and Infection Prevention Program The biweekly COVID-19 residential and long-term care facility call originally scheduled for Wednesday, October 19 is canceled. We are currently reviewing the meeting structure and schedule with the ninth amended Public Health Order 20-20 and updated mitigation guidance documents. Please find the slide presentation links from last week’s guidance meetings below: ·        Assisted Living Residences and Group Homes - October 14, 2022 ·        Nursing Homes and Intermediate Care Facilities - October 14, 2022 Questions can be sent to the Infection Prevention Program and Residential Care Strike Team. 

Reminder: Long-term care facility booster clinic request form deadline

 

To: Residential care facilities (Nursing Homes, Assisted Living Facilities, Group Homes, and Intermediate Care Facilities)  From: CDPHE Residential Care Strike Team The deadline to complete the Long Term Care Facility (LTCF) Booster Clinic Request Fall 2022 form is Friday, Oct. 14, 2022. The Colorado Department of Public Health and Environment (CDPHE) will provide one vaccine clinic before November 1, 2022 to facilities that are unable to provide a vaccine clinic on their own or use a community vaccine provider. In addition to the clinic request form, facilities requesting CDPHE assistance to provide a vaccination clinic need to complete the following EMResource question to allow for clinic scheduling. Question: CDPHE COVID-19 Vaccine Clinic Assistance Definition: The RCF Comprehensive Mitigation Guidance requires that facilities offer a COVID-19 vaccine clinic to staff and residents inside their facility within 60 days of any update to CDC’s vaccine recommendations. CDC recommended COVID-19 omicron bivalent booster vaccine doses on Sept. 1, 2022. CDPHE can assist with vaccination clinics for facilities that need it, but encourages all facilities to develop plans with community partners and document that information in the Ongoing COVID-19 Vaccination and Treatment Form. Does your facility require any CDPHE assistance to hold that clinic? Yes: Complete and submit the following form by Oct. 14, 2022 to request CDPHE assistance in providing a COVID-19 vaccine clinic at your facility by copying and pasting the below link into a new browser tab: https://docs.google.com/forms/d/e/1FAIpQLSfBhN3qGHjdUIzcg7oJw1tzUoCbgTKM9WriXP1Ftro--P1uhw/viewform No: The facility is responsible for providing its own vaccine clinic and should report the vaccine provider they will use in the comments section. After your facility answers YES to this EMResource question AND completes the Long-Term Care Facility: Booster Clinic Request 2022 form, a CDPHE representative will contact your facility to gather the necessary information to schedule the clinic. To prevent communication delays, ensure all contact information listed for your facility in the Colorado Health Facilities Interactive (COHFI) system is accurate.  A designated facility representative needs to quickly connect with a CDPHE representative to begin this process. When you receive contact from CDPHE inquiring about your COVID-19 vaccination needs, answer or return the call or email as soon as possible.   This clinic can be used by both residents and staff to provide the updated omicron bivalent and/or primary COVID-19 vaccine doses. Find out how many doses are needed for residents and staff to provide the highest level of protection by using the COVID-19 Vaccine Dose Calculator.