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In Focus Newsletter November 13, 2020

November 13, 2020

CHCA Welcomes a New Team Member

CHCA is excited to announce the addition of Erin Thomas to our team! Erin began her work at the association this month as our Director of Quality & Regulatory Affairs. Prior to joining CHCA she served in various roles for Madison Creek Partners, including Director of Regional Operations and Director of Clinical Operations. As an RN with operations experience Erin brings a very valuable perspective to help CHCA serve our membership. She looks forward to providing insight and resources to our members with all matters clinical, operational, and regulatory in nature. We look forward to getting her introduced to the membership over the coming months. Meanwhile, please feel free to contact Erin with any questions at ethomas@cohca.org or 720-935-5490.

Colorado Specific Updates

Colorado’s Newest Public Health Order:
On November 10, the Colorado Department of Public Health and Environment (CDPHE) issued an Updated Public Health Order that impacts all Nursing Home and Assisted Living Communities. Changes that will go into effect on November 20 include the following:
• All long-term care facilities must implement ongoing surveillance testing, plus outbreak testing as needed.
• Surveillance testing will be required weekly for staff, as well as for any residents who have left the facility.
• All surveillance and outbreak testing will be conducted utilizing polymerase chain reaction (PCR) tests, the most effective test for detecting infection with COVID-19 available.
• Any single positive test within a facility will initiate outbreak testing of all residents and staff, regardless of the presence or absence of COVID-19-related symptoms.

The state of Colorado has partnered with Curative Labs, a national COVID-19 testing company, to assist facilities in meeting the new testing requirements. Through Curative Labs, the state will be providing test kits to all residential care facilities at no cost.

For an overview of the updated public health order, the process for participating in the Curative Labs process, and Curative training dates, please see the CDPHE Memo. At a minimum, please be aware that your facility’s administrator of record with CDPHE will be receiving an email from: support@curative.com with information that is critical to receiving access to Curative Lab. If you have questions or need assistance, please reach out to Doug Farmer (Dfarmer@cohca.org)

State Indoor Visitation Policy: The state has indicated that they have reached some initial agreement with CMS on how to craft a state visitation policy that also meets federal requirements and guidance, and we expect to see new indoor visitation guidelines in the near future. Meanwhile, CDPHE has made it clear that providers in Colorado will be held to the State guidance, and CDPHE will not be surveying to the federal guidance at this time. If you are considering indoor visitation, please review Colorado’s Indoor Visitation Guidance. Please contact Erin Thomas (athomas@COCHA.org) with specific questions.

14 Day Admission Hold: We realize that the 14-day admission hold for any positive cases has had a deeply negative impact on census throughout the pandemic. In many instances the 14-day admission hold has been extended by local health departments, and the policy has been inconsistently administered at the county level. Specifically, the state indicates that bans should be put in place for new RESIDENT cases, but some counties have extended the ban to situations where new EMPLOYEE cases arise. The Governor’s Residential Care Strike Force has shown a willingness to create an admission ban policy that would allow a provider to clear the ban when certain thresholds have been met (ie. new round of baseline testing, ability to quarantine, and appropriate levels of staffing and PPE). We hope to have an updated policy to share in the near future.

PASRR Training Resources: The state PASRR coordinator recently shared updated training information, training modules, and pre-recorded tutorials. A link to the PASRR website, and a list of the training materials can be found here.

New Paid Family & Medical Leave Insurance (FAMLI) Act: During this year’s election Colorado voters approved Proposition 118 which provides paid family and medical leave to all employees in the state. The program will be operated by the Colorado Department of Labor and paid through a combination of employee and employer contributions. The contributions will begin in 2023 and the program will be operational in 2024. CHCA is working to provide a webinar for providers on the details of this law. Meanwhile, for more information about the Act please see a FAMLI Act Q&A Overview provided by the law firm of Husch Blackwell.

Navigating the Holidays: As the holidays approach there is meaningful concern that if current indoor visitation guidelines aren’t changed, many families will opt to take their loved ones outside of the care community for holiday celebrations. This practice could lead to a concerning level of COVID-19 spread in LTC communities. CHCA is working with the state to create some type of holiday visitation guidance in addition to re-working the overarching indoor visitation policy to allow it to be more widely used. As it seems increasingly unlikely that the indoor visitation policy will be relaxed in the near future, we are now asking the state’s assistance to get the word out to the public that taking their loved ones outside of LTC communities is not advised. Some providers have begun sending letters to family members alerting them that any resident taken outside of a care center will result in a 14-day quarantine upon return. CDPHE has indicted that such a policy is not a violation of resident rights.

Keeping Up to Date 

Value Based Purchasing: We know that the Value Based Purchasing payments that were distributed this month were surprisingly small in Colorado. Right up until the distribution came out, we were led to believe that payments would be an average of around $45,000 per facility that qualified and that roughly 60% of all facilities in the country would qualify. In the end, 178 communities in Colorado qualified for a share of $2.4 Million. Colorado got a smaller than expected share of the available funds because we had relatively fewer active COVID-19 cases in September than many other states. The payments will be recalculated for October, November, December and a final overarching payment at the end of the year using the Nursing Home Quality Incentive Payment Methodology.

COVID-19 Vaccines: Recent information from the federal government indicates that the first wave of COVID-19 vaccine could be ready for distribution as soon as December. Long term care residents and workers are at the highest priority level to receive the vaccines. By now all providers should have signed up to have their residents vaccinated and are either using Walgreens, CVS, or their long-term care pharmacy. The state will be determining the process to vaccinating health care workers, and we are working to ensure that nursing home and assisted living providers remain in the very first tier for access to vaccines. We will provide updates as soon as a formal state plan is confirmed.

We also know that there is concern among employees and residents about taking an initial vaccine. To help ensure that people are acting on accurate information, CHCA is working with the Colorado Medical Directors Association to provide you with information that will help to educate residents and staff members on COVID-19 vaccines, in the interest of getting as many vaccinated as possible.

Ideas for Celebrating the Holidays: As the holidays approach us, we know that everyone is searching for ways to help our residents celebrate in these challenging times. Thanks to our friends at Vivage Senior Living for sharing some great ideas for Celebrating the Holidays During COVID-19.

Legal Survey: CHCA is aware that a number of legal actions have been filed against long term care providers across the country in relation to COVID-19. In an effort to inform public policy and defend the profession in relation to these lawsuits, CHCA is asking that members share information about any cases that might be filed in Colorado. Specifically, we are interested in knowing about cases that allege a failure to follow public health orders, CDC or CMS guidance related to COVID-19 matters. If you have questions about this request or information to share, please contact Doug Farmer (Dfarmer@cohca.org)

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