As part of the unprecedented efforts taken by the Trump Administration, President Trump announced several new CMS initiatives designed to protect nursing home residents from Coronavirus Disease 2019 (COVID-19).

“From the moment the threat of this virus materialized, the Trump Administration has placed a priority on protecting nursing home residents,” said CMS Administrator Seema Verma. “Today’s multi-pronged intervention represents the latest efforts in fulfilling that unwavering commitment. As caseloads continue to increase in areas around the country, it has never been more important that nursing homes have what they need to maintain a sturdy defense against the virus. These measures will help them do exactly that.”

New Funding:

HHS will devote $5 billion of the Provider Relief Fund authorized by the Coronavirus Aid, Relief, and Economic Security (CARES) Act to Medicare-certified long term care facilities and state veterans’ homes (“nursing homes”), to build nursing home skills and enhance nursing homes’ response to COVID-19, including enhanced infection control. This funding could be used to address critical needs in nursing homes including hiring additional staff, implementing infection control “mentorship” programs with subject matter experts, increasing testing, and providing additional services, such as technology so residents can connect with their families if they are not able to visit. Nursing homes must participate in the Nursing Home COVID-19 Training (described below) to be qualified to receive this funding. This new funding is in addition to the $4.9 billion previously announced to offset revenue losses and assist nursing homes with additional costs related to responding to the COVID-19 public health emergency and the shipments of personal protective equipment provided to nursing homes by the Federal Emergency Management Agency.

Enhanced Testing:

Building on the initiative HHS announced last week, in which rapid point-of-care diagnostic testing devices will be distributed to nursing homes, and the new funding from the Provider Relief Fund, CMS will begin requiring, rather than recommending, that all nursing homes in states with a 5% positivity rate or greater test all nursing home staff each week. This new staff testing requirement will enhance efforts to keep the virus from entering and spreading through nursing homes by identifying asymptomatic carriers.

More than 15,000 testing devices will be deployed over the next few months to help support this mandate, with over 600 devices shipping this week. Funds from the Provider Relief Fund can also be used to pay for additional testing of visitors.

Additional Technical Assistance & Support:

The Trump administration recently deployed federal Task Force Strike Teams to provide onsite technical assistance and education to nursing homes experiencing outbreaks in an effort to help reduce transmission and the risk of COVID-19 spread among residents. The first deployments took place in 18 nursing homes in Illinois, Florida, Louisiana, Ohio, Pennsylvania and Texas between July 18 and July 20.  The Task Force Strike Teams are composed of clinicians and public health service officials from CMS, the Centers for Disease Control & Prevention (CDC), and the Office of the Assistant Secretary for Health.

The Task Force Strike Teams went into nursing homes based on data they reported to the CDC that indicated an increase in COVID-19 cases. The teams focused on the four key areas of support, including keeping COVID-19 out of facilities, detecting COVID-19 cases quickly, preventing virus transmission, and managing staff. The goal was to determine what immediate actions nursing homes needed to take to help reduce the spread and risk of COVID-19 among residents, and to better understand what federal, state, and local resources nursing homes need to ensure the health and safety of their residents. CMS and its partners plan to use what is learned on the ground to determine remote education and other critical needs to support nursing homes and mitigate future outbreaks.

In addition, CMS, in partnership with the CDC, is rolling out an online, self-paced, on-demand Nursing Home COVID-19 Training focused on infection control and best practices. The training being offered has 23 educational modules and a scenario-based learning modules that include materials on cohorting strategies and using telehealth in nursing homes to assist facilities as they continue to work to mitigate the virus spread in their facilities. This program supplements training already underway to better equip nursing homes to contain and stop the spread of COVID-19. The training is a requirement for nursing homes to receive the additional funding from the Provider Relief Fund Program.

The training will be available to all 15,400 nursing homes nationwide along with specialized technical assistance to nursing homes who have been found to have infection prevention deficiencies in their most recent CMS inspection and had recent COVID-19 cases based upon their data submissions to CDC. A certificate of completion is offered and recognition badges can be downloaded for nursing homes to display on their website.

Weekly Data on High Risk Nursing Homes:

Early on during this pandemic, CMS required nursing homes to inform residents, their families and representatives of COVID-19 cases in their nursing homes. Starting in May, CMS and CDC began collecting weekly data on each nursing home including their number of COVID-19 cases. Now that this data collection process has matured, the White House and CMS will release a list of nursing homes with an increase in cases that will be sent to states each week as part of the weekly Governor’s report to ensure states have the information needed to target their support to the highest risk nursing homes.

This announcement builds on the unprecedented and aggressive actions CMS has taken to address the impact of COVID-19 in nursing homes.

See the full text of this excerpted CMS Press Release (issued July 22), including a list of actions CMS took to address the impact of COVID-19 in nursing homes.

By April Simpson

“As the COVID-19 pandemic battered large, metropolitan areas this spring, rural hospitals prepared to be next on the frontlines. But in order to ready their facilities for a potential surge in patients, those small hospitals had to forgo many of their most profitable operations. Months later, a few rural hospitals are fighting outbreaks. But others have empty beds, further threatening their viability in an era of shrinking health care options for people living in rural communities.” Read the full article here.

By Rob Brown

Selling a company to its employees could be a way to preserve small town and rural businesses with generations of tradition behind them. Rob Brown from Business Ownership Solutions has some advice on how to do it. Read more

By Liz Carey

Although the federal government dedicated significant funds to support rural hospitals during the pandemic, some struggle with murky spending rules and fear having to pay it back after the crisis is over. Read more

By Bill Bishop

Using the White House Coronavirus Task Force definition, the Daily Yonder found that 32% of rural counties and 41% of metropolitan counties should be enacting more stringent measures to control the spread of Covid-19. Read more

The Pennsylvania Psychiatric Leadership Council (PPLC) is hosting a variety of free support groups for nurses, doctors and front-line workers impacted by COVID-19 and looking to connect with other professionals. The purpose of these groups is to provide free emotional support, encouragement and compassionate self-care to those of you working with this pandemic daily. Please note that this is not free therapy and is to serve as support only.

With the flu season not that far away, a new Centers for Disease Control & Prevention (CDC) page discusses the similarities and the differences between influenza (flu) and COVID-19 that may be of interest to health center staff and patients. Because some of the symptoms of flu and COVID-19 are similar, it may be difficult to tell the difference between them based on symptoms alone, and testing may be needed to help confirm a diagnosis. Flu and COVID-19 share many characteristics, but there are some key differences between the two. While more is learned every day and there is still a lot that is unknown about COVID-19 and the virus that causes it, the page offers the best available information to date.

The world of telehealth has expanded into what some may consider “non-traditional” arenas. Retailers Walgreens, Walmart and CVS have all entered the healthcare space in a variety of ways, including telehealth. Walgreens and CVS offer virtual visits and telehealth services to consumers while Walmart includes telehealth services in its employee benefits plan. Here are some things to know about each retail company’s telehealth strategy. See article in Becker’s Hospital Review.

• Walgreens offers 24/7 online doctor visits to consumers for $75 cash through MDLIVE; doesn’t accept insurance but some insurance companies will accept telehealth claims from the visits; takes HSA and FSA cards for payment; physicians can write prescriptions for non-narcotic medications and information is provided to primary care physicians in accordance with state and federal laws.
• CVS offers consumer video visits for $59 per visit; available 24/7 for 365 days per year; accepts debit and credit cards as well as FSA and HSA cards; accepts some insurance but isn’t required for treatment; video visits are available in 44 states and the District of Columbia; they are not available in Nevada, Montana, Alaska, Georgia, North Carolina and Massachusetts.
• Walmart offers telehealth to employees through their benefits plan with 24/7 access; video chat with a doctor with the premier plan, saver plan and local plans is $0 through Doctor On Demand; and associates and families not enrolled in the Walmart medical plan can use Doctor On Demand for $75 for medical visits, $70 for a 25-minute psychology consultation, $119 for a 50-minute psychology consultation, $99 for a 15-minute call with a psychiatrist or $229 for a 45-minute call with a psychiatrist.

Now in addition to searching for those health centers that offer COVID-19 testing, the HRSA Find a Health Center tool has also been updated to allow users to filter their search for health center sites that offer telehealth services.