COVID Updates for ACF and Nursing Home Providers

In a recent meeting with the Department of Health (DOH), DOH noted an increase in COVID cases in nursing homes and adult care facilities (ACFs) in comparison to weeks prior. The cases are similar to the levels seen at this point in time the year prior. DOH reminds providers to use all of the tools available for infection prevention and control. For more information regarding cases, see the below data sources:

New Vaccine Available

Of course, the newest tool is an updated COVID vaccine that has just been made available. Updated COVID vaccines are available from Pfizer-BioNTech and Moderna. The Centers for Disease Control and Prevention (CDC) recommends that everyone age six months and older get an updated COVID vaccine to protect against the potentially serious outcomes of COVID illness this fall and winter. The CDC recommends that if you have not received a COVID vaccine in the past two months, you receive an updated vaccine now to protect yourself this fall and winter. Clinical guidance, including dosing information and Frequently Asked Questions (FAQs), can be found here.

ACFs and Nursing Homes Reminded of Regulatory Requirement Regarding Access to Vaccination

With the availability of the new vaccine, ACF and nursing home members are reminded of their responsibility to ensure that their residents and staff are aware of the opportunity and facilitate access to vaccination for all who consent to be vaccinated. Because this is a new opportunity for a recommended vaccine, regulations require ACF and nursing home providers to revisit this with all residents and staff. DOH recently issued a Dear Administrator Letter (DAL) for nursing homes reminding them of this responsibility. The DAL reiterates nursing homes' regulatory requirements, including the responsibility to:

ensure the opportunity for vaccination for all new admissions, readmissions, and new hires within 14 days;
post conspicuous signage regarding the availability; and
obtain documentation from those who decline to be vaccinated: “...a written affirmation for their signature, which indicates that they were offered the opportunity for a COVID-19 vaccination but declined. Such affirmation must state that the signatory is aware that, if they later decide to be vaccinated for COVID-19, it is their responsibility to request vaccination from the facility. The facility shall maintain signed affirmations on file at the facility and make such forms available at the request of the Department.”

ACF regulatory requirements are slightly different, but with the same overarching responsibility to facilitate access. ACFs must make diligent efforts to arrange for all consenting personnel and residents to obtain the vaccine and document efforts. For new hires, new admissions, and readmissions, the ACF must arrange for those who consent to access the vaccine within seven days. This should be discussed during the admission or hiring process and should be documented. Lastly, the ACF must obtain documentation from those who decline to be vaccinated: “...a written affirmation for their signature, which indicates that they were offered the opportunity for the facility to arrange for a COVID-19 vaccination, but declined. Such affirmation must state that the signatory is aware that, if they later decide to be vaccinated for COVID-19, it is their responsibility to request the facility arrange for their vaccination. The facility shall maintain signed affirmations on file at the facility and make such forms available at the request of the Department.”

Both ACFs and nursing homes are subject to penalties if they fail to comply. The penalties are outlined here.

It should be noted that the state and federal requirements for personnel working in these settings to be vaccinated is no longer in effect.

Any members who are having difficulty accessing the vaccine or treatments should let us know.

CDC Will Change NHSN LTC Surveillance Definition of “Up to Date”

Our colleagues at LeadingAge National report that nursing homes should be aware that the CDC will change the National Healthcare Safety Network (NHSN) surveillance definition of “up to date” for reporting weeks beginning on Sept. 25, 2023, to align with the new Advisory Committee on Immunization Practices (ACIP) recommendations for COVID vaccines. Once the new vaccine and new vaccination recommendations are applied to surveillance data collection, the percentage of long term care residents and health care personnel who are reported as up to date for the COVID vaccine may change. (Note that this does not change anything about requirements for initial shots and boosters; it changes only the definition of “up to date” for reporting purposes starting on Sept. 25^th.) The CDC is providing several trainings for long term care facilities to discuss these anticipated changes. More information can be found here.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828