Here are some home health related updates for this week:
AMITY’S NEWS
Education Event
Clinical Competency: Key Step for Successful Preparation for Home Health Value-Based Purchasing
Join Irina Gorovaya, Owner and President of Amity Healthcare Group, and Lourdes Wiley, RN MSN & Clinical Educator at Amity Healthcare Group, as we discuss the critical impact of effective clinical competency on quality of care and successful implementation of Home Health Value-Based Purchasing (VBP) model.
Learning Objectives
- Learn about primary components of VBP
- Review the impact of the clinical competency and quality of care on VBP outcomes
- Identify real solutions and strategies for successful navigation of VBP model
This is a free webinar. All participants will receive 1 CEU
Presented at 11 a.m. MST on Wednesday, January 19, 2022.
2022 Onboarding/Competency Program Updates
In addition to our comprehensive onboarding/competency program, effective January 1, 2022, Amity Healthcare Group will be offering targeted live training modules that can be utilized for the purpose of annual and/or ongoing competency as well ongoing professional development.
The modules include:
· Initial Onboarding Skilled Nursing Competency (2 hours)
· Urinary Catheter and Ostomy Care Skilled Nursing Competency (1 hour)
· Central Line/IV Skills Nursing Competency (1 hour)
· Respiratory and Tracheostomy Care Skilled Nursing Competency (1 hour)
· Wound Care Skilled Nursing Competency (1 hour)
· Pediatric Home Health Module (2 hours)
These modules are available to home health providers nationwide.
For more information, questions or registration, please go to https://amityhealthcaregroup.com/nursing-competency
For Colorado Providers only:
Amity Healthcare Group will continue to provide in-person competencies for Colorado home health providers. Competencies will be available on-demand basis.
In addition, providers are also able to rent our CNA and Nursing skills lab and utilize assistance of our instructors.
To schedule your in-person competency and/or for lab rental, please call 303-690-2749.
Amity Healthcare Group Consulting Services
Amity Healthcare Group is providing continuous support to home health providers nationwide.
Our consulting services included, but not limited to :
- Medicare Certification/Accreditation Survey preparation
- Regulatory and clinical compliance review
- QAPI implementation and analysis
- Emergency Preparedness
- COVID-19 Policies and Procedures
- Home Health startups
For inquiries, please call 303-690-2749 or email ig@amityhealthcaregroup.com
NATIONAL NEWS
OSHA Healthcare Emergency Temporary Standards (ETS)
On December 28, 2021, OSHA announced that it is withdrawing the non-recordkeeping portions of the healthcare Emergency Temporary Standard that was adopted on June 21, 2021 and put in place to protect healthcare workers from COVID-19. Please note that the following COVID-19 log and reporting provisions remain in effect:
- 29 CFR 1910.502(q)(2)(ii) and (3) (ii)-(iv) Recordkeeping. Requiring employers with more than 10 employees to establish and maintain COVID-19 logs recording each instance in which an employee is COVID-19 positive, and to make such records available upon request to employees or their representatives (in redacted form where necessary), and OSHA.
- 29 CFR 1910.502(r) Reporting COVID-19 fatalities and hospitalizations to OSHA. Requiring the employer to report each work-related COVID-19 fatality within 8 hours of the employer learning about the fatality and each work-related COVID-19 in-patient hospitalization within 24 hours of the employer learning about the in-patient hospitalization.
OSHA’s official statement on the status of the COVID-19 Healthcare ETS includes the following:
On June 21, 2021, OSHA adopted a Healthcare Emergency Temporary Standard (Healthcare ETS) protecting workers from COVID-19 in settings where they provide healthcare or healthcare support services. 86 FR 32376. Under the OSH Act, an ETS is effective until superseded by a permanent standard – a process contemplated by the OSH Act to occur within 6 months of the ETS’s promulgation. 29 U.S.C. 655(c).
OSHA announces today that it intends to continue to work expeditiously to issue a final standard that will protect healthcare workers from COVID-19 hazards, and will do so as it also considers its broader infectious disease rulemaking. However, given that OSHA anticipates a final rule cannot be completed in a timeframe approaching the one contemplated by the OSH Act, OSHA also announces today that it is withdrawing the non-recordkeeping portions of the healthcare ETS. The COVID-19 log and reporting provisions, 29 CFR 1910.502(q)(2)(ii), (q)(3)(ii)-(iv), and (r), remain in effect. These provisions were adopted under a separate provision of the OSH Act, section 8, and OSHA found good cause to forgo notice and comment in light of the grave danger presented by the pandemic. See 86 FR 32559.
With the rise of the Delta variant this fall, and now the spread of the Omicron variant this winter, OSHA believes the danger faced by healthcare workers continues to be of the highest concern and measures to prevent the spread of COVID-19 are still needed to protect them. Given these facts, and given OSHA’s anticipated finalization of this rule, OSHA strongly encourages all healthcare employers to continue to implement the ETS’s requirements in order to protect employees from a hazard that too often causes death or serious physical harm to employees.
As OSHA works towards a permanent regulatory solution, OSHA will vigorously enforce the general duty clause and its general standards, including the Personal Protective Equipment (PPE) and Respiratory Protection Standards, to help protect healthcare employees from the hazard of COVID-19. The Respiratory Protection Standard applies to personnel providing care to persons who are suspected or confirmed to have COVID-19. OSHA will accept compliance with the terms of the Healthcare ETS as satisfying employers’ related obligations under the general duty clause, respiratory protection, and PPE standards. Continued adherence to the terms of the healthcare ETS is the simplest way for employers in healthcare settings to protect their employees’ health and ensure compliance with their OSH Act obligations.
OSHA believes the terms of the Healthcare ETS remain relevant in general duty cases in that they show that COVID-19 poses a hazard in the healthcare industry and that there are feasible means of abating the hazard. OSHA plans to publish a notice in the Federal Register to implement this announcement.
Please note that OSHA is collecting public comments on the above until January 31, 2022.
CMS To Begin Enforcing Staff COVID-19 Vaccinations in Certain States
On December 29, 2021, The Centers for Medicare & Medicaid Services (CMS) has issued interpretive guidance for the Interim Final Rule (IFC) – Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination, along with enforcement deadlines.
Please note that this guidance does not apply to the following states at this time: Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Texas, Utah, West Virginia and Wyoming. Surveyors in these states should not undertake any efforts to implement or enforce the IFC regulatory requirements.
CMS is staggering enforcement of the requirements for mandatory staff vaccinations into two phasers and providing some flexibility for compliance as follows.
Phase I Implementation date is January 27, 2022
- Policies and procedures are developed and implemented for ensuring all facility staff, regardless of clinical responsibility or patient contact are vaccinated for COVID-19, including all required components of the policies and procedures specified below (e.g., related to tracking staff vaccinations, documenting medical and religious exemptions, etc.); and
- 100% of staff have received at least one dose of COVID-19 vaccine or have a pending request for, or have been granted a qualifying exemption, or are identified as having a temporary delay as recommended by the CDC, the facility is compliant under the rule; or
- Less than 100% of all staff have received at least one dose of COVID-19 vaccine, or have a pending request for, or have been granted a qualifying exemption, or are identified as having a temporary delay as recommended by the CDC, the facility is non-compliant under the rule. The facility will receive notice of their non-compliance with the 100% standard. A facility that is above 80% and has a plan to achieve a 100% staff vaccination rate within 60 days would not be subject to an enforcement action. Facilities that do not meet these parameters could be subject to additional enforcement actions depending on the severity of the deficiency and the type of facility (e.g., plans of correction, termination).
Phase II Implementation date is by February 28, 2022
- Policies and procedures are developed and implemented for ensuring all facility staff, regardless of clinical responsibility or resident contact are vaccinated for COVID-19, including all required components of the policies and procedures specified below (e.g., related to tracking staff vaccinations, documenting medical and religious exemptions, etc.); and
- 100% of staff have received the necessary doses to complete the vaccine series (i.e., one dose of a single-dose vaccine or all doses of a multiple vaccine series) or have been granted a qualifying exemption, or are identified as having a temporary delay as recommended by the CDC, the facility is compliant under the rule; or
- Less than 100% of all staff have received at least one dose of a single-dose vaccine, or all doses of a multiple vaccine series, or have been granted a qualifying exemption, or are identified as having a temporary delay as recommended by the CDC, the facility is non-compliant under the rule. The facility will receive notice of their non-compliance with the 100% standard. A facility that is above 90% and has a plan to achieve a 100% staff vaccination rate within 30 days would not be subject to an enforcement action. Facilities that do not meet these parameters could be subject to additional enforcement actions depending on the severity of the deficiency and the type of facility
If facilities participate in and are certified under the Medicare or Medicaid programs and are regulated by the CMS health and safety standards known as the Conditions of Participation (CoPs), Conditions for Coverage (CfCs), and Requirements for Participation, then they are expected to abide by the requirements established in the CMS Omnibus Staff Vaccination Rule.
Within 90 days and thereafter following issuance of the guidance, facilities failing to maintain compliance with the 100% standard may be subject to enforcement action, which include civil monetary penalties, denial of payments, and—as a final measure—termination of participation from the Medicare and Medicaid programs if a provider does not comply with all regulatory requirements.
Federal, state, Accreditation Organization, and CMS-contracted surveyors will begin surveying for compliance with these requirements as part of initial certification, standard recertification or reaccreditation, and complaint surveys 30 days following the issuance of this memorandum (January 27, 2022).
Additional information:
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- For a complete CMS interpretive guidance for the Interim Final Rule, please go to: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/guidance-interim-final-rule-medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-0
- For a Home Health specific guidance/CoP, please go to: https://www.cms.gov/files/document/qso-22-07-all-attachment-g-hha.pdf
- CMS also updated its Current Emergencies Page with corresponding FAQs and infographics. These items can be found under the “Clinical and Technical Guidance for All Health Care Providers” using the following link: https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page
- National Association for Home Care and Hospice (NAHC) issued a comment letter in response to the CMS Interim Final Rule (the letter can be located at https://discussion.nahc.org/wp-content/uploads/wpforo/default_attachments/1640816229-cms-vaccination-comments-draft.pdf ) to address lack of accommodations for employees who choose not to get vaccinated, as well as potential impact of the CMS requirements on workforce status.
Notice of Admission
Just a reminder that starting January 1, 2022, the Notice of Admission (NOA) for Home Health Agencies (HHAs) went into effect. Remember that if your EMR system is not ready for the cross-over period, your agency will be required to key the NOAs directly into the Direct Data Entry (DDE) system. Below is a link to a job aid that provides details of keying the NOA into the DDE, developed by CGS, NGS, and Palmetto GBA:
https://cgsmedicare.com/hhh/education/materials/pdf/billing_noa.pdf
CDC Update to Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2
Please note that on December 23, 2021, CDC updated its Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2. The updates are focused on recommendations regarding when health care personnel with SARS-CoV-2 infection could return to work.
For a complete guidance, please go to:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html#print
COLORADO NEWS
COVID-19 Vaccination Mandate
As you know, on December 15, 2021, the Colorado Board of Health held a rulemaking hearing in regards to COVID-19 Vaccination Mandate. As the result of this hearing, several changes were implemented to Colorado state Vaccination Mandate.
Please go to https://drive.google.com/file/d/1WgKKxwnHJbTBd_MAXq-44sok1YL3ILSg/view for updated vaccination requirements. Please review a summary of the significant changes to the regulations on pages 2 and 3 of the document.
The key change involves clarification that medical and religious exemptions will be treated in the same manner. Employees will apply for an exemption from their employer and the employer will determine if that application meets the requirements of the facility policy. The Department will calculate compliance with the 100% requirement as follows:
100% = # of vaccinated individuals + # of employees with medical exemptions + # of employees with religious exemptions.
In the light of the above, the Agencies will no longer be required to apply for waivers based on religious exemptions.
Please also note that Colorado is one of the states that is subject to CMS Interim Final Rule (IFC) – Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination requirements. Please review CMS To Begin Enforcing Staff COVID-19 Vaccinations in Certain States section of this newsletter above for detailed information.
Revision of 6 CCR 1011-1, Chapter 26, Home Care Agencies
Please note that proposed revisions to 6 CCR 1011- 1 Chapter 26, Home Care Agencies were approved by the Colorado Board of Health on December 15, 2021 and are currently in effect.
Please go to https://drive.google.com/file/d/1w3zGqgq0u-_luftNxHUFjTtBWZQteC7x/view to get acquainted with approved revisions.
Occurrence Reporting
Please note the CDPHE updated its contact information related to Health Facilities Occurrence Reporting. Please visit the HFEMSD website to download and obtain the most updated version of the Occurrence Reporting Manual (https://cdphe.colorado.gov/health-facility-reported-incidents)
The updated contact information is:
General Occurrence Questions/Information:
Occurrence Intake Coordinator: (303)692-2826
Occurrence Line: (303) 692-2900
Occurrence Section Manager: (303) 968-7541
Email: cdphe.hfoccur@state.co.us Fax: (303) 753-0139
Amity’s Friday emails (newsletters) will be archived on Amity’s Healthcare Group website at https://amityhealthcaregroup.com/resources/ under Weekly Newsletter section.
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Thank you,
Irina Gorovaya, RN BSN, MBA
Amity Healthcare Group, LLC
Home Health Consulting, Education and Outsourcing Services
720-353-7249 (cell) 303-690-2749 (office) 720-398-6200 (fax)