WHCA/WiCAL Meets with DQA Leadership on Regulatory Questions

On Thursday, January 20, Rick Abrams, CEO, Jim Stoa, Director of Government Relations & Regulatory Affairs, and Jena Jackson, Director of Quality Advancement & Education participated along in the DQA/Nursing Home Provider Community Monthly meeting. The following areas were discussed.

DQA report –

  • Admissions –
    • Complaints that nursing facilities are not accepting admissions. Ann Angell stated she supports facilities not admitting unless they have enough staff to care for that resident. Local health departments should not be attempting to unilaterally prohibit admissions, and if they are telling facilities they can’t admit, facilities should discuss it with the Regional Infection Preventionist and if needed with Ann Angell or Jessica Radtke.
  • Complaint trends –
    • DQA has received a number of complaints from physicians regarding facilities not answering phones. Ann requested that all facilities make sure a system is in place to have phones answered as this could also affect residents/families.
    • Ann also discussed the issue of Quality of Care related to resident deaths and hospitalization with no assessment completed or physician calls, including sending to hospital without this assessment.
    • Ann stated there have been no complaints relating to the Bed Tracker system. Otis Woods stated that if discharge planners are stating otherwise, contact him.

COVID Testing/Supplies

Gregory Malcolm, a COVID testing coordinator, joined the call and answered questions regarding COVID testing. Discussion included:

  • There have been delays over the holidays due to the surge of Omicron and panic to get testing done. There have not always been supplies available as the entire country surged.
  • Testing labs have now ramped up and you should start seeing the 24-48 hour turnaround we have anticipated. Exact Sciences has now ramped up testing so hopefully the problem facilities have been experiencing will now be eliminated.
  • Use of antigen tests remains appropriate.
  • You can change you bed count and number of residents/staff when ordering supplies at WICOVIDTEST@wisconsin.gov.
  • Biweekly testing supplies will be in place until the surge is over and manufacturers have ramped up their supplies.

Staff vaccination mandate.

  • Ann Angell suggests everyone reads the CMS training guides on “Surveying for the New Staff Vaccination Rule” which can be found HERE.
    • This document explains exactly what information the surveys will be reviewing and how Scope and Severity will be determined.
  • The Vaccination survey information will be gathered at the initial recert, standard recert, and all complaint surveys.
  • Surveyors will ask to review 8 staff members, including two who are vaccinated, and six who are unvaccinated (if there are that many unvaccinated staff – this will likely include a mix of those with med exemptions, those with religious exemptions, those with a CDC-approved delay in vaccination, and any unvaccinated staff with no exemption/approved delay). This will include agency staff. You should have easy access to vendor and agency information, so Ann stated that and attestation statement from the agency would probably not be accepted.
  • On the subject of facilities’ mitigation plans related to unvaccinated staff who have received exemptions or who fall under a CDC-approved delay in vaccination: Ann Angell stated that surveyors should not be scrutinizing a facility’s determination on what is the safest and best policy and plan for COVID spread mitigation, but rather should be ensuring that there is a plan in place, and that the facility is following that plan via their policies/procedures. That should be discussed as part of the QAPI process and the team determining what precautions should be in place.
  • Surveyors will also not be judging religious or other exemptions with the exception of verifying documentation for medical exemptions requirements included in the training.

Additional topics:

  • New information has been put into place for waivers in facilities that have NATCEP prohibition to allow the site to be used for training as long as a third party is completing the training.
    • Contact Jim Stoa if you have any questions on two-year NATCEP prohibition waiver opportunities.
  • Surge Staffing. – Wave 1 is in progress. Wave 2 will be announced within the next 3 weeks and Wave 3 will be around the end of February. Facilities will be notified if they are selected.  The National Guard is presently receiving CNA training.

 

 

 

Posted in COVID-19