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June 15, 2021

In this Issue:

  1. Today is World Elder Abuse Awareness Day; Webinar Friday
  2. Advocates Call on CMS to Restore Full Visitation Rights
  3. Long-Term Care Resident and Staff Vaccine Access
  4. Nursing Home Vaccination Rate Data Available from CMS
  5. H-CAP Launches Center for Advancing Racial Equity and Job Quality in Long-Term Care
  6. Advocates Urge CMS to Rescind Guidance Allowing Hours Worked by CNAs to Count Towards Training

Today is World Elder Abuse Awareness Day; Webinar Friday

World Elder Abuse Awareness Day (WEAAD), observed each year on June 15th, serves as a call-to-action for our communities to raise awareness about abuse, neglect, and exploitation of elders, and reaffirm our commitment to the principle of justice for all.

Elder abuse is widespread. Every year an estimated 1 in 10 older Americans are victims of elder abuse, neglect, or exploitation. We can prevent elder abuse from happening.

Consumer Voice has several resources available for preventing, identifying, and reporting abuse, neglect and exploitation:

In recognition of World Elder Abuse Awareness Day (WEAAD), join the National Long-Term Care Ombudsman Resource Center (NORC) on Friday, June 18th at 3:00pm ET for a webinar - Resuming In-Person Visits During COVID-19: Tips for Identifying Trauma, Potential Abuse, and Supporting Residents. Learn how to identify and respond to signs of trauma and potential abuse or neglect and support residents as Ombudsman programs resume in-person visits during the COVID-19 pandemic.

Alaska State Long-Term Care Ombudsman In Discussion with Deputy Assistant Secretary for Aging

As part of the Administration for Community Living’s commemoration of WEAAD, Deputy Assistant Secretary for Aging Edwin Walker recently spoke with Alaska Long-Term Care Ombudsman Stephanie Wheeler and Alaska Adult Protective Services (APS) Program Manager Sandra Jenkins about the experiences of Alaska’s older adults during the pandemic, how each of their programs adapted to serve Alaskans, and what the two leaders have learned about reaching Alaskan Native and remote communities.

Watch the Conversation

New York Elder Justice Resource Guide

The Harry and Jeanette Weinberg Center for Elder Justice at the Hebrew Home at Riverdale and the New York State Unified Court System’s Division of Policy and Planning co-authored an Elder Justice Resource Guide.  This Guide, the most up to date and user friendly guide of its kind, presents a compendium of resources, information, and support for New York’s judges, court personnel, and other legal professionals interacting with older adults, including those who are experiencing abuse.

Get the Guide

Advocates Call on CMS to Restore Full Visitation Rights

Consumer Voice, along with partner advocates, have sent a letter calling on the Centers for Medicare and Medicaid Services (CMS) to fully restore the visitation rights of nursing home residents.

In March 2020, CMS issued guidance which closed nursing home doors, banned in-person visitation, and, in many cases, left nursing home residents confined to their rooms.  While the guidance was initially put in place to protect residents from the impact of COVID-19, over time it has resulted in residents declining, suffering, and dying from isolation, loneliness, neglect, and poor care.  

Despite additional guidance from CMS in September 2020 and March 2021 allowing more indoor and outdoor visitation, varying state policies and significant discretion provided to long-term care facilities has resulted in widespread and arbitrary variation in visitation practices, often not reflecting the needs and preferences of the residents, nor the presence, or lack thereof, of COVID-19 in a facility.   As a result, residents continue to suffer and decline.

With the success of vaccination efforts and the Centers for Disease Control and Prevention’s (CDC) easing of masking and social distancing measures in nursing homes, it is time to remove restrictions on visitation rights. While recognizing that all visitation needs to comply with CDC Core Principles of Infection Prevention, our organizations call on CMS to take immediate action to restore nursing home residents’ full right to visitation and lay out a plan and timeframe for implementation.

Read our full letter.

Long-Term Care Resident and Staff Vaccine Access

Until early April, the Pharmacy Partnership for Long-Term Care Program facilitated on-site COVID-19 vaccination of residents and staff at participating long-term care facilities through three on-site vaccination clinics. Although these vaccination clinics have concluded, all nursing home and assisted living facility residents and staff can receive a COVID-19 vaccine from the long-term care facility where they live or work. Through means outlined on this CDC webpage, long-term care facilities can access COVID-19 vaccines in the following three ways:

1.  A long-term care facility can receive COVID-19 vaccines from a long-term care pharmacy that is an enrolled COVID-19 vaccination provider with their state or territory. A long-term care pharmacy is a pharmacy designed to meet the needs of long-term care residents.
  1. Facilities can coordinate directly with participating long-term care pharmacies to access COVID-19 vaccines and plan vaccination clinics. 
  2. A long-term care pharmacy not enrolled as a COVID-19 vaccine provider with their state or territory should visit their state’s immunization program website to explore becoming a COVID-19 vaccination provider.

2.    A Long-term care facility can receive COVID-19 vaccines from a long-term care pharmacy that is an enrolled COVID-19 provider through the Federal Retail Pharmacy Program. The Federal Retail Pharmacy Program is a partnership between the federal government, state and territorial governments, and national and independent pharmacy networks to distribute COVID-19 vaccines to the American public. Based upon vaccine availability, the Federal Retail Pharmacy Program distributes vaccines to participating long-term care pharmacies.

  1. Facilities can work directly with a long-term care pharmacy participating in the Federal Retail Pharmacy Program to access COVID-19 vaccines and plan vaccination clinics. A list of participating long-term care pharmacies can be found here.
  2. A long-term care pharmacy not enrolled as a COVID-19 vaccine provider through the Federal Retail Pharmacy Program should visit their state’s immunization program website to explore becoming a COVID-19 vaccination provider.

3.    A Long-term care facility can receive the COVID-19 vaccine by enrolling with their state or territory to become a COVID-19 vaccination provider.

  1. The process for a facility to become a COVID-19 provider varies by state. To find out more information, the facility should contact their state’s immunization program.

Applicability to Long-Term Care Residents and Staff

Any long-term care resident or staff person interested in receiving a COVID-19 vaccine should ask their long-term care facility’s administrator or nurse to arrange vaccine access. If their facility does not provide access to a COVID-19 vaccine upon request, that individual should contact their long-term care ombudsman or state Department of Health. Contact information for state specific long-term care ombudsman and other advocacy resources to ensure quality long-term care access can be found on the Get Help resource page of The National Consumer Voice for Quality Long-Term Care website.

Nursing Home Vaccination Rate Data Available from CMS

The Centers for Medicare & Medicaid Services (CMS) has begun publishing COVID-19 vaccination data for individual nursing homes on the CMS COVID-19 Nursing Home Data website.  Data includes vaccination rates for staff and residents.  Nursing homes have been required to submit this data since May 21.  The data shows that, as of May 30, 748 of about 15,000 nursing homes had reached the industry's goal of vaccinating 75% of workers.  CMS issued a memo reminding nursing homes of the requirement to submit data or face civil monetary penalties.

Learn more in the article in McKnight's.

H-CAP Launches Center for Advancing Racial Equity and Job Quality in Long-Term Care

Juneteenth (June 19th) commemorates the end of slavery in the United States.

This Juneteenth, we recognize the launch of The Center for Advancing Racial Equity and Job Quality in Long-Term Care (Center for Equity). The Center for Equity is a project of the Healthcare Career Advancement Program (H-CAP) that will serve as a national hub for developing innovative workforce policy and fostering narrative change in long-term care (LTC).

Funded by the W.K. Kellogg Foundation, the Center for Equity will confront the systemic racism within LTC that deeply impacts its predominantly Black and brown workforce. Long-term care workers are chronically underpaid and undervalued, a legacy of historical and present day structural racism. Intentional policy choices leading up to the present day have reinforced the devaluation of caregiving work and precipitated a vast workforce shortage crisis due to high turnover and little career mobility.

H-CAP’s Center for Advancing Racial Equity and Job Quality in Long-Term Care is borne of the need to address the care crisis by improving the workplace standards of LTC workers, envisioning equitable, sustainable careers in caregiving, and ensuring that those who need care can access the quality services they need.

Learn more about the Center for Equity

Advocates Urge CMS to Rescind Guidance Allowing Hours Worked by CNAs to Count as Training

A coalition of advocacy organizations is asking the Centers for Medicare & Medicaid Services (CMS) to rescind its guidance, released in April, that recommends states allow hours worked during the public health emergency (PHE) to count toward certified nurse aide (CNA) training hours.  At the beginning of the pandemic, CMS issued a blanket waiver that allowed nurse aides to work for longer than four months without completing their training.  Aides are regularly required to complete 75 hours of training, on topics such as infection control, residents' rights, and basic nursing skills, no later than four months after they start work.  A CMS announcement in April did not revoke the blanket waiver but recommended states "consider allowing some of the time worked by the nurse aides during the PHE to count towards the 75-hour training requirement."  Advocates argue that the pandemic has proven that well-trained staff are crucial for nursing home safety, and that there's no reason to assume work experience would equate to training. The training regulations are in place to protect both residents and workers. Advocates have sent letters to CMS urging that the training requirements be reinstated.

Learn more in the article from Inside Health Policy.

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