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September 14, 2021

In this Issue:

  1. CMS Updates Guidance on COVID-19 Testing in Nursing Homes
  2. New York Times Article Highlights How Antipsychotic Drugs Are Misused in Nursing Homes
  3. COVID-19 Vaccination Required for All Staff of Medicare and Medicaid-Certified Facilities
  4. Take Action: Tell Congress to Support Nursing Home Provisions and Elder Justice Act Provisions in Current Budget and Reconciliation Package
  5. Study Finds COVID-19 Cases and Deaths Omitted from Federal Data
  6. Senators Wyden and Casey Call for Improved Access to Nursing Home Vaccination Data
  7. New Website with Resources for Families Caring for Loved Ones with Dementia

CMS Updates Guidance on COVID-19 Testing in Nursing Homes

On September 10, 2021, the Centers for Medicare & Medicaid Services (CMS) issued updated guidance regarding COVID-19 testing in nursing homes.  The guidance makes two significant changes to testing protocols for residents and staff, updating how facilities may conduct testing when there is a COVID-19 outbreak in a facility and how often facilities must routinely test unvaccinated staff.

Outbreak Testing
Prior to the updated guidance, when a new case of COVID-19 was identified in a facility, all staff and residents had to undergo testing, regardless of vaccination status.  Under the new guidance, if a facility can identify all individuals who had close contact with the COVID-19 positive staff or resident, the facility may test only those individuals.  If a facility is unable to identify all individuals who had contact with the positive staff or resident, then it must broaden its testing to group level (unit, floor, etc.).  Importantly, it does not require facility wide testing unless necessary.

Routine Testing of Staff
CMS is still requiring routine testing of unvaccinated staff, but is changing the method by which facilities must determine the frequency of testing.  Rather than continuing to rely on the test positivity rate in the county in which the facility is situated, facility’s must base its testing protocol on the level of community transmission.  This new metric is based on the number of new cases per 100,000 persons and the percentage of positive COVID-19 tests in the past seven days in the county in which the facility is located.  These levels can be found on the CDC website.

New York Times Article Highlights How Antipsychotic Drugs Are Misused in Nursing Homes

This past Saturday, the New York Times published an article detailing the disturbing rise of residents with schizophrenia diagnoses in nursing homes and an accompanying rise in the use of antipsychotic medication.  The report found that “The government and the [nursing home] industry are obscuring the true rate of antipsychotic drug use on vulnerable residents.”   An analysis of Medicare data found:

  • A 70% increase in the number of residents with a schizophrenia diagnosis since 2012.
  • 1 in 9 nursing home residents have received a schizophrenia diagnosis.  The rate in the general population is 1 in 150.  
  • 21% of nursing home residents are being medicated with antipsychotic drugs.
  • Antipsychotic drug use increased during the pandemic.  

Although the federal government tracks antipsychotic drugging in nursing homes and posts it on Medicare Care Compare, residents with schizophrenia diagnoses are not included.  As a result, a facility's illegal use of antipsychotics is hidden by falsely diagnosing residents with schizophrenia.

Too many residents, particularly those living with dementia, are being given off-label antipsychotic drugs to control their behavior instead of quality care. These drugs can have serious, life threatening side effects for older people and are not approved for the treatment of dementia.

Consumer Voice and AARP Foundation’s Avoiding Drugs as Chemical Restraints consumer education campaign aims to educate consumers about their rights when it comes to antipsychotic medications. It seeks to change the culture of care to ensure that all nursing home consumers can avoid chemical restraints and receive the quality, person-centered care they deserve.  Visit the campaign's website - https://theconsumervoice.org/stop-chemical-restraints.

COVID-19 Vaccination Required for All Staff of Medicare and Medicaid-Certified Facilities

Last week, the Biden-Harris Administration announced it will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified healthcare facilities.  The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), announced that emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others, as a condition for participating in the Medicare and Medicaid programs. The decision was based on the continued and growing spread of the virus in health care settings, especially in parts of the U.S. with higher incidence of COVID-19.

Read the press release for more information.

Take Action: Tell Congress to Support Nursing Home Provisions and Elder Justice Act Provisions in Current Budget and Reconciliation Package

We have a huge opportunity to get meaningful nursing home reforms passed into law!  

Congress is gearing up to pass a budget reconciliation package and there are several important nursing home provisions, from the “Nursing Home Improvement and Accountability Act of 2021” (HR 5169) currently included.  Language from the Elder Justice Reauthorization Act (HR 4969) is included as well.  We encourage you to reach out to your representatives and ask them to support these provisions!  

Learn more and take action using our simple online tool for contacting your member of Congress.

Study Finds COVID-19 Cases and Deaths in Nursing Homes Omitted from Federal Data

A study from Harvard has found more than 68,000 unreported COVID-19 cases and 16,000 unreported COVID-19 deaths in nursing homes nationwide.  The cross-sectional study of 15,307 nursing homes found that approximately 44% of COVID-19 cases and 40% of COVID-19 deaths that occurred before the start of reporting were not reported by the National Healthcare Safety Network.  The study shows that federal data underestimates the impact of COVID-19 on nursing homes because federal reporting guidelines did not require facilities to report case and death data until May 24, 2020.

Read the full report.

Senators Wyden and Casey Call for Improved Access to Nursing Home Vaccination Data

Senate Finance Committee Chair Ron Wyden (D-OR) and Senate Aging Committee Chair Bob Casey, Jr. (D-PA) asked the Biden administration to take additional steps to provide the public with more usable and accessible information on the rate of COVID-19 vaccinations among residents and workers in our nation’s nursing homes.  In a letter to the Centers for Medicare & Medicaid Services (CMS), the Senators requested that vaccination data be included on Care Compare, the federal website for consumers seeking information about health care providers participating in Medicare.

Read the Senators' letter to CMS.

Earlier this year, the Senators called on CMS to collect and release vaccination data. However, it currently resides on a separate website run by CMS and the CDC. Consumer Voice created a video walk-through of this webpage, as it can be difficult to navigate.

New Website with Resources for Families Caring for Loved Ones with Dementia

In the Moment, a nonprofit doing work in the field of dementia, creativity in care and culture change, has created a new website - beinginthemoment.org.  The site is a response to the need of family caregivers to have practical, person-centered education and resources that they can access anytime, with skills to use in their everyday life. The site provides free resources to friends and families of persons living with dementia.


 

Order Residents' Rights Month Stickers Before October!

RRM 2021 StickersResidents' Rights Month stickers are a great way to raise awareness for this year's theme, and they make a great giveaway for residents, family members, and Ombudsman program representatives!  Stickers are available now in our online store.

 

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