COVID-19 Reporting for Nursing and Assisted Living

Facilities

REQUIRED REPORTING FOR NURSING FACILITIES

Residents, Resident Representatives and Families• First notification, if applicable, must occur by 5:00 p.m. on Sunday, May 9, 2020• Must inform all residents, resident representatives and families by 5:00p.m. the next

calendar day of the occurrence of:• A single confirmed case of COVID-19 infection (of staff or resident) or• Three or more residents or staff with new-onset of respiratory symptoms* that occur

within 72 hours • Must provide updates to resident and resident representatives:

• Weekly or • A new confirmed case of COVID-19 infection or• Three or more residents or staff have a new onset of respiratory symptoms* within 72

hours

REQUIRED REPORTING FOR NURSING FACILITIES

Residents, Resident Representatives and Families• Notification to residents/resident representatives must:

• Include mitigating actions to prevent or reduce the risk of transmission• Identify any resulting changes to facility operations• Be reported in accordance with existing privacy statutes and regulations

*Respiratory symptoms, per CMS, are shortness of breath, difficulty breathing, new or change in cough, sore throat, or new loss of taste or smell; and, to a lesser extent, new sputum production, rhinorrhea, or hemoptysis

REQUIRED REPORTING FOR NURSING FACILITIES

Center for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN)• Register with CDC’s NHSN and then register with SAMS

• Complete NHSN enrollment on SAMS homepage and accept NHSN AgreementEnforcement• First report is due by 11:59p.m. on Sunday, May 17, 2020

• May 24, 2020 at 11:59 pm: Two-week grace period ends • May 31, 2020 at 11:59 pm: Facilities that fail to begin reporting receive a warning letter • June 7, 2020 at 11:59 pm: Facilities that have not reported will have a $1,000 CMP for that week

• Each subsequent week: Facilities that fail to report, will receive an additional CMP increased by $500 for each week

• If facility reports in week 6, but then fails to report in week 7, a $2,000 CMP amount will be imposed ($500 more than the last imposed CMP amount) for total CMPs imposed $4,500

REQUIRED REPORTING FOR NURSING FACILITIES

Center for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN)CMS anticipates publicly posting CDC’s NHSN data (including NF names, number of COVID-19 suspected and confirmed cases, deaths, and other data as determined appropriate) weekly on Mondays by the end of May on this CMS webpage.

REQUIRED REPORTING FOR NURSING FACILITIES

Connie Vogt and Team at Department of Health and Human Services:• Complete the blank Excel spreadsheet following Connie’s guidance and example

below and email to: dhhs.healthcarefacilities@nebraska.gov• Forms and Instructions

• Blank COVID-19 Spreadsheet (.XLXS Download)• Example COVID-19 Spreadsheet (.XLXS Download)• COVID-19 Spreadsheet Explanation

• Update with changes and email to: dhhs.healthcarefacilities@nebraska.gov

REQUIRED REPORTING FOR NURSING FACILITIES

Your Local Health Department• NHCA recommends contacting your LHD in advance to ensure the department wants

this information and, if so, to identify the desired format and contact information. • LHD Map and Contact Information

REQUIRED REPORTING FOR ASSISTED LIVING

Connie Vogt and Team at Department of Health and Human Services:• Complete the blank Excel spreadsheet following Connie’s guidance and example

below and email to: dhhs.healthcarefacilities@nebraska.gov• Forms and Instructions

• Blank COVID-19 Spreadsheet (.XLXS Download)• Example COVID-19 Spreadsheet (.XLXS Download)• COVID-19 Spreadsheet Explanation

• Update with changes and email to: dhhs.healthcarefacilities@nebraska.gov

REQUIRED REPORTING FOR ASSISTED LIVING

Your Local Health Department• NHCA recommends contacting your LHD in advance to ensure the department wants

this information and, if so, to identify the desired format and contact information. • LHD Map and Contact Information

Center for Disease Control and Prevention’s National Healthcare Safety Network (NHSN)

Mandatory for NF

Optional for AL

Preparing to Enroll in NHSN

• Recommend the latest version of your internet browser

• Need to identify NHSN Administrator as point of contact

• Need CMS Certification Number (CCN) and CCN Effective Date

• Check that spam-blocker allows emails from NHSN and SAMS

NHSN Enrollmenthttps://www.cdc.gov/nhsn/ltc/covid19/index.html

NHSN Enrollment

NHSN Enrollment

NHSN Enrollment

NHSN:Finding Your Facility’s CCN and Participation Date

https://qcor.cms.gov/main.jsp

NHSN:Finding Your Facility’s CCN and Participation Date

https://qcor.cms.gov/main.jsp

NHSN:Finding Your Facility’s CCN and Participation Date

https://qcor.cms.gov/main.jsp

ABC NURSING HOME295605

NHSN Enrollment

NHSN Enrollment

NHSN Enrollment

NHSN Enrollment

NHSN Enrollment

Entering Data in NHSN

• Daily reporting will provide the timeliest data

• At a minimum, facilities should enter data once a week.

• The module is made up of 4 separate reporting pathways:

• Resident Impact and Facility Capacity • Staff and Personnel Impact • Supplies and Personal Protective Equipment • Ventilator Capacity and Supplies

Entering Data in NHSN

• Questions include aggregate counts and check box responses.

• Can navigate each pathway during one session or multiple ones.

• Have the ability to SAVE incomplete data in one or all pathways.

• Specific resident and staff information is not collected.

• Data may be entered at any time. • A Table of Instructions or TOI is available for

each pathway.• May enter data manually or upload data using a

CSV file.

AHCA/NCAL Guidance• AHCA recommends accurately reporting your facility’s staffing and Personal

Protective Equipment (PPE) needs in NHSN based on normal standards, not conservation guidance.

• It is important that the data reported to NHSN gives an accurate picture of staffing and PPE as well as the other areas collected in NHSN.

• Federal and state governments will use this data to hold nursing homes accountable for care and services provided and to identify who needs additional resources.

• The information you report on PPE and staff will likely also be used by surveyors when comparing what they find during their surveys.

NHSN Data Entry

NHSN Data Entry

NHSN Data Entry

NHSN Data Entry

NHSN Data Entry

AHCA/NCAL Guidance

• NHSN asks “Does your organization have a shortage of staff and/or personnel?”

• Answer YES if any of the following are occurring during the time period of reporting:

• Staffing less than your facility needs or internal policies for staffing ratios prior to COVID or based on increased needs since COVID

• Employing contingency or crisis strategies for staffing shortage

• Using more agency staff than you used before the pandemic

• Using more volunteers for staffing needs than you used prior to the pandemic

• Using any temporary positions (i.e., temporary nurse aide, medication aide or dining assistant)

NHSN Data Entry

AHCA/NCAL Guidance

• NHSN asks “Do you have enough supplies (each item listed separately) for one week?” Answer NO if any of the following are occurring during the time period of reporting:

• Employing any conservation strategies for PPE use; if you are not able to use PPE per conventional transmission-based precautions in place before the pandemic you should answer NO

• Using alternative PPE (e.g., cloth masks or gowns, other types of face coverings)

• Reusing any single use supply item such as gown or masks• Keep in mind your PPE supply will be compromised if in the

next week: • Additional residents will need to be placed on precautions• Additional staff will need to use PPE when returning to

work• Visitors or contractors need to visit

AHCA/NCAL Guidance

As a reminder, facilities should keep documentation of efforts to secure more PPE as well as staffing and report to your local and state health departments that you are employing contingency and crisis strategies to conserve PPE and staffing.

NHSN Data Entry

Survey Enforcement

Survey Enforcement

How are you notifying:

RESIDENTS RESIDENT REPRESENTATIVES

FAMILIES

What responses have you received?

Resources

AHCA/NCAL NF Reporting Guidance: https://www.nehca.org/wp-content/uploads/Summary-CMS-Reporting-Requirements.pdfHugh Heaton NHSN Guidance:https://www.nehca.org/wp-content/uploads/NHSN-COVID-19-Module-Forms-Instructions-Resources.pdfNHCA Required Reporting for NF and AL:https://www.nehca.org/wp-content/uploads/REQUIRED-COVID-REPORTING-SUMMARY-UPDATED-05.13.20.pdf

QUESTIONS?

If Questions, contact:

• Cindy Kadavy at cindyk@nehca.org• Allen Meade at allenm@nehca.org• NHCA Team at 402-435-3551