Questions & Answers Nursing Facility/Skilled Nursing ...

Questions & Answers Nursing Facility/Skilled Nursing Facility Provider Call

Wednesday, October 20th, 2021 1:00 PM ? 2:00 PM

Links provided in the Q&A chat box or in Q&A can be locate at the end of this document. Testing:

1. Q: How do we find the county colors for testing?

A: The CDC Level of Community Transmission (county colors) can be located on the COVID Data Tracker site at . The link can easily be found in the NH Testing Grid and in QSO-20-38-NH Revised 09/10/21.

2. Q: Our CMS Test Positivity Rate shows our county in yellow but the CDC Levels of Community Transmission shows us in red, who do we listen to?

A: QSO-20-38-NH Revised 09/10/21 now directs you to the CDC COVID Data Tracker site at for your testing intervals. The Level of Community Transmission shows your county color. This link can also be found in the NH Testing Grid.

3. Q: The logic of what we are being forced to do in regards to COVID, which now has a vaccine, makes me ask the following question: Do we test employees for the flu that aren't vaccinated for the flu every week?

A: COVID testing is a regulatory requirement from CMS, flu testing is not. Consider all of your practices and polices. Include your infection preventionist in those conversations.

4. Q: Do you have any reason to think CMS will not allow regular testing of employees who decline vaccines?

A: We really don't know. Once CMS goes into rule promulgation, they can't even discuss it. There has been no indication of this one way or the other.

5. Q: Can employees COVID test themselves for routine and outbreak testing if they are trained and checked off on COVID testing?

A: It is always recommended that you have more than one person trained to administer the COVID test. Think about what self testing looks like. You have to be mindful of technique, consistency and verification. Many people pull away during the testing. It would be very difficult to expect someone to appropriately or adequately self administer the test. This could become a regulatory concern.

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CLIA surveyors are going to want to know how you are ensuring efficacy and how you are making sure this is an appropriately administered test.

Miscellaneous:

6. Q: What is the link to the Telligen survey?

A: The link to Telligen's "Blue Ribbon in COVID-19 Vigilance" is .

7. Q: Where does Oklahoma stand on the vaccination mandate that has been proposed?

A: This department does not have a stance. If it is federally regulated, we have responsibilities and obligations under our partnership with CMS to ensure compliance with the requirements.

8. Q: Do we need to order PPE through BigCommerce or can we just pick it up when they come to our county?

A: There is not a guarantee they are coming through the counties. If they are coming to your county, it might be under a specific arrangement. We have encouraged using BigCommerce since there is a tracking system that allows LTC to be aware of what the facilities needs are. We don't have a definitive answer for you, but encourage using BigCommerce at

9. Q: Are annual surveys being completed or just COVID Focused and complaint surveys?

A: We are completing annual surveys. We are also working on the backlog of complaints.

10. Q: What steps do you recommend facilities start to take to prepare for the loss of up to 25% - 45% of their staffing due to the vaccine mandate? The latest information from Leading Age Oklahoma shows approximately only (10%) - 30 of 300 LTC Facilities have at least 75% of their staff vaccinated. The State Wide - LTC Staff Vaccination Rate stands at approximately 55%. This leaves an enormous gap in the LTC Staffing Community. What would the OSDH - Long Term Care Division say to facility administrators across the state facing this stark reality?

A: This is not just indicative of Oklahoma, there is a shortage nationwide. One resource we have is the Medical Reserve Corp, but they may still have limitations also. Staffing is a global concern for everyone, however, each facility's needs will be different. The main thing we would say to every facility is to reach out to us. We are here not just to regulate you, but to be your advocate when we can. This is a discussion we have with CMS on a weekly basis. We are addressing your concerns and reporting what you are saying. We don't have limitless control, and just like you, we are waiting to see what this will look like. Please keep communicating your staffing concerns with us.

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11. Q: Is there any consideration for changing the at-the-door screening. This practice doesn't seem to mitigate COVID in facilities, however it is a trying resource? A: The Core Principles from the QSO-20-39-NH Revised policy has not changed and this is where that guidance comes from. We have heard of some facilities where this has mitigated COVID-19. If you haven't seen this, it may mean you have educated your families and visitors well. If nothing else, knowing that you are screening may be a deterrent for those who are not feeling well.

12. Q: Have all Health Department inspectors received the vaccination? A: We cannot share that with you at this point. We can tell you we are looking pretty good.

13. Q: What are facilities doing for their Halloween carnivals? Are any having indoor trick or treaters? A: We don't know what they are doing. Consider the level of risk. Think about the ages of those entering the building. Be creative in finding ways for the residents to feel engaged while minimizing the risks. One facility responded, "We are having a Halloween parade with cars and including all the facilities in our area. Residents can watch from windows, from outside..."

14. Q: Can you please discuss CDC funding of LTC strike teams and how OSDH plans to implement? A: At this time we cannot share this. We will tell you that the HAI area has increased staff and been working on resources for mitigation. Discussions are being held in reference to the funding. As soon as we have specifics on the project's guidance, we will make sure all appropriate individuals are made aware of them.

Dr. Frasier's final comments: Thank you for all of the questions as they help us understand what your concerns are. Thank you for the information and for sharing what you are doing. I want you to know that on every CMS meeting I talk about these calls, the questions you are asking and the different things you are doing. We are advocating for you. Thank you for taking time out of your day to meet with us.

The next call will be on November 3, 2021. To sign up to receive the communications, email DianeH@health. or LTC@health.

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Links provided in the Q&A chat box or in Q&A: BigCommerce (PPE and testing supplies) - CDC- COVID Data Tracker (county colors) - CMS ? QSO-20-38-NH Revised 09/10/21 - CMS ? QSO-20-39-NH Revised - OSDH: Contacts: Long Term Care (LTC) ? Email: LTC@health. Phone: 405.426.8200 NH Testing Grid - Telligen: Website ? Contact: Micki Reyman email mreyman@ phone 405.810-3221 "Blue Ribbon in COVID-19 Vigilance" -

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