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A monthly newsletter highlighting events and resources for Nursing Homes & Community Coalitions
In this issue:
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 ***CMS Nursing Home COVID-19 Toolkit***
The Toolkit is updated biweekly, and is found under “Health Facilities” section. This document is a compilation of actions employed by organizations, including state governments, in the United States and outlying territories to assist nursing homes in meeting the needs of nursing home residents since the onset of the COVID-19 pandemic recognized in early 2020. The actions were collected by the contractors of the QIO Program, a statutorily mandated program of quality improvement contractors who work for the Centers for Medicare & Medicaid Services (CMS) to improve the care of Medicare beneficiaries, including beneficiaries who reside in nursing homes. By law, a QIO works in every state and territory. This information was collected first by the QIOs in late April 2020, and compiled by CMS and its contractors to provide a rapid-access compendium for providers and administrators of nursing homes in the United States to learn from the many creative plans that state governments and other entities have put into operation in a short period of time. This compendium is not intended as guidance from CMS. It does not replace or serve as a substitute for CMS requirements and policy. The actions outlined in this document have not been evaluated for effectiveness by CMS or any government agency. This compendium is solely an informational product offered by CMS to nursing homes as well as state and local officials during the National Public Health Emergency. Access Toolkit
CMS Nursing Home Trainings
CMS-CDC Fundamentals is a 13-part training series about COVID-19 prevention for nursing home management. They can be found on QIOprogram.org underneath the tab heading “Nursing Homes,” then “On-Demand Trainings.” The Comprehensive National Nursing Home Training Series is also available on this page, and these were designed for hot spot areas. Access Trainings
Hurricane Season & COVID-19
The CDC has provided this short video to help prepare for hurricane season. Watch Now
COVID-19 Laboratory Reporting Requirements
Healthcare Providers Urged to Collect Demographic Information When Ordering COVID-19 Laboratory Tests...
The public health response to COVID-19 depends on comprehensive laboratory testing data. The Coronavirus Aid, Relief, and Economic Security (CARES) Act and the HHS Laboratory Data Reporting Guidance released on June 4, 2020 require every COVID-19 testing site to report specific data elements for every diagnostic and screening test performed to detect SARS-CoV-2 or to diagnose a possible case of COVID-19 (e.g., molecular, antigen, antibody). The data are to be reported to the appropriate state or local public health department, based on the individual’s residence. Read More
Trump Administration Launches National Training Program to Strengthen Nursing Home Infection Control Practices
On August 25, under the leadership of President Trump, CMS is implementing an unprecedented national nursing home training program for frontline nursing home staff and nursing home management. The training is designed to equip both frontline caregivers and their management with the knowledge they need to stop the spread of Coronavirus Disease 2019 (COVID-19) in their nursing homes. The training will be available immediately to staff of America’s 15,400 Medicare and Medicaid certified nursing homes and focuses on critical topics like infection control and prevention, appropriate screening of visitors, effective cohorting of residents, safe admission and transfer of residents, and the proper use of personal protective equipment – all critical elements of stopping the spread of COVID-19. The first-of-its kind scenario-based training is called the “CMS Targeted COVID-19 Training for Frontline Nursing Home Staff and Management” and it has been designed specifically with COVID-19 in mind. The program features a tailored course that incorporates the most recent lessons learned from nursing homes and teaches frontline staff best practices they can implement to address issues related to COVID-19. The training is available now on the CMS Quality, Safety & Education Portal, with five specific modules designed for frontline clinical staff and 10 designed for nursing home management. Finally, while the training is comprehensive, CMS and the Centers for Disease Control and Prevention will also have subject matter experts available on bi-weekly webinars through January 7 from 4 to 5 pm ET, to answer questions. Registration is required for these Question & Answer sessions. If a nursing home’s staff is unsure which training module best meets their needs, CMS is offering an online self-assessment tool to help them identify their needs and suggest the appropriate training modules. A certificate of completion is offered for each completed training course. See the full text of this excerpted CMS Press Release (issued August 25).
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Leadership Lessons ~ Words of advice from leaders on the front lines.
Each month, Alliant Quality shares tips and advice from leaders in healthcare. This month’s issue is courtesy of Linda Kluge, Executive Director, IDIQ for Alliant Health Solutions. Linda offers suggestions for self reflection and gaining perspective based on the southern expression, "You can't read the label from inside the jar. You need help from the outside." Read More
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Telehealth 101 - A Tip Sheet for Patients
This one-page flyer outlines the key tips for patients to help prepare for telehealth visits. Download Tip Sheet
Virtual Meeting Tips & Tricks
Virtual meetings are an effective and efficient way to keep moving ahead on community coalition initiatives when face-to-face meetings are not possible. This document summarizes tips about how to establish a virtual meeting forum, plan for the meeting, and provides a checklist you can use to successfully engage participants virtually. Taking the time to plan, practice, and establish guidelines for virtual meeting etiquette can make all the difference in ensuring your coalition can make measurable progress towards established goals. Download Tool
Community Coalition Assessment Tool
Transformational change occurs when diverse stakeholders come together to proactively execute new paradigms, new service delivery systems, or new ways of creating and deploying resources that are efficient, sustainable, and result in a better healthcare experience for consumers and providers. Complete an assessment at least annually for self-evaluation of current effectiveness of interventions and goals, and to guide the identification of opportunities for further growth and sustainability. Download Tool |
AHSCAST - Making Health Care Better
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Quality health care should be provided to all. Every other Thursday, join Alliant Health Solutions as they interview guests committed to making health care better. If you are a health care consumer, clinician or physician, healthcare insurer, system, provider or consultant, this is the podcast for you. Listen Now |
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Events
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| Learning & Action Network Events
Please join us for the following Learning and Action Network Events. Each month, Alliant Quality invites experts in the field to discuss top-of-mind topics for Medicare Beneficiaries and the Nursing Homes & Communities that care for them.
Access the recordings from prior LAN events and bite size learnings on Alliant Quality's YouTube channel.
- Initiating an Effective Medication Reconciliation Program
- Using SBIRT for Effective Screening and Referral to Treatment
- How to Create a Trauma Responsive Environment: Covid-19 Protective Factors and Responses
- This Changes Everything: Grief in the Time of COVID-19
- Assessing and Reducing Opioid Prescribing in Long Term Care
- Essential Communication Strategies for Cross Continuum Infection Control
- COVID-19 in LTCF: Keeping it out & keeping it together
- Telehealth Service in our Communities
- Providing Telehealth Services in Nursing Homes
- Alliant Quality Bite Size Learning: Telehealth Implementation - Workflows
- Alliant Quality Bite Size Learning: C. Diff Reporting and Reduction
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- Alliant Quality Bite Size Learning: Meet My Loved One
- QII Webinar: Root Cause Analysis: Creating a Good Project Foundation
- The Power of Engaging Local Government in Community Coalitions: Chattanooga-Hamilton County COVID-19 Community Task Force Successes and Lessons Learned
- Self Care for Health Care Providers
- Million Hearts Initiative 2020
- Understanding the Quality Measures & Quality Measure STAR Rating
- Engaging Community-based Organizations
- Alliant Quality Recruitment Webinar: Getting to know your QIO
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Partner Events
CMS-CDC Fundamentals of COVID-19 Prevention for Nursing Home Management
IMPORTANT ANNOUNCEMENT: To provide more options to view these important Nursing Home Trainings, we are moving to an on-demand, pre-recorded format. Live Q&A Sessions will be available on a bi-weekly basis to address questions and answers. The first of these hour-long sessions will begin August 27th at 4pm E.T. Registration is required. Register
CMS Coronavirus (COVID-19) Stakeholder Calls
CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts. Access Recordings | Register for Upcoming Calls
IHI Special Series: Tackling High-Priority COVID-19 Challenges for Nursing Homes
The Institute for Healthcare Improvement (IHI), with support from The John A. Hartford Foundation, has launched the COVID-19 Rapid Response Network for Nursing Homes to support nursing home leadership, staff, residents, families, and communities impacted by the COVID-19 pandemic. Register
Access the summarized take-aways here: Week 9-Advanced Care Planning | Week 10-QAPI and the 4Ms Framework | Week 11-Workforce and Staffing | Week 12-State and Other Re-opening Guidance
*Important Update*: IHI is taking a two week pause (August 24-September 4) to give you and your colleagues time to reflect on the learnings, digest resources, and test changes in your organizations. IHI and JAHF will also take this time to plan how to optimize our time together on the huddles. Starting the week of September 7, we will start the huddles up again at 2 days per week (Tuesdays and Thursdays), still 20-minutes in length from 12:00-12:20 ET. Tuesdays will look like our past huddles, featuring data, policy, and best practice presentations. Thursdays will be more interactive to give us an opportunity to learn from each other. Thank you for your continued participation and contributions to the Rapid Response Network!
FREE IHI Virtual Learning Hour Series
Join the Institute for Healthcare Improvement (IHI) in partnership with Well Being Trust for the free IHI Virtual Learning Hour Special Series: Caring for Caregivers. Taking place every other Friday from July 10 – September 11, this special series will focus on topics related to the prevention, prediction, and mitigation of poor mental health among caregivers. Register
American Association of Kidney Patients (AAKP) - 45th National Patient Meeting Goes Virtual!
On September 11-12, AAKP will host a timely and interactive virtual meeting featuring a diverse line-up of speakers crossing all sectors of the kidney community, including the top influencers in kidney care from federal government, medical professionals, academia, private industry, and non-profit professional organizations in the kidney community; along with a virtual exhibit hall which will allow participants to engage with various kidney-related companies/organizations. Register
The Kentucky Enduring, Education & Care Network for Collaborative Dementia Care Series 2019-2021 - Nutrition and Feeding Behavior: Diagnosis and Management and Management of Pain and Other Chronic Health Conditions in Dementia
Tuesday, September 1, 2020: We are excited to announce the addition of Dr. Gayatri Devi, MD, to speak on the topic of nutrition and feeding in older adults with dementia. Dr. Devi will be joining us from New York City and is an esteemed neurologist providing frontline care for older adults with dementia. Her insights will be a great addition to the panel of wonderful speakers including, Dr. Gregory Jicha, a world-renowned neurologist in the area of dementia care, and Dr. Nancy Stiles, an active geriatrician from the University of Kentucky. The presentation will be live on Zoom on 9/1/2020 from 3:00-4:30pm EST, registration is free, and offers free continuing education credits for attendance. Register
HHS Telemedicine Hack
Wednesdays through September 23rd join the learning community to accelerate telemedicine implementation for ambulatory providers. Register
COVID-19 CLINICAL ROUNDS: A Peer to Peer Virtual Community of Practice
The U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR), in collaboration with the National Ebola and Special Pathogens Training and Education Centers (NETEC), and Project ECHO, launched a series of COVID-19 Clinical Rounds on March 24th. This initiative supports a series of three weekly teleECHO programs – 1) Critical Care: Lifesaving Treatment and Clinical Operations; 2) Emergency Department: Patient Care and Clinical Operations; and 3) EMS: Patient Care and Operations. The aim is to create peer-to-peer learning networks where clinicians who have more experience treating patients with COVID-19 share their challenges and successes with clinicians across the U.S. and around the world with a wide variety of experience treating COVID-19. Read More | Register
Medicare Learning Network: Dementia Care Call — Tuesday, September 22 from 1:30 to 3 pm ET
National Partnership to Improve Dementia Care and Quality Assurance Performance Improvement
During this call, learn about the unique challenges facing nursing home residents living with dementia during the COVID-19 pandemic and best practices to support them. Register
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Resources
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Opioids and COVID-19: An Epidemic Within An Epidemic
As the world fights two consecutive epidemics, COVID-19 and Opioids, community support for both epidemics continue to be top priorities for Alliant Quality. Alliant Quality has a goal to support the implementation of pain and opioid best practices and patient centered approaches through collaborations with community-based coalitions. Read the Article
September is...
| National Suicide Prevention Month |
Recovery Month |
| A time in which individuals and organizations across the country join together to proclaim the message that suicide is preventable. Download Suicide Prevention Guide |
Stacy Hull, Alliant Quality's Behavioral Health Aim Lead assembled resources and information to Get Help for Mental Health and Substance Use. Visit Website |
Loneliness and Social Connection
According to AARP Public Policy Institute Insight on the Issues, well before the COVID-19 pandemic, Medicare spent an additional $6.7 billion annually on older adults that were experiencing social isolation. Download Flyer
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Access FREE expert guidance on this topic: Contact Stacy Hull |
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Check your COVID-19 Nursing Home Data
The Nursing Home COVID-19 Public File includes data reported by nursing homes to the CDC’s National Health Safety Network (NHSN) system COVID-19 Long Term Care Facility Module, including Resident Impact, Facility Capacity, Staff & Personnel, and Supplies & Personal Protective Equipment, and Ventilator Capacity and Supplies Data Elements. Visit Data.CMS.gov to ensure your data are accurate.
The Association for Professionals in Infection Control and Epidemiology (APIC) COVID for LTC Website
The most dire of COVID-19 symptoms disproportionately affect older adults and those with pre-existing conditions. Infection preventionists (IPs) working in long-term care (LTC) facilities, including skilled nursing and assisted living facilities, need information and support to combat this deadly virus and keep patients safe. APIC is pleased to provide these curated FREE resources for those working in Long-Term Care. Visit Website
APIC Text Chapter Collection: Long-Term Care
In response to COVID-19, APIC is providing complimentary access to APIC Text Chapter Collection: Long-Term Care through Sept. 30. This Collection of 32 chapters from the APIC Text provides an overview of infection prevention and control (IPC) for those working in a long-term care or long-term acute care center. Chapters 27, 28, 31, and 108 have been identified (by an IP) as the most relevant overall for the COVID-19 outbreak.
NHSN Hygiene: Reminder to Report on Time!
Add users to keep your facility reporting on time and avoid costly fines.
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Alliant Quality has many resources to help you navigate NHSN!
- Click here for the new frequently asked questions. Add User instructions are on page 11.
- Attend an upcoming Infection Prevention "Surveillance, Tracking and Reporting" (STAR) Facilities Shop Talk webinar session!
- Contact Marilee Johnson for support
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QIO Program Expands in Response to Pandemic: Free Expert Support for Nursing Homes on Infection Control and Prevention
The QIO Program has a long history of rising to face challenges impacting healthcare providers, the communities in which they operate, and the patients or beneficiaries they serve. This could never be more needed than today. In response to the pandemic, CMS has directed the QIO Program, one of the largest federal programs dedicated to improving health quality at the community level for people with Medicare, to provide direct infection prevention support to nursing homes. Learn More
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Access FREE expert guidance on this topic: Contact Melody Brown |
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Preventing Diabetes: Know More. Do More.
This one-page flyer outlines considerations for preventing diabetes. Download Flyer
CDC Resources for Vaccinations for Adults with Chronic Conditions
It is especially important for patients with chronic health conditions to be up to date on recommended vaccinations as they are at increased risk for complications from certain vaccine-preventable diseases. Download Resources
COVID-19 & Cardiovascular Disease: Partner Activation Toolkit
During the COVID-19 pandemic, cardiovascular health remains a top public health priority. Public health officials are now warning about the relationship between COVID-19 and cardiovascular disease. Not only are there more deaths from cardiovascular disease during COVID-19, but people who have serious heart conditions are at higher risk for severe illness from COVID-19. CDC Million Hearts and CDC Foundation have worked with key partners to produce two CDC-approved public service announcements (PSAs) to spotlight the importance of heart health during COVID-19.
- Emergency Care Focus: One PSA explains the risks of neglecting emergency medical attention for heart attack or stroke.
- Heart Health Focus: The other PSA promotes heart health management for those who have experienced a cardiovascular event.
As a trusted source for critical health information, especially during COVID-19, we hope you will find these messages to be helpful and valuable for keeping your audiences engaged. Download Toolkit
Get Your Flu Shot!
While there is not yet a vaccine for COVID-19, there are vaccines that reduce risk of other diseases that could make COVID illness more complex and severe. Since the public health emergency was declared, immunizations for those over 65 years old are down an estimated 45% from May 2019-May 2020. Immunization providers might consider offering creative solutions for catching up and immunizing patients utilizing recall systems, drive up, delivery or other reduced contact opportunities. Now is a great time to catch up on immunization visits before the double threat of a potential COVID resurgence and flu season come in the fall. Those with chronic health conditions, like diabetes, hypertension and kidney disease, are more likely to suffer more severe illness if they get COVID-19. Dr. L.J. Tan, of the Immunization Action Coalition, in an interview with the BBC, encouraged "taking flu off the table" in the fall to reduce the double threat of influenza and COVID. Listen Here
Similarities and Differences Between Flu and COVID-19
Influenza (Flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. Because some of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone. This table compares COVID-19 and flu, given the best available information to date. Read More
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COVID-19 Hospital Transfer Form for Patients With Intellectual and Developmental Disabilities
Individuals with intellectual or developmental disabilities may have unique care needs, behavioral support needs or need accommodations in order to communicate with members of their health care team. The Developmental Disabilities Primary Care Program (DDPCP) at Surrey Place in Toronto, Canada developed a hospital transfer form to help family members communicate how to best accommodate patients medical, communication and coping needs when families are not able to accompany patients or visit in the hospital. The tool can also be used when individuals with intellectual or developmental disabilities are transferring from a post-acute care setting to the hospital. Download Tool
Meet My Loved One
Last month, Alliant Quality released the bite-sized learning video "Meet My Loved One" featuring University of Alabama at Birmingham Center for Palliative and Support Care physicians Dr. Rodney Tucker and Dr. Sylvia Huang. The video highlights the successes and benefits of implementing a Meet My Loved One program, which can help with care transitions even when family visitations are limited due to COVID-19. Alliant Quality also worked with our Beneficiary and Family Advisory Council to develop a first-person version of the Meet My Loved One tool. For the tool and companion Tips for Implementing guidance. Download Tool | Download Companion Tips for Implementation
Common Challenges for Beneficiary Transitions and Beneficiary Care Activities & Transitions
To better understand the challenges that people face when undergoing care transitions, the Centers for Medicare & Medicaid Services listened to the stories of 46 Medicare beneficiaries and their caregivers. In recounting their experiences, people spoke of a broad range of obstacles they confront. These obstacles and challenges have been amplified in the current environment of restrictions on visiting and accompanying patients to medical appointments. CMS developed two materials depicting insights, informed by this research, on the most commonly shared challenges and activities noted to be particularly challenging. Originally shared during the 1st Annual Care Transitions Awareness Day in 2019, these materials provide the framework for evaluating patient and beneficiary journeys across care transitions in communities and identifying priorities for community coalition collaboration and process improvement. Beneficiary Care Activities & Transitions | Common Challenges for Beneficiary Care Transitions
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Sparkling Surfaces: Stop COVID-19’s Spread
This resource contains a pre and post-test that can be used to evaluate baseline knowledge and effectiveness of the training on the Centers for Disease Control and Prevention’s Key COVID-19 Prevention Messages for Frontline Long-term Care Staff, specifically how sparkling surfaces stop the spread of COVID-19. Download Resource
Preventable Readmissions Initiative Medication Discrepancies Data Collection Tool: For Hospital to SNF Transitions
This tool is designed to help skilled nursing facilities (SNF) collect data on medication discrepancies found upon admission to the SNF for patients discharged from the hospital to the SNF. Download Tool
Working Together to Prevent Adverse Drug Events (ADE)
An adverse drug event has been defined by the Institute of Medicine as “an injury resulting from medical intervention related to a drug.”1. This broad definition includes harm directly caused by a drug including medication errors, drug reactions, overdose, allergic reactions, inadequate dosing or additional negative events occurring as a result of drug use.
Long term care (LTC) residents are at a particularly high risk for ADEs; the average LTC resident uses seven to eight different medications each month, with about one-third of residents receiving nine or more medications.2 In LTC centers, an estimated 2 million ADEs occur each year with at least 10 ADEs occurring each month in an average size center. One in seven LTC residents will be hospitalized as a result of an ADE.3
A defined group of ADEs that are considered to be clinically significant and preventable include high-risk drug classes such as anticoagulants, diabetes agents, opioids and antipsychotic medications. Older populations are at the highest risk of acquiring an ADE during a subacute or long term care stay. ADE is preventable, focused intervention aimed at preventing and reducing ADEs links to standardize quality practices and strategies around the management of high-risk medications to include pharmacovigilance, team approach, awareness of high risk medications, medication reconciliation, systematic collection and monitoring data, quality practices and evidence based tools to ensure safe medication prescribing and administration.
1.Kohn LT, Corrigan JM, Donaldson MS (Institute of Medicine), 2 Doshi JA, Shaffer T, Briesacher BA. National estimates of medication use in nursing homes: findings from the 1997 Medicare current beneficiary survey and the 1996 medical expenditure survey. J Am Geriatr Soc. 2005;53(3):438-443., 3 Handler SM, Hanlon JT. Detecting adverse drug events using a nursing home specific trigger tool. Ann Longterm Care. 2010;18(5):17-22.
Some helpful ADE references include:
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