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A monthly newsletter highlighting events and resources for Nursing Homes & Community Coalitions

In This Issue:
The Latest News from CMS


CMS Returning to Certain Pre-COVID-19 Policies in Long-Term Care and Other Facilities 
The Centers for Medicare & Medicaid Services (CMS) is taking steps to continue to protect nursing home residents’ health and safety by announcing guidance that restores certain minimum standards for compliance with CMS requirements. Restoring these standards will be accomplished by phasing out some temporary emergency declaration waivers that have been in effect throughout the COVID-19 Public Health Emergency. These temporary emergency waivers were designed to provide facilities with the flexibility to respond to the COVID-19 pandemic. Read More

COVID-19 Essentials & Vaccine Updates​​

Our team is collecting and curating the essential trainings, events, resources and vaccine updates about COVID-19 and influenza on our website so you can visit one page to find the information you need. We've also outlined the essentials below.

View All COVID-19 News & Resources

Training & Resources

  • Managing Psychological Distress During COVID-19. A bite-sized learning presentation aimed at supporting mental health needs. Watch Video 
  • Using Motivational Interviewing to Increase COVID-19 Vaccinations. Download Resource
  • Motivational Interviewing to Increase COIVD-19 Vaccinations: Vignettes Download Resource
  • Centers for Disease Control and Prevention (CDC) COVID-19 Toolkits – Toolkits on a variety of topics to help you successfully communicate with your audiences. Get Toolkits
  • COVID-19 Data Tracker – Maps, charts and data provided by the CDC and updated daily. This information can be used at the facility level to show Community level COVID-19 data and help reduce COVID-19 transmission by staying aware. View Data Tracker
  • Visitor Talking Point—Visitor Flyer
  • Attention Visitor Flyer
  • Putting COVID-19 Numbers and Vaccinations into Context. This presentation and video help explain the risks of COVID-19 relative to other events such as lightning strikes, tornadoes, traffic fatalities, etc. and illustrate the impact that COVID-19 vaccinations have on reducing risks. Get the Presentation and Videos 
Requirement for Face Mask on Public Transportation Conveyances and at Transportation Hubs: As of April 18
As a result of a court order, effective immediately and as of April 18, 2022, the CDC’s January 29, 2021, order requiring masks on public transportation conveyances and at transportation hubs is no longer in effect. Therefore, the CDC will not enforce the order. The CDC continues to recommend that people wear masks in indoor public transportation settings at this time. Read More
CDC Recommends Additional Boosters for Certain Individuals 
Data show the importance of vaccination and booster doses to protect individuals both from infection and severe outcomes of COVID-19. For adults and adolescents eligible for a first booster dose, these shots are safe and provide substantial benefits. During the recent omicron surge, those who were boosted were 21 times less likely to die from COVID-19 compared to those who were unvaccinated and seven times less likely to be hospitalized. CDC continues to recommend that all eligible adults, adolescents, and children ages 5 and older be up-to-date on their COVID-19 vaccines, including getting an initial booster when eligible. Read More

Updated Strategies to Mitigate Health Care Personnel Staffing
Due to concerns about increased transmissibility of the SARS-CoV-2 omicron variant, the CDC guidance was updated to enhance protection for health care personnel, patients and visitors and address concerns about potential impacts on the environment the health care system given a surge of SARS-CoV-2 infections. View Strategies

Vaccine Updates

Flu Season: Is is Over?
In the United States, flu season occurs in the fall and winter. While influenza viruses spread year-round, most of the time flu activity peaks between December and February, but activity can last as late as May. For up-to-date information on current flu season and activity, Click Here

Pneumonia Update
Some patients with COVID-19 have had pneumonia. Learn More 

2022 CDC Adult Immunization Schedule  
The 2022 Adult Immunization Schedule is available from the CDC. The schedule includes recommendations for adults ages 19 years and older. Printable schedules and the CDC vaccine schedules app are available for health care providers. Visit the Webpage



Leadership Lessons
​​​Words of advice from leaders on the front lines.

This month’s leadership lesson is from Linda Kluge, RD, LD, CPHQ, the executive director of Alliant QIN-QIO.

May Is the Perfect Time To Show Appreciation

Quality improvement work is a team sport, and it needs the discipline and rigor of a plan for success. Many of the staff that work with the QIOs around the country use a simple PDSA (Plan, Do, Study, Act) format that is easy to convey and share with everyone to document what you are looking to improve. It can become a communication tool for what needs to be done better. The last step, Act, is often missed or passed over to ensure the plans continue. It only takes a moment to do as you decide how to move forward—Act, Adapt or Abandon. Do you want to act on what you did, adapt what was done and try another test, or abandon the idea? The Act step calls us to reflect, memorialize, document and celebrate the work that was done.

This is the perfect time to add another A word to the PDSA model: Appreciate. Thank your team members for their efforts, and recognize and honor those who worked to improve the processes in addition to everything else they are doing professionally and personally. May is an ideal time to build appreciation into your celebrations. It is the month of graduations, family gatherings and Mother’s Day. Our memories of these life events can last forever. In the workplace, there is Nurses Day, celebrated during the week of May 8, National Skilled Nursing Care Week, with the theme “Creating and Nurturing Connections,” and National Hospital Week, with the theme “We Are Health Care.” For those who work in the communities that serve seniors, May is Older Americans Month, with the theme “Age my Way” to encourage older adults to live independently and get involved in their communities, which requires making the connections to stay wherever they call home.

May is also the time to recognize our military. During the week of May 21, we honor those in the armed services who sacrificed for our nation, and the Memorial Day weekend caps off the month of appreciation. Make it a great month of celebration and appreciation as we work and improve lives together.

Read on our Website

Best Practice Corner
Each month Alliant Health Solutions collects exemplar practices from organizations across the seven-state region. Thank you for your leadership, creativity and perseverance. 

Alabama Creates a Network of Social Action Champions To Spread COVID-19 Facts
The Alabama Community Engagement Alliance Against COVID-19 Disparities, powered by the University of Alabama at Birmingham Minority and Health Disparities Research Center, is expanding its impact across the state by creating a network of Social Action Champions who are trusted voices in their communities. Read More

Kentucky Dept. of Public Health Updates COVID-19 Booster Information 
The Kentucky Department of Public Health updated its Up-To-Date Chart and flyer to reflect the most current guidance for Kentuckians regarding second booster (4th dose). Visit the KDPH Site 

NCDHH Hosts Spanish Language Town Hall To Discuss COVID Vaccines and Boosters
The North Carolina Department of Health and Human Services hosted a live Cafecito and Spanish language tele-town hall to discuss COVID-19 vaccines and boosters. Key topics included COVID-19 vaccine safety and effectiveness for children ages 5 and older, what it means to stay up to date on COVID-19 vaccines, current recommendations for women who are pregnant or may become pregnant and tips for a healthier spring and summer season. Watch the Recording 

Do you have a promising practice to share? Please reply to this email and we will feature you in an upcoming issue.

Health Equity Corner

Health Equity 101 and How It Impacts You 
In this month’s episode of Alliant’s Making Health Care Better podcast, with Alliant’s health equity lead, Rosa Abraha, MPH, discusses health equity. Health equity is achieved when every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances. As the end of April marks the end of National Minority Health month, Rosa shares the origin of the month’s concept and how health inequities impact all. Listen Now | Watch Video 

Podcast: AHSCAST - Making Health Care Better

graphic of AHScast logo and recent episodes Everyone deserves quality health care.
Tune into the Alliant Health Solutions Making Health Care Better podcast every other Thursday as they interview guests committed to making health care better. If you are a health care consumer, provider, insurer, system or consultant, this is the podcast for you. View All Podcast Episodes


Upcoming Learning & Action Network (LAN) Events
  • Combined Community Coalitions and Nursing Homes: Strategies To Support Care Partners and Improve Care Transitions To Reduce Readmissions​​
    Thursday, May 26 at 12:30 p.m. ET / 11:30 a.m. CT (30 min.)
    Join the conversation as we introduce you to two leaders in caregiver support and care transitions. Jennifer Heston-Mullins, Ph.D., LISW, will walk us through Miami University’s Our Family, Our Way, communication and care coordination resources for caregiving families to help identify gaps and conflicts. Mark Tole, Ph.D., RN, from UNC-Chapel Hill, will share how lessons learned from the Connect-Home transitions of care pilot can lead to an improved transitional care experience. When used separately or together, these tools can help you reduce readmissions. Be sure to invite those who help with discharge planning at your facility to this special event.
    Register Now 

Register for Upcoming LAN Events

​Last Month's Learning & Action Network (LAN) Events

  • Combined Community Coalitions and Nursing Homes: Applying Evidenced-Based Best Practices To Prevent, Mitigate and Manage Delirium Across Care Settings: Part 4
    Recorded on April 19
    Part 4 of our delirium series featured discussions related to delirium prevention, identification, treatment and management. Case examples across the health care continuum were also introduced. 
    ​​​​View Recording|View Slides 

    Watch Previous LAN Events and Bite-Size Learnings

We want your feedback

Were You Able to "Use Tomorrow" What You Heard During the LAN Events? 
If Yes, Click Below. 

Nursing Homes LAN Attendees: Click here
Community Coalition LAN Attendees: Click here


Upcoming Infection Prevention Shop Talks
  • May 2022 Shop Talk Call
    Thursday, May 19 at 2 p.m. ET / 1 p.m. CT (60 min.)

    Join the Alliant Health Solutions Patient Safety Team to get updates on the NHSN system and CMS requirements.
    We will review the new updates to the Weekly Vaccination Module & COVID-19 Event Level Forms. And, as always, we will conduct a live question and answer session to help with your immediate needs. Submitting data accurately into NHSN will help you more confidently plan your risk assessments and quality improvement initiatives. 

    ​​​​Register Now

View Previous Shop Talks

Join the Alliant Quality NHSN Group!
Joining the group and conferring rights to Alliant Quality to view NHSN data allows for seamless support and technical assistance.
View Step-By-Step Guide



Behavioral Health​​​​​​

Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Prevention Week: May 8-14, 2022 
National Prevention Week is a national public education platform bringing together communities and organizations to raise awareness about the importance of substance use prevention and positive mental health. SAMHSA's Prevention Day will take place on Monday, May 9, and it will be delivered virtually through an interactive online conference platform. Hear from prevention leaders; learn about the latest developments in the areas of mental illness and substance abuse prevention, treatment, and recovery; network with other practitioners; and sharpen your skills. Register Here

Daily topics include:

May 9: Strengthening Community Resilience: Substance Misuse and Overdose Prevention
May 10: Preventing Substance Use and Promoting Mental Health in Youth
May 11: Preventing Suicide: Everyone Plays a Role
May 12: The Talent Pipeline: Enhancing the Prevention Workforce
May 13: Prevention is Everywhere: Highlighting Efforts Across Settings and Communities
May 14: Celebrating Prevention Heroes

It’s OK to Ask for Help: A Free Resource for Finding Mental Wellness Assistance 
Alliant Health Solutions created a downloadable and printable flyer with a list of resources for anyone needing help coping with grief, stress, anxiety, depression or overall mental wellness. Alliant is a strategic partner with the Morehouse School of Medicine's National COVID Resiliency Network. Download Flyer

Access FREE expert guidance on this topic: Contact Tanya Vadala

CDC, CMS Call for Rebuilding Health System After Patient Safety Measures Drop 
According to an analysis published on February 12 by The New England Journal of Medicine, as patient safety declines amid the pandemic, the United States must rebuild a health care delivery system in which safety is embedded in every step of the process. Read More

Integrating Principles of Safety Culture and Just Culture Into Nursing Homes: Lessons From the Pandemic 
Alliant’s medical director, Dr. Swati Gaur, is a contributing author of an article published in The Journal of Post-Acute and Long-Term Care Medicine (JAMDA) that looks at concerns about the quality of care provided by nursing homes that have led state and federal agencies to create layers of regulations and penalties. The article suggests that integrating a safety culture into nursing homes will require nursing homes and regulatory agencies to acknowledge the high-risk nature of post-acute and long-term care settings, embrace a just culture, and engage nursing home staff and stakeholders in actions supported by evidence-based best practices. Read the Article



Essential Resources to Help You Navigate NHSN
​​​Weekly COVID-19 Vaccination Data Reporting & Training
Effective August 23, report health care personnel and residents who are eligible to receive the COVID-19 booster (additional vaccine).
Training slides (reference slides 9 & 20-23) 

Who is eligible for the booster? Reference the CDC website for current considerations for use of an additional COVID-19 dose.

Watch Our NHSN Shop Talk Shorts Series!​​​
​​​​​We know you're busy. Our new video series answers the most common questions we receive regarding navigating NHSN in a brief way. Available videos cover the following topics:

View NHSN Shop Talk Video Series

Access FREE expert guidance on this topic: Contact Melody Brown

Resources for Acknowledging Bone Health and Osteoporosis Month 
Bone health should be on everyone’s mind in May since it is Osteoporosis Awareness Month. Over 28 million Americans are affected by osteoporosis, a disease characterized by a gradual wearing down of bone that can lead to breaks and fractures.

The National Osteoporosis Foundation (NOF) states that an estimated $19 billion are spent on osteoporosis related-bone breaks and fractures. Health care costs for the treatment of osteoporosis are estimated to rise to $25.3 billion by the year 2025. According to the NOF, hospitalizations for osteoporosis-related bone fractures are higher than those due to breast cancer, heart attacks, and stroke. Patients with chronic diseases are at considerable risk for impaired bone health and an increased likelihood of a fragility fracture at the hip, spine, or wrist due to falling. Chronic conditions including hypertension, heart disease, stroke, and type 1 diabetes proved to increase the risk of osteoporosis-related bone fractures in a study using participants from the Global Longitudinal Study of Osteoporosis in Women. Each year, a quarter of hip fracture patients are admitted to nursing homes for rehabilitation, and only half regain their previous level of function and ambulation ability, despite comprehensive treatment. Osteoporosis treatment encompasses a combination of pharmacological and non-pharmacological interventions. 

Pharmacological interventions for osteoporosis
The most prescribed class of osteoporosis medications (oral bisphosphonates) requires attention to certain dietary considerations. Make sure to advise your patients not to eat and remain upright for at least 60 minutes after taking Alendronate (Fosamax, Binosto), Risedronate (Actonel, Atelvia), and Ibandronate (Boniva). Patients should also avoid consuming antiacids and dietary sources of calcium, iron, and magnesium within two hours of taking these medications. Injectable medications such as Ibandronate (Boniva) and Zoledronic Acid (Reclast) are also available to treat osteoporosis. Supplementation with calcium and vitamin D may be necessary to maximize the effects of pharmacological treatment. Patients should review any medication safety concerns with their pharmacists. Repeat bone density tests for patients at least every two years and within a year of prescribing a new medication.

Non-pharmacological interventions for osteoporosis
Lifestyle interventions focused on ensuring adequate nutrition and regular physical activity are essential to enhancing the benefits of pharmacological treatment. Regular physical activity, including weight-bearing and resistance exercises, helps maintain muscle strength. Exercise specialists specializing in osteoporosis care can assist in providing safe, supervised movement instruction tailored to patients’ therapeutic needs. A registered dietitian nutritionist (RDN) can help guide patients in meeting their daily requirements of calcium and vitamin D-rich foods, balancing meals, and time medications accordingly. RDNs can also evaluate patients’ physical activity habits and restrictions to better inform weight management plans. Community-based, lifestyle-centered self-management programs can help complement clinical interventions and support patients in upkeeping their care goals. The CDC recommend evidence-based self-management education (SME) programs that encompass lifestyle and behavior change strategies to help patients manage chronic conditions, including chronic pain, and reduce the risk of falls and fragility fractures. The Self-Management Resource Center facilitates a variety of peer-led, evidence-based self-management programs designed to help patients take control of their health in collaboration with their health care team and community support. 

Reach out to the chronic disease team for more information on incorporating self-management programs into your interventions.
Check out these great resources for you and your patients:
  1. Bone Health and Osteoporosis Foundation (BHOF)
  2. BHOF interactive calendar of tools, resources, and webinars
  3. Self-Management Education (SME) Programs for Chronic Health Conditions
  4. Free CME: BHOF Fracture Liaison Service (FLS) ECHO program

Access FREE expert guidance on this topic: Contact Ingris Garcia

New Delirium Tools and Resources and YouTube Delirium Playlist 
The impact of delirium on patient daily cost, rehospitalization rate, need for skilled nursing facility (SNF) placement, and the mortality rate is the reason for continued focus on delirium prevention, early identification and management strategies. The April issue of the Journal of the American Geriatrics Society looks at comparative salary costs of using a brief app-directed delirium protocol. It is just one piece of information when evaluating the screening costs versus long-term treatment and management costs. Alliant Health Solutions continues to expand our delirium toolkit to assist providers across the continuum of care in implementing, expanding or evaluating delirium-associated processes. 
Newly posted on the Alliant website this month is a one-page overview of toolkit elements and tips for implementation and a link to the fourth 30-minute webinar focused on non-pharmacological interventions. Coming soon will be resources to engage families and care partners, a bite-size learning video case study and a delirium Jeopardy game for use in staff education. Alliant YouTube Delirium Playlist

Circle Back Process To Improve Care Transitions and Reduce Readmissions 
Improved communication between care settings is an evidenced-based best practice for reducing readmissions, improving customer satisfaction and reducing provider burden across the continuum of care. Alliant Health Solution’s new Circle Back Tool consists of six questions that, when discussed consistently within 24-72 hours of transfer from a hospital to an SNF, can identify opportunities to improve the care transitions process and allow providers to work collaboratively to address any newly identified or increased risks for readmission. Download Circle Back Interview Tool

Save the Date for Our Twitter Chat 
Alliant Health Solutions is hosting our first live Twitter chat on Tuesday, June 28. Use #ChatwithAlliant to join the conversation and engage with others passionate about reducing readmissions and improving the care transitions experience. Follow Alliant on Twitter

NCRN COVID-19 Resources 
Alliant Health Solutions is a strategic partner in the Morehouse School of Medicine National COVID-19 Resiliency Network (NCRN) in mitigating the effects of COVID-19. For information on the NCRN or local, state and national resources, see the resources flyer. English | Spanish

​​​ Access FREE expert guidance on this topic: Contact Carolyn Kazdan

Report Shows Increase in Antipsychotic Medications in Long-Term Care Facilities 
The U.S. Department of Health and Human Services released a report titled “Antipsychotic Medication Prescribing In Long-Term Care Facilities Increased In The Early Months Of The Covid-19 Pandemic.”
Key points from the report:

  • Prescriptions dispensed for antipsychotics in nursing homes and assisted living facilities increased since the beginning of the pandemic, with 20.8 million dispensed in 2020 compared to 20.5 million in 2019. This represents a 1.5% increase in total prescriptions since the beginning of the pandemic despite lower resident census levels in long-term care facilities (LTCFs).
  • In 2020, the highest increase in the number of prescriptions dispensed occurred during the first quarter of the pandemic, with an increase of 7.4% compared to the first quarter of 2019. After this initial increase, the quarterly number of prescriptions for antipsychotic medications dropped close to pre-pandemic levels, despite a declining nursing home resident census and likely a declining LTCF resident census overall.​​​​

The number of prescriptions dispensed for four out of the five most frequently prescribed antipsychotics in LTCFs increased in 2020 and 2021 compared to pre-pandemic levels. Aripiprazole had the largest increase, of 14% in the first quarter of 2020 compared to 2019 levels.
Read the Report Brief | Download Full Report 
Did patterns in your facility’s utilization of antipsychotic medications change during the pandemic? Alliant Health Solutions offers a menu of tools and resources to support facilities in analyzing, documenting and reducing antipsychotic utilization, including:

  • Antipsychotic Admission and Quarterly Review Tool
  • Antipsychotic Medication Rounding Tool
  • Antipsychotic Medication Trigger Tool
  • Antipsychotic Medication Adverse Drug Events Flyer
  • Comfort Menu Flyer

Alliant Health Solutions quality advisors are available to support you in implementing antipsychotic medication quality improvement initiatives. 

Supporting Caregivers with Free Family Meeting Planning and Calendar Resources 
Our Family, Our Way is a communication and care coordination process developed by Miami University’s Scripps Gerontology Center to help caregiving families think and talk about caregiving. Helping families work through who will do what, where and when it will happen, and how it will be accomplished can positively impact the quality of life for individuals with care needs and their care partners. In addition, identifying and proactively addressing identified gaps in care can reduce ED visits and rehospitalizations. The online tools and resources are all free to download and use or use virtually with multiple family members.
Alliant Health Solutions partnered with Scripps Gerontology to create an eight-minute video overview of the tools and resources and navigating the website. In addition, Alliant Health Solutions senior quality advisors and hospital and long-term care association partners are available to assist you in implementing these resources in your facility or health system. Learn more about Our Family Our Way in our upcoming May LAN event

Access FREE expert guidance on this topic: Contact Carolyn Kazdan

Members of the Beneficiary & Family Advisory Council are our partners in making health care better. To join us in this important work, contact Mel Brown or submit this referral form.

Browse resources our council has worked on below: 

FDA Authorizes Second Booster Dose of COVID-19 Vaccines for Older and Immunocompromised Individuals 
The U.S. Food and Drug Administration (FDA) authorized a second booster dose of either the Pfizer-BioNTech or the Moderna COVID-19 vaccines for older people and certain immunocompromised individuals. The FDA previously authorized a single booster dose for certain immunocompromised individuals following the completion of a three-dose primary vaccination series. This action will make a second booster dose of these vaccines available to other populations at higher risk for severe disease, hospitalization and death. Emerging evidence suggests that a second booster dose of an mRNA COVID-19 vaccine improves protection against severe COVID-19 and is not associated with new safety concerns. Read More

Medicare Covers Over-the-Counter COVID-19 Tests 
Medicare has a new initiative that will cover up to eight over-the-counter COVID-19 tests each calendar month at no cost for those who have Part B, including anyone enrolled in a Medicare Advantage Plan. For those in a Medicare Advantage plan, the tests covered under the initiative will be covered outside of the existing plan’s coverage, and in addition to any over-the-counter tests that may be covered under the plan as a supplemental benefit. Medicare won’t cover over-the-counter COVID-19 tests for those who only have Medicare Part A (Hospital Insurance) coverage. Read More

Contact members of the BFAC via Melody Brown

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This material was prepared by Alliant Health Solutions, the Medicare Quality Innovation Network-Quality Improvement Organization for Alabama, Florida, Georgia, Kentucky, Louisiana, North Carolina, and Tennessee, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this document do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement or that product or entity by CMS or HHS. 12SOW-AHSQIN-QIO TO1 – NH TO1 - CC--1920-04/29/22 
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