February 10, 2021
Featured News
Senate Committee Advances Background Studies Bill
On February 10, 2021 by Jonathan Lips
The Minnesota Senate’s Human Services Licensing Policy Committee has advanced a proposal designed to address challenges with Minnesota’s background studies system.
Authored by Sen. Paul Utke (R-Park Rapids), Senate file 496 has two components. First, it authorizes the Minnesota Department of Human Services (DHS) to continue “emergency” background studies, without fingerprints, for up to 180 days after the expiration of Minnesota’s peacetime emergency relating to COVID-19. Under current law DHS could extend the waiver of fingerprints only for 60 days past the end of the emergency. Governor Walz is not expected to end the peacetime emergency anytime soon, but this bill is looking ahead to the day when that does happen.
The length of the transition period is important because, eventually, everyone who has only had an emergency background study will be required to have a new study with fingerprints, and the more time that’s available to tackle the backlog, the better. According to DHS, at least 125,000 emergency studies would need to be re-processed if the peacetime emergency ended today.
Second, the bill seeks to build greater fingerprinting capacity by authorizing background study subjects to obtain fingerprints at local law enforcement agencies or other locations and submit those to NETStudy. This provision was added to the bill through an amendment offered by Sen. Jim Abeler (R-Anoka).
In testimony on the bill, DHS acknowledged the need to increase capacity, noting that it is working with the State’s fingerprinting contractor to ensure that enough sites will be available to process studies when needed. Part of the challenge, said DHS, is that fingerprinting sites tend not to be open when there are not people to use them, and so there is a chicken-and-egg problem. Another challenge is that state law currently allows DHS only to have one vendor in place, and the Department would like to explore the possibility of expanding the number of vendors, in order to meet the unprecedented demand that is building up while the waiver is in place.
LeadingAge Minnesota testified in support of the bill, along with our Long-Term Care Imperative partner, as did the Minnesota Hospital Association and other provider groups. The proposal moves next to the Senate committee on Civil Law and Data Practices Policy. Currently there is not a House companion to the Senate bill, but we will engage with House Health and Human Services Committee leadership on this issue as it moves forward. Please contact Jonathan Lips with any background studies questions.
FAQ: Can You Quarantine a New Admission for Fewer Than 14 Days?
On February 10, 2021 by Kari Everson
A 14-day quarantine after admission is daunting for many residents. Transitions may already be difficult and are now compounded by the necessary infection prevention and control practices in place during the pandemic.
This begs the very understandable question . . . can you eliminate or reduce quarantine time for new admissions and/or resident transfers. The Minnesota Department of Health answered this question for LeadingAge Minnesota during one of our meetings this week. The department pointed to three pieces of guidance we should use to guide our decision-making and policy creation for admission and transfer quarantine which include Long-Term Care Guidance For Non-Medically Necessary Outings, the LTC Tookit, and Principles Of Covid-19 Cohorting In Long-Term Care. MDH points out that while there is no one document that contains all of the information, these three documents have everything we need to determine quarantine processes for our communities. As a reminder, there is no current exception to quarantine time or any other guidance change based upon the organization’s vaccination status of residents or staff.
New Admissions/Transfers that have had COVID-19 in the last 90-days
If you are admitting or transferring back a resident who has had COVID-19 in the last 90-days you may not have to quarantine the resident for all or part of the 14-day quarantine period.
No quarantine needed IF:
- Tested positive for COVID-19 in the last 90-days by RT-PCR testing - OR - Tested positive for COVID-19 by antigen test without confirmatory RT-PCR; and had symptoms during their illness; AND
- Meet the criteria to discontinue transmission-based precautions
Partial quarantine needed IF:
- Tested positive for COVID-19 in the last 90-days by RT-PCR testing - OR - Tested positive for COVID-19 by antigen test without confirmatory RT-PCR; and had symptoms during their illness; AND
- Meet the criteria to discontinue transmission-based precautions
- Time left on isolation with transmission-based precautions. In this event, the resident should finish out the remaining isolation days. For example, 8 days of isolation completed in the hospital then the resident would need to complete 2 isolation days in the long-term care community.
Co-located SNF/AL/HWS
If there are two buildings co-located on the same campus you may not have to quarantine transfers between the buildings if infection prevention and control policies are the same or largely similar. Examples of those policies include staff and visitor screening, resident monitoring, testing, etc.
Transmission-Based Precautions
Transmission-based precautions can be discontinued in our settings if the following symptom-based criteria are met:
- At least 10 days passed after symptoms first appear
- This increases to 20 days if the resident had severe to critical illness or severe immune compromise
- At least 24 hours since last fever without the use of fever-reducing medications
- Symptoms have improved
The test-based criteria are outlined in the Long-term Care Guidance for Non-Medically necessary outings.
If you have questions talking through specific situations, please contact Kari Everson – keverson@leadingagemn.org.
Reference Documents
- Long-term Care Guidance for Non-Medically Necessary Outings
- Principles for COVID-19 Cohorting in Long-term Care
- COVID-19 LTC Toolkit: discontinuing transmission-based precautions located on page 25.
COVID-19
MAGIC Launches Resource to Address Vaccine Hesitancy
On February 10, 2021 by Libbie Chapuran
This week, the Minnesota Association for Geriatrics Inspired Clinicians (MAGIC) launched a new video resource to help providers address vaccine hesitancy in long-term care settings.
In response to low vaccination rates among frontline caregivers, MAGIC created this video with trusted healthcare providers in our community to address hesitations and misinformation related to the COVID vaccine. The video was developed to provide accurate and up to date information and dispel myths regarding the vaccine. The goal is to increase vaccination rates, specifically among frontline health care workers, by providing meaningful information from a trusted source that allows them to make an educated decision.
MAGIC encourages you to share this 7-minute video as a resource to leaders and staff within your organization and with your partners.
For more info about MAGIC, visit, https://www.minnesotageriatrics.org/
CMS Director Joins LeadingAge Call to Answer Questions about Visitation Guidance Changes
On February 10, 2021 by Libbie Chapuran
Evan Shulman, Director of the Division of Nursing Homes, Centers for Medicare and Medicaid Services, will answer questions about how CMS is approaching any changes in visitation guidance on Thursday, February 11 at 2:30 on the Coronavirus Update Call hosted by LeadingAge, the national partner of LeadingAge Minnesota.
LeadingAge is reporting that changes to visitation guidance are not anticipated in the near future, and Evan will explain why. He will also talk about current recommendations in this regard and answer other questions that have come up recently, as well as take caller questions.
LeadingAge will also host a call on Wednesday, Feb. 10 on which you will hear from by returning guest, Rev. Derrick DeWitt from the Maryland Baptist Home For The Aged. He’ll be interviewed later this week by Ted Koppel and Gayle King, but hear him first on the LeadingAge call. He will provide updates on his continued measures to keep COVID out of his nursing home that have ensured that they have not had a single case with residents or staff. He is also going to provide tips on how to work with staff to increase trust and agree to be vaccinated.
If you haven’t signed up for the calls, you can register here.
Resilience Tip: Sleep & Resilience
On February 10, 2021 by LeadingAge
Featuring Dr. Alyson VanAhn from Associated Clinic of Psychology
You are in good company if you have noticed changes in your sleeping patterns during COVID-19. Because of factors like extra screen time, change in routines and increase in stress, we are prone to poor sleep at this time. Sleep is important not only for our well-being and stability of mood, but it is also linked to immune system function.
In case good sleep is hard to come by for you like so many others, the list below provides some suggestions:
- Add routines for bedtime, for wake time, for relaxation time prior to bed and for anything else. Loss of routines is an important link to our sleep and stress troubles.
- Get as much exposure to natural light as you can. Time outdoors, opening shades, simply having the light touch your skin can improve sleep.
- Exercise and remain active during the day as much as possible instead of taking naps.
- Use your bed only for sleeping. If you have difficulty sleeping, get out of bed, do something calm and return in a few minutes to try again versus staying in bed and struggling.
- Take “mini naps” during the day. They may be even more refreshing than longer rests and might be less impactful on night-time sleep. Even a 10-minute rest can help you rejuvenate a bit without jeopardizing evening sleep.
More suggestions detailed at https://www.sleepfoundation.org/sleep-guidelines-covid-19-isolation. If sleep is a consistent issue for you, or if difficulties persist for many days or weeks, it may be time to talk with your physician about other options for getting more good sleep.
For more information about stress relief during COVID-19, go to www.leadingagemncoaching.com.
At no charge, you can arrange virtual staff support groups through LeadingAge Minnesota Foundation’s COVID-19 Staff Coping & Support Line project. Contact Terri Foley at tfoley@leadingagemn.org or 651-815-8137.
State News
Public Comment Period on Assisted Living Licensure Concludes
On February 10, 2021 by Bobbie Guidry
The public comment period on the proposed rules for assisted living closed on Tuesday, Feb. 9 at 4:30 p.m. In addition to comments provided during the public hearing held Jan. 19 and 20, over 275 were submitted to the administrative law judge (ALJ) on the topic of assisted living licensure.
Many LeadingAge Minnesota members provided comments based on experiences as providers and consumers. Your advocacy is greatly appreciated and the comments and concerns you shared be a valuable resource as the rule is finalized.
Yesterday, alongside our partners in the Long-Term Care Imperative, we submitted additional comments addressing the cost of assisted living licensure, both the impact of the rule and the statute. We used the results of our cost study from last fall to estimate the cost of various components including emergency preparedness requirements, license fees and numerous other components.
While we support licensure and increased protections for aging Minnesotans, there are issues in the proposed rules that require further consideration and clarification. The Minnesota Department of Health (MDH) has heard and responded with favorable comments on several items frequently raised by providers.
MDH has indicated that the definition of elopement will be adjusted to apply to only those identified at risk due to needs identified in their assessment rather than to any person living in the setting. The Department proposes to modify the definition to read: “Elopement” means a resident who lacks self-preservation skills leaves the premises or a safe area without necessary supervision to do so.”
Related to providing training “certificates” for each area of competency demonstrated, MDH has noted that any documentation of training that meets the requirements of the proposed rule will be accepted as proof of compliance, whether or not the documentation is expressly labeled as a certificate.
Finally, regarding posting the staffing schedule daily on each floor, MDH has indicated that they intend to modify this proposal so that the schedule is required to be posted in each building, rather than on each floor of each building.
Many issues in the proposed rule and the statute remain to be addressed and clarified and our advocacy work continues.
We now enter a rebuttal comment period from Feb. 10 – 16, 2021. This will allow commenters to respond to other comments filed during the initial comment period.
The ALJ will then take all the comments and other materials submitted and evaluate the rules to determine whether the agency has met the standard and demonstrated that the rules are needed and reasonable. If the ALJ determines that the agency has not met the legal and procedural requirements, the rules are submitted to the Chief ALJ. If the Chief ALJ supports the ALJ, the agency may not adopt the rule until the defects are corrected. Once the ALJ approves the rules, the agency may submit them to the governor and take other procedural steps for final adoption.
If the ALJ and the Chief ALJ determine the agency has not established the need or reasonableness for the rules, the rules are submitted to the Legislative Coordinating Commission and to the House and Senate Government Operations committees for comment. After seeking these comments, the agency may adopt the rules.
At this time, we anticipate the assisted living licensure rules to be finalized near the end of March. Many issues in the proposed rule and the statute remain to be addressed and clarified and our advocacy work continues. On Friday, MDH will reconvene the assisted living stakeholder group to continue discussing identified issues toward possible resolution.
JOIN US: Virtual Advocacy Week at the Capitol Slated for March 15 – 19.
On February 10, 2021 by Libbie Chapuran
Join us starting March 15, 2021 for a week of virtual advocacy at the Capitol featuring expert training from our public affairs team, inspiring conversations with aging services leaders, opportunities to meet with your legislator, and times to share with colleagues from around the state about your successes and challenges in serving seniors.
This year, the Legislature is conducting the State’s business virtually, and our day at the Capitol will follow suit. We’ve spread the annual Day at the Capitol activities into a full week to give you ample opportunity to participate. Here is the schedule of events:
March 15: Advocacy Training Day- Join us virtually during one of three one-hour trainings hosted by our public affairs team to get equipped with advocacy tools and strategies for when you meet with lawmakers. Choose a session at 8:00 a.m., noon, or 4:00 p.m. on March 15 to learn the about our issues and the most effective ways to advocate for the seniors we serve and their caregivers.
March 16: Conversations about the 2021 Senior Care Priorities- Hear from and have an opportunity to connect with LeadingAge Minnesota members and staff about the latest updates in long-term care. Join your colleagues for a one-hour conversation from 9:00 a.m. – 10:00 a.m.
March 16-March 18: Meet with legislators online- We will schedule meetings via Zoom on your behalf with the lawmakers that represents your setting. Not to worry – we will give you all the tools and talking points you need to be confident before your meetings. If you have any specific accommodations we should keep in mind, we can do our best to accommodate. Just let us know.
March 19: Reflection and next-steps conversation with colleagues- This is an opportunity to reflect with your colleagues and discuss the best practices for following-up on the issues you brought up with your legislators. Join your colleagues for a one-hour conversation from 9:00 – 10:00 a.m.
Staff, residents, volunteers and board members are all encouraged to attend Day at the Capitol, so please feel free to share this invitation with others.
Registration is now open. There is no cost to participate in Day at the Capitol. By registering once, you’ll be signed up to participate in all of the session. During the registration process, you can share if you would like us to schedule meetings with the lawmaker that represents your setting and if you have any additional information you would like us to consider when setting up your meetings.
Please register by March 6 to ensure we have time to schedule meetings with your lawmakers.
We hear it from lawmakers all the time: what matters most to them as they weigh issues and make decisions at the State Capitol is their constituents. That’s why your voice matters! It’s time to be heard.
If you have questions about the Day at the Capitol or need any special accommodations, please contact Matt Steele at msteele@leadingagemn.org or 651-659-1430.
At the Capitol: Committees on Human Services and Taxes Hear LTC-focused Bills
On February 10, 2021 by Matt Steele
With about a month to go until the first of three lawmaking deadlines, policy makers are shepherding numerous bills through the committee process, in particular, legislation that allows for providers to have extra time to get background reviews completed for their employees following the expiration of the public health emergency. Here is what you need to know about what’s happening at the Capitol:
This Week
The Senate Committee on Human Services Licensing Policy heard S.F. 496, a bill that extends the waiver on background study requirements issued at the outset of the pandemic to 180 days following the end of the state of emergency. The passage of this bill will help senior care providers maintain the workforce they need to care for their residents. More on this proposal can be found here from Jon Lips’ analysis and overview of his testimony before the committee on Tuesday.
Additionally, the Senate Committee on Taxes heard S.F. 463, a bill that expands the long-term care insurance tax credit. While this would involve additional investment from the state in a tight budget year, we are supportive of the increase in this incentive as it helps offset the increasing costs of care for our seniors, especially those not covered by Medicaid.
Last Week
Last Thursday, the Senate Human Services Reform Finance and Policy Committee hosted a hearing on nursing facility rate payment in Minnesota. LeadingAge Minnesota, Care Providers of Minnesota and the Department of Human Services (DHS) were asked to provide an overview of the rate process and issues that occurred as a result of the COVID-19 pandemic.
Despite the hearing format being informational, the conversation hinted that lawmakers are supportive of holding care centers harmless from rate cuts, however lawmakers may still be interested in reforms that will generate savings. Committee Chairman Senator Jim Abeler (R-Anoka) briefly reviewed how the suggestions from the Health and Human Services Blue Ribbon Commission will be included in the budget and asked the Long-Term Care Imperative to provide their insight to help guide the committee’s analysis.
What’s Ahead
On Wednesday, March 17 at 8:30 a.m., the Senate Committee on Aging and Long-Term Care Policy will review analysis of vaccine rollout data from the Minnesota Department of Health. Committee members will also listen to a presentation from the Volunteers of America on older adult guardianship. We will be monitoring the conversation closely to see if the state makes any shifts from previous weeks in how its distributing vaccines to seniors.
What to Watch
LeadingAge Minnesota will be having its annual Day at the Capitol on the week of March 15. This year’s event will be virtual and will feature expert training from our public affairs team, inspiring conversations with industry leaders, opportunities to meet with your legislator, and times to share with colleagues from around the state about your successes and challenges in serving seniors. Click here to register and find out more information.
Each week during the legislative session, follow Advantage for regular updates about what’s happening at the Capitol.
MDH Announces Webinar on Assisted Living Licensure
On February 10, 2021 by Bobbie Guidry
The Minnesota Department of Health is offering a webinar on Thursday Feb. 18, 2021, from 10:00 - 11:30 a.m. Information will be provided regarding changes to the laws that affect home care, assisted living and housing with services providers in relation to assisted living licensure.
Topics will include:
- How an Assisted Living Facility License is different from a comprehensive home care license and a housing with services registration
- Who should keep a home care license (governed under 144A)
- Licensed Assisted Living Director (LALD) requirements
- Campus definition discussion
- Physical plan requirements
- Emergency preparedness requirements (Appendix Z)
To join the meeting, you will need the following information:
- Meeting number (access code): 146 476 0147
- Meeting password: iXaZ9Jd2gB4)
If you have general questions about assisted living licensure, contact Bobbie Guidry at LeadingAge Minnesota. For questions about the meeting, contact lindsey.krueger@state.mn.us
More ways to join:
- Join from the meeting link: https://minnesota.webex.com/minnesota/j.php?MTID=m0a71f3d6acc07e5ab0ff67401db69108
- Join by phone: 1-415-655-0003 United States Toll; 1-855-282-6330 United States Toll Free
- Join from a video system or application: Dial 1464760147@minnesota.webex.com. You can also dial 173.243.2.68 and enter your meeting number.
Federal News
LeadingAge Continuing to Provide Five-Star Analysis Reports
On February 10, 2021 by Jeff Bostic
Earlier today, LeadingAge sent all care center members Five-Star Analysis reports that reflect updates to the data implemented by CMS a couple weeks ago. For more details on the scoring updates, go to this recent Advantage story that covers the changes in depth.
In addition to being reflected in the most recent Five-Star Analysis Report, the new data and star results are also loaded into the Quality Metrics and the SNF Trend Reports, both of which provide perspective on scores over time and can be accessed through links on the Five-Star Analysis Report. The Five-Start report and these related resources are a great tool for tracking performance over time and targeting areas to improve the Five-Star score.
NHSN Updates for Care Centers
On February 10, 2021 by Jonathan Lips
We noted two newsworthy items from CDC this week relating to the National Healthcare Safety Network (NHSN) data collection system.
Monoclonal Antibodies
CDC has added data fields for monoclonal antibodies to the NHSN COVID-19 surveillance module.
The module now asks facilities to enter the number of residents who received either Bamlanivimab (Lilly) or Casirivimab plus Imdevimab (Regeneron) during a given week, either in the facility or elsewhere. The COVID-19 Resident Therapeutics data reporting form and Table of Instructions are posted to the NHSN website with revision dates of Feb. 4, 2021.
Training on Point of Care Test Reporting
The NHSN team will offer trainings this week with basic guidance for data entry for the NHSN Long-term Care Facility COVID-19 Point of Care (POC) Test Reporting Tool, as well as tool updates released on Feb. 4, 2021.
There are two learning opportunities. The webinars are identical in content, so you may choose the more convenient option: Thursday, Feb. 11 at 1:00 – 2:00 PM central time or Friday, Feb. 12, at 12:00 – 1:00 PM central time.
The registration link is the same for both webinars. After registering, you will receive a confirmation email containing information about joining the webinar.
Notable News
2020 Compensation Reports Available for Purchase
On February 10, 2021 by Jeff Bostic
LeadingAge Minnesota recently mailed out complimentary copies of the 2020 compensation reports for nursing facilities and senior housing providers to members who participated in those surveys. Copies of those reports are now available for purchase by members who did not participate.
The salary and benefits survey has been conducted jointly with Care Providers of Minnesota and the Healthcare Human Resources Association of Minnesota for over twenty years, and the reports are comprehensive tools that allow members to determine whether their wages for key positions fit with their market, which is especially important in the current turbulent workforce environment.
Those members that did not participate in the surveys may order a copy of either report for $95. Members who are interested in making an order should contact Jeff Bostic.
Member News
Governor Walz visits Jones-Harrison to Highlight Vaccine Successes
On February 10, 2021 by Libbie Chapuran
Gov. Tim Walz and Minnesota Department of Health (MDH) Commissioner Jan Malcolm visited Jones-Harrison to highlight Minnesota’s successful vaccination effort in long-term care settings on the afternoon of Tuesday, Feb. 9.
Gov. Walz noted that, while the fight is ongoing, the tide is turning against COVID-19 and he thanked caregivers for their frontline work in the fight against the virus.
Annette Greely, President and CEO at Jones-Harrison, shared that they completed their second vaccinations clinics on Friday, Feb. 5 and nearly 100% of the residents participated.
Peter Green, a Jones-Harrison resident, thanked Jones-Harrison staff making his vaccination experience a “happy festival” instead of a solemn occasion, and his daughter Caroline shared her appreciation for the essential caregiver program and the wonderful care her parents have received since moving into the community in September of 2020.
Gov. Walz concluded the press conference on a hopeful note, as long-term care communities are completing their second vaccination clinics and additional vaccines are becoming available.
For more information, we encourage you to check out yesterday’s press conference.
Friendship Village of Bloomington Opens First Phase of Redevelopment Project
On February 10, 2021 by Libbie Chapuran
This month, Friendship Village of Bloomington will officially open the first phase of its new health center to area seniors. The project adds 16 assisted living apartment homes and five memory care suites to the senior living community, bringing the total communitywide capacity to 42 assisted living apartments and 32 memory care suites. The three-story building is equipped with a secure memory care courtyard, game and activity room, and spa bath.
This phase is part of a larger ongoing community-wide expansion and redevelopment initiative. The overall project also includes a new independent living building with 93 apartments and a new skilled nursing building with 66 suites.
Education Solutions
Next Gen Governance for a Next Gen World: A Two-Part Governance Workshop
On February 10, 2021 by Barbara Landeen
Next Gen Governance for a Next Gen World is a two-part workshop for executives and board members to explore proactive and agile governance in navigating your organization through and beyond the COVID-19 pandemic. It also explores reputation management to restore consumer confidence and includes a study of top trends impaction senior living.
The Governance Workshop is April 7 and 14, 4 – 6 p.m. each day. Find complete details and register here.
Free Webinar! Optimizing Therapy Services Considering COVID Challenges
On February 10, 2021 by Heidi Simpson
Respiratory disease is one of the leading causes of death and disability. During COVID-19, respiratory therapists are treating even greater numbers of clients with compromised lung function. Two complimentary webinars hosted by Select Rehabilitation provide strategies for treatment interventions and in-room therapy.
Part 1 – Managing Therapy Needs for the Client with Compromised Respiratory Function
Feb. 24, 11 a.m. – Noon. click here to register
Part 2 – Treatment and Documentation for In-Room Therapy Sessions
March 3, 11 a.m. – Noon. click here to register
This webinar series is hosted by LeadingAge Minnesota, Select Rehabilitation and LeadingAge Savings and Solutions.