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In recognition of severe staffing shortages facing assisted living providers and nursing homes in Minnesota, the Chief of Staff to Governor Walz yesterday sent a message to 36,000 state employees, asking them to consider volunteering for a potential redeployment to help long-term care residents and facilities at some point in the future. “We could need assistance in communities across the state, particularly in Greater Minnesota,” the message noted. “Facilities could make use of any RNs, LPNs, or Certified Nursing Assistants (CNAs). No prior experience is required. If needed, we will provide CNA training prior to deployment.”

Late yesterday, DHS released a memo that suspends the physician signature requirement for the single room rate differential. It also allows the charging of a differential to private pay without advance notice. The waiver applies only for the fourteen day quarantine period for new admissions or residents returning from leave, and it is in place through the end of the state public health emergency.

There have been many questions regarding quarantine periods in long-term care communities over the past several weeks. In order to clarify, here is information about the quarantine period for staff in various circumstances:

Receiving a vaccination is one of the most effective ways for people to protect themselves and those around them including residents. Development of a COVID-19 vaccination has been on a fast-track since the beginning of the pandemic in early 2020. Many teams working toward vaccines for the SARS-CoV-2 (COVID-19) virus previously worked on vaccines for similar viruses such as the original SARS virus, influenza, and other coronavirus pathogens contributing to the speed at which vaccines for COVID-19 are developing. On November 18, 2020 Pfizer applied for the first COVID-19 vaccination emergency use authorization (EUA) and will shortly be followed by other manufacturers such as Moderna, Astra-Zeneca, and others. Currently, vaccines are projected to be available the end of December 2020 or the beginning of January 2021.

On December 9-11, the Minnesota Leadership Council on Aging hosts its 2020 Virtual Summit Series, a forum to discuss the policies and practices needed to create communities and systems that support aging with dignity and a spirit of well-being in Minnesota. This year’s event will focus on improving health equity for older adults in our state.

Dealing with the various aspects of the current crisis brought about by the pandemic, nurse leaders in aging services settings are facing even more challenges and stressors than ever before. It is critical that they find ways to build up their strengths and their reserves so they can be present to support others—their staff, their residents and families—both now and as we look ahead to the future of aging services. LeadingAge Minnesota’s Nurse Leadership Certificate Program is designed to do just that and in a virtual environment. It builds on the solid program content and expert faculty that were formerly a part of the venerable Nursing Leadership Symposium and the Assisted Living Nurse Manager program – updated to address today’s challenges.

LeadingAge Minnesota is excited to announce that Luke Jenkins has accepted the position of Director of Membership. Luke comes to LeadingAge Minnesota with almost 10 years of experience in the senior care field, most recently serving as Director of Community Relations and then Corporate Marketing & Sales Consultant with Ebenezer. He has also been active in LeadingAge Minnesota—he is a member of our Stars Among Us Awards Committee, serves as faculty for our Sales & Marketing Certificate Program, and is a Leadership Academy fellow. Luke is a graduate of Iowa State University with a BA in Speech/Communications and a BS in Operations & Supply Chain Management. Luke’s first day is December 3. Please join us in welcoming Luke Jenkins to LeadingAge Minnesota!

In early September the Centers for Medicare & Medicaid Services (CMS) launched Care Compare, a streamlined redesign of eight existing CMS healthcare compare tools. The goal of this work was to allow consumers to access Nursing Home Compare, Hospice Compare, Home Health Compare, etc. all in the same location.

A special “Home Care Matters Call” will be held Monday, November 30, from 11:00 am to 12:00 pm. The call will cover Assisted Living Licensure topics and discussion. A full announcement with call-in information is expected today and we will share additional detail in next week’s Advantage. Also expected later this week is an FAQ that MDH will cover during the call.

The customized living and overall case mix caps in the Elderly Waiver (EW) program increase effective January 1 because they are tied to the increase in care center rates. The customized living caps increase by 3.64%, which is the amount of the 2020 care center increase, and the overall EW caps are going up by 3.60% due to some minor rate changes in a couple of EW services. Members should be aware that, particularly for any clients who are near one or both of those caps, the higher cap will allow the case manager to authorize additional services that they have not been able to authorize previously.

Compilations of lessons learned from the early months of the pandemic were launched recently from LeadingAge and from CMS.

Guest contributor Alyson VanAhn, PhD, Associated Clinic of Psychology

The COVID-19 era has made life exponentially more challenging for all of us. This may be particularly true for those of you who are charged with keeping others at their best in a workplace that brings chronic stress. Today’s focus is on resilience-building/stress-reducing strategies for leaders who want to build up their teams and themselves—even when not feeling at their best. This is the first in a series of articles that will focus on resilience strategies leaders can share with their teams to improve quality of work life despite the ongoing pandemic and the stressors that come with it.

In a Nov. 17 news release CMS urges nursing homes to take advantage of targeted COVID-19 training and highlights facilities that have already done so. This is the free course available on QSEP that offers modules for both front-line staff and management staff (access training here); it is separate from the longer QIO training offerings and from Project ECHO.

For those tracking the COVID-19 test positivity rate by county, particularly care centers using that data to determine their staff testing protocol, the accelerated community spread in the last few weeks has had a huge impact. CMS test data for the two weeks ended 9/30 showed Minnesota with 35 green counties (positivity less than 5%), 46 yellow counties (5-10%) and 6 red counties (over 10%). In the most recent data, for the two weeks ended 11/11, virtually all MN counties are now red, with only four rural counties (Cook, Fillmore, Lake and Lake of the Woods) with yellow status and none in green.

We received good news today on two fronts:

Background Studies: The Minnesota Department of Human Services will be returning to emergency COVID-19 background studies that were previously in place. The Department is finalizing its implementation plan and anticipates this will be effective Thursday morning (Nov. 19).

Do you want to be better equipped to address wandering, hoarding and resisting cares? What about repetitive statements, paranoia, inappropriate sexual expressions or aggression? Our dementia care training can help.

At noon tomorrow (11/12), LeadingAge Minnesota CEO Gayle Kvenvold will be featured as part of LeadingAge National’s Annual Conference. Kvenvold was asked to provide a Mission Moment—a personal reflection on our missions of service in these challenging times.

A common struggle for family members of older individuals who are beginning to exhibit memory challenges is the discussion regarding stopping driving or “driving retirement.” CarFreeMe is a program for people with memory loss living in Minnesota who are considering retiring from driving or are acclimating to driving retirement. Information is available for anyone interested in participating in the program and study.

Some Minnesota providers have experienced issues with timely and approved VA payments and there may be some options available. VA and its third-party administrators (TPA), Optum and TriWest, will reconsider payment to providers who had a claim denied for simple routing errors.

On November 6, 2020, the Centers for Medicare & Medicaid Services (CMS) released the 2021 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs. 

The Minnesota Secretary of State released a notice of vacancies for various state boards, councils and committees that are accepting applications. LeadingAge Minnesota members are encouraged to apply for and serve in these important public service roles. Vacancies include:

The Department of Labor and Industry (DOLI) is hosting a series of events during National Apprenticeship Week. Attend their virtual event “Introduction to Apprenticeship for National Apprenticeship Week” on Friday, November 13 at 10:00 AM to learn about registered apprenticeship as a workforce development model. The event will offer an overview of registered apprenticeship and the benefits of growing and sustaining an innovative workforce through employment-based training. Click here to register for the event using the event password: kaPpjyMH983

For two more years, Minnesota will continue to have the distinction of having the only divided Legislature in America, with the Republicans holding on to control of the Minnesota Senate by a one-vote margin and the House DFL retaining control of the House, albeit with a smaller majority than last year. 

As a sign of hope in the battle with COVID-19, the new multi-media Pandemic Playbook: Moving From Fear to Action from LeadingAge features a 10-minute video documenting a New Jersey nursing home’s victory over COVID-19 in the early days of the pandemic.

CDC has announced two more training session opportunities on the new point-of-care testing tool on NHSN. Trainings will be held this week on Thursday, November 12 at 2:00 PM Central Time and Friday, November 13 at 11:00 AM Central Time. Register for these training sessions here. The slides have been posted here. CDC has promised to post a recording of the training session in the future.

As COVID-19 cases continue to surge throughout the state, many providers are again experiencing PPE shortages – especially with gloves – and we thought it would be helpful to remind members of the process for requesting supplies from the State.

On Friday, the Minnesota Department of Health released its Long-term Care COVID-19 Response: November 2020 Update and provided some updates regarding benchmarks with respect to how COVID-19 is impacting senior care providers and the people they serve.

Monoclonal antibody therapy is a COVID-19 treatment that appears to prevent the progression of COVID-19 disease, decrease the length of illness, and may prevent hospitalizations. An Emergency Use Authorization (EUA) was published today allowing the emergency use of monoclonal antibody therapy (Bamlanivimab) for adults and children with a positive COVID-19 test. Recipients must be 12 years of age or older or at least 40kg in weight. There are specific criteria for use of this therapy including:

• The recipient should have a confirmed COVID-19 infection;
• The recipient should be early in the disease progression; and
• The recipient should be symptomatic but not severely ill.    

DHS has posted the materials for the annual care center statistical and cost report for the year ending September 30, 2020 and the corresponding instruction manual on the DHS Nursing Facility Provider Portal. DHS also indicates that there will be a Supplemental Schedule to the 2020 cost report that is not yet final but is being developed to address various issues including use of federal relief funds. DHS expects the 2020 Supplemental Schedule to be available in mid-December, and they ask that providers refrain from submitting any 2020 Cost Reports before December 15. As always, cost reports are due by February 1.

LeadingAge sent all care center members their Five-Star Analysis reports this week. The pandemic has taken a toll on the collection and reporting of quality data, so while the staffing data is relatively new, the data on inspections and quality measures is from many months ago. We will continue to provide these reports regularly and expect CMS to be updating the data more regularly soon.