CMS and Comagine offer interactive, scenario-based course for frontline clinical and administrative staff The Centers for Medicare and Medicaid Services (CMS) Quality, Safety & Education Portal (QSEP) is offering an interactive, scenario-based course that incorporates recent best practices from nursing homes. With this training, frontline staff and management have an opportunity to fine-tune their skills and enhance their ability to address challenges related to COVID-19. You’ll need to sign up to log in, launch the training and receive a certificate of completion. Modules include “Training for Frontline Staff” and “Training for Nursing Home Management.” See the attached flyer for details on these modules and more information.
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Technical bulletin provides details on authorization and administration of vaccine On Monday, the U.S. Food and Drug Administration (FDA) issued full approval to the Pfizer-BioNTech COVID-19 vaccine, which will now be marketed as Comirnaty, for use as a two-dose series indicated for individuals 16 years of age and older. Comirnaty will remain available under the existing Emergency Use Authorization (EUA) to prevent COVID-19 in individuals ages 12 through 15 years and to provide a third dose to individuals 12 years of age and older who have been determined to be moderately to severely immunocompromised.
FDA’s full approval of the first COVID-19 vaccine, which required additional safety and efficacy data beyond what was provided for the EUA, is an important milestone that should reassure anyone who has concerns about getting vaccinated. On top of the rigorous testing and trials that went into Emergency Use Authorization of the Pfizer vaccine, the FDA has now completed additional analysis of the effectiveness and safety data from tens of thousands of clinical trial participants ages 16 years and older, as well as the analysis of real-world safety data. A technical bulletin on the Division of Public and Behavioral Health’s website outlines details on these related topics:
Effort aims to reach small and communal living situations with boosted payments to providers The Centers for Medicare and Medicaid Services (CMS) is expanding opportunities for people to receive COVID-19 vaccinations in their home. To ensure Medicare beneficiaries who have difficulty leaving their homes or are otherwise hard to reach can receive the vaccination, health care providers can now receive additional payments for administering vaccines to multiple residents in one home setting or communal setting of a home.
The CMS announcement aims to further boost the administration of COVID-19 vaccines – including second and third doses – in smaller group homes, assisted living facilities and other group living situations by allowing vaccine providers to receive the increased payment up to five times when fewer than 10 Medicare beneficiaries get the vaccine on the same day in the same home or communal setting. This policy will help ensure that at-risk patients in smaller settings have the same opportunities as others to receive the vaccination. The additional payment amount also accounts for the clinical time needed to monitor a beneficiary after the vaccine is administered, as well as the upfront costs associated with administering the vaccine safely and appropriately in a beneficiary’s home. The payment rate for administering each dose of a COVID-19 vaccine, as well as the additional in-home payment amount, is geographically adjusted based on where the service is furnished. For full details, see the Aug. 24 special edition of the Medicare Learning Network newsletter. For help finding vaccine providers in Nevada, visit https://www.immunizenevada.org/covid-19-vaccine-locator. Amid growing evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy and demonstration that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks, the American College of Obstetricians and Gynecologists (ACOG), the Society for Maternal-Fetal Medicine, and the CDC are recommending COVID-19 vaccination for people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.
On Aug. 10, the CDC published a new analysis showing the cumulative risk of miscarriage after receiving a mRNA COVID-19 vaccine (13%) was similar to previously published estimates (11-16%). The analysis included 2,456 pregnant people enrolled in the V-Safe pregnancy registry who received at least one dose of a mRNA COVID-19 vaccine just before pregnancy or prior to 20 weeks of pregnancy as of July 19, 2021. These data do not suggest an increased risk for miscarriage after receiving a mRNA COVID-19 vaccine just before or within the first 20 weeks of pregnancy. These preliminary findings are reassuring and can help inform discussions about COVID-19 vaccination during pregnancy between pregnant people and their health care providers. Technical bulletins from the Nevada Department of Health and Human Services provide more details on this and other COVID-19 topics and can be accessed on the Division of Public and Behavioral Health Technical Bulletins web page. Online guide to help skilled nursing facilities meet reporting requirements An educational slideshow about inputting data to the National Healthcare Safety Network (NSHN) is now available to help skilled nursing facility (SNF) staff navigate the system and boost reporting of COVID and other infectious disease transmission.
This “National Healthcare Safety Network Reporting Toolkit” was written by the Department of Health and Human Services’ Office of Public Health Investigations and Epidemiology (OPHIE) and Bureau of Health Care Quality and Compliance (HCQC) to review state and federal mandate NHSN reporting for SNFs and guide staff on COVID-19 and health care-associated infection (HAI) reporting methods within the NSHN. The guide covers such topics as:
The Centers for Disease Control’s (CDC) independent Advisory Committee on Immunization Practices (ACIP) has recommended that people with moderately to severely compromised immune systems receive an additional dose of mRNA COVID-19 vaccine following their initial two-dose vaccination series. CDC Director Dr. Rochelle Walensky accepted those recommendations and released a statement.
Below is a list of resources related to the recommendation:
It’s important to note that individuals can self-attest and receive the additional dose wherever vaccines are offered. This will help ensure there are not additional barriers to access for this vulnerable population receiving a needed additional dose. CDC will be providing further information regarding vaccine administration to immunocompromised individuals to states, pharmacies, health centers, and all vaccine providers. More provider resources for new vaccination updates for immunocompromised:At this time, there is no recommendation for additional doses of Johnson and Johnson (Janssen) vaccine. Nevada’s vaccinating providers may move forward using their discretion to provide an additional dose of mRNA COVID-19 vaccine to moderately to severely immunocompromised persons. Flyer helps providers determine if patients are eligible for infusion The Nevada Board of Pharmacy has developed a flyer (see attached) to help health providers learn about monoclonal antibody treatments that may enable high-risk COVID-19-positive and high-risk COVID-19-exposed outpatients avoid hospitalization. The flyer addresses patient criteria to receive the treatments through taking early action and finding treatment locations. This phe.gov link provides information on the Regeneron Emergency Use Authorization (EUA), and the direct ordering process. These treatments could help the immune system respond more effectively to the virus and are likely to be most effective when given early in disease course. Early evidence appears to reduce the relative risk of hospitalizations by up to 70% in high-risk patients. An individual’s health care provider can help determine if this treatment is appropriate for him or her. To learn more, check out the Monoclonal Antibodies Project ECHO session now available on YouTube
CDC provides update for 2021 and new Nevada law requires testing to be offered by primary care providers and emergency departments The Centers for Disease Control and Prevention (CDC) has updated its Sexually Transmitted Infection (STI) Treatment Guidelines. These guidelines provide current evidence-based diagnostic, management, and treatment recommendations for STIs.
The new guidelines include notable updates from the previous 2015 guidance, including updated treatment recommendations for chlamydia, and for uncomplicated gonorrhea in neonates, children, and other specific clinical situations (e.g., proctitis, epididymitis, sexual assault), which builds on broader treatment changes published in Morbidity and Mortality Weekly Report late last year. A Nevada Department of Health and Human Services technical bulletin linked on this page under “Other Topics” includes a summary of treatment updates, and a link to the CDC’s full 192-page guidance document. Another technical bulletin linked in the Other Topics section addresses a new Nevada law requiring primary care providers and emergency departments to offer testing for the human immunodeficiency virus (HIV) and sexually transmitted diseases (STDs) to their patients aged 15 to 64. The intent of the new law (Senate Bill 211) is to identify cases early through increased HIV and STD screening. Additionally, the stigma surrounding HIV and STDs can be reduced by normalizing testing and discussion between providers and their patients. Order applies to testing for individuals concerned with exposure and/or infection The standing order attached to this email (issued by the Nevada Division of Public and Behavioral Health, Department of Health Services) authorizes any medical provider/trained personnel at a medically supervised COVID-19 testing unit in the State of Nevada to collect and send a SARS-CoV-2 RT-PCR test for any individual in accordance with Nevada Revised Statutes 652.210 with the conditions of this order. This standing order is issued pursuant to the Governor’s Declaration of State of Emergency on March 12, 2020, pursuant to Nevada Revised Statutes Chapter 414, which directs state agencies to “save lives, protect property, and protect the health and safety of persons in this state. The results of such tests shall constitute protected health information and may be disclosed, only as authorized by law. All test results shall be shared in accordance with the State’s mandated laboratory reporting laws, as noted in the attached orders.
Monoclonal antibody therapeutics (mAb) are available for ordering and can be used to treat eligible non-hospitalized patients who have tested positive for COVID-19 and have mild to moderate symptoms. According to the Centers for Disease Control and Prevention (CDC), these treatments mimic the immune system’s response to SARS-CoV-2 (the infection that causes COVID-19) and are available to eligible patients 12 years and older with a high risk of progressing to severe forms of COVID-19 or being hospitalized. The federal Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (HHS/ASPR) has an ample supply of all COVID-19 monoclonal antibody therapeutic products and is encouraging state and territorial health departments as well as health care providers to continue ordering and using these products. Pause in the distribution of bamlanivimab/etesevimab In June, ASPR paused all distribution of bamlanivimab/etesevimab together and etesevimab alone on a national basis until further notice. In addition, the Food and Drug Administration (FDA) recommends that health care providers nationwide use alternative authorized monoclonal antibody therapies, REGEN-COV (casirivimab and imdevimab) and sotrovimab, and not use bamlanivimab/etesevimab administered together at this time.
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AuthorThe Bureau of Health Care Quality and Compliance (HCQC) licenses medical and other health facilities, child care facilities and personnel, and medical laboratories and personnel in Nevada. HCQC also conducts compliance surveys and takes complaints. Archives
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