Guidelines aimed at preventing spread of multidrug-resistant organisms. The Centers for Medical and Medicaid Services (CMS) is issuing new guidance for State Survey Agencies (such as the Bureau of Health Care Quality and Compliance in Nevada) and long-term care (LTC) facilities on the use of enhanced barrier precautions (EBP) to align with nationally accepted standards.
Recommendations now include use of EBP for residents with chronic wounds or indwelling medical devices during high-contact resident care activities regardless of their multidrug-resistant organism (MDRO) status. The new guidance related to EBP is being incorporated into F880 Infection Prevention and Control. Full information on this new guidance can be found online in QSO-24-08-NH. For questions or concerns relating to this memorandum, send an email to [email protected].
Check out CMS’s new Quality in Focus interactive video series. The series of 10-15 minute videos are tailored to provider types and aim to reduce the deficiencies most commonly cited during the CMS survey process, like infection control and accident prevention. Reducing these common deficiencies increases the quality of care for people with Medicare and Medicaid. Learn to:
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New federal guidance means there is additional information for facilities to include on reports .The Centers for Medicare/Medicaid Services (CMS) has revised the guidance in Chapter 5 of the State Operations Manual (SOM) to strengthen the oversight of nursing home complaints and facility-reported incidents (FRIs). The goal of the federal complaint/incident process is to establish a system that will assist in promoting and protecting the health, safety and welfare of residents, patients and clients receiving health care services.
Below is a summary of changes to the FRI form for skilled nursing facilities:
Data reported by licensed health care facilities was used to create the report The State of Nevada Healthcare Associated Infections (HAI) Program has published the Community-Wide Surveillance for Carbapenem-Resistant Organisms (CROs) Report for 2019-2021. This report includes surveillance definitions, monthly case counts for each year, figures that depict the trend of CROs, descriptive statistics for reported CRO cases, case counts for carbapenemase-producing organisms (CPOs), characterization of CPO cases, annual rate of CPO/CRO in hospitals, links to antibiograms, infection prevention guidance, and reporting guidance. The data source that was used for this report comes from surveillance data for carbapenem-resistant organisms reported to the State of Nevada HAI Program by state-licensed health care facilities and the State Public Health Laboratory as mandated by Nevada Revised Statutes 441A.
To review the reports visit the HAI Program webpage at Healthcare Associated Infection Prevention and Control (HAI) – Publications web page. To report cases and for infection prevention guidance, email the HAI Program at [email protected]. Proposed changes now being enforced by health facilities regulators Health facilities should be aware that recently proposed regulations (LCB File No. R048-22) are now in effect and must be followed.
The regulations amend Nevada Administrative Code Chapter 449 (Medical Facilities and Other Related Entities) and Chapter 450B (Emergency Medical Services). Issues addressed by the changes include:
Training about this emerging fungus will cover prevention, transmission, testing and more A free webinar about Candida auris, an emerging and often multi-drug reistant fungus that presents a serious global health threat, will be held at 10 a.m. on June 28. The webinar is a joint effort of the Nevada Office of Public Health Investigations and Epidemiology (OPHIE), Washington State Department of Health and Centers for Disease Control and Prevention (CDC). Additional information about Candida auris can be found in the technical bulletin linked here.
The objectives of the webinar are:
The webinar has been approved for 1 nursing CEU. Questions can be emailed to [email protected]. Specifics about completing the self-report form described online for facilities to reference Skilled nursing facilities are required to self-report certain types of incidents to the Nevada Department of Health and Human Services’ Bureau of Health Care Quality and Compliance (HCQC) by using an online form.
The types of incidents required to be reported are:
CMS is ending certain waivers in May in response to impacts on resident health The Centers for Medicare and Medicaid Services (CMS) is ending specific emergency declaration blanket waivers for skilled nursing facilities, inpatient hospices, intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) and end-stage renal disease (ESRD) facilities that were enacted to provide flexibility during the COVID-19 pandemic.
These waivers include:
The termination of these blanket waivers will have no effect on other blanket waivers that remain in place such as those for hospitals and critical access hospitals (CAHs). Those blanket waivers remain in effect to assist hospitals and CAHs, among others, in dealing with their response to the surges of COVID-19 cases in the community. Providers are expected to take immediate steps so that they may return to compliance with the reinstated requirements according to the timeframes listed below. We also recommend that providers continue to follow CDC guidance for preventing the spread of COVID-19 especially during activities that may increase patient or resident contact. Full details (including additional waivers that are ending and timeframes) can be found at the CMS website at Update to COVID-19 Emergency Declaration Blanket Waivers for Specific Providers. Quarantine is being recommended for certain residents Due to concerns about increased transmissibility of the SARS-CoV-2 Omicron variant, guidance from the Centers for Disease Control and Prevention (CDC) is being updated to enhance protection for health care personnel (HCP), residents and visitors and to address concerns about potential impacts on the health care system given a surge in COVID-19 infections. These updates will be refined as additional information becomes available to inform recommended actions.
In this update, empiric use of Transmission-Based Precautions (quarantine) is recommended for residents who are newly admitted to the facility and for residents who have had close contact with someone with COVID-19 infection if they are not up to date with all recommended COVID-19 vaccine doses. In general, quarantine is not needed for asymptomatic residents who are up to date with all COVID-19 vaccine doses or who have recovered from SARS-CoV-2 infection in the prior 90 days; potential exceptions are described in the guidance. However, some of these residents should still be tested as described in the testing section of the guidance. Additional updates that will have implications for nursing homes were made in the guidance documents at the link below. Click here to access the updated CDC guidance. Older adults living in congregate settings are at high risk of being affected by respiratory and other pathogens, such COVID-19. A strong infection prevention and control (IPC) program is critical to protect both residents and HCP. Even as nursing homes resume normal practices, they must sustain core IPC practices and remain vigilant for COVID-19 infection among residents and HCP in order to prevent spread and protect residents and HCP from severe infections, hospitalizations and death. Staff must properly assess residents upon admission to ensure care can be provided without relying on EMS The Bureau of Health Care Quality and Compliance (HCQC) has identified a current need to provide information regarding use of Emergency Medical Services (EMS), including the use of fire departments and paramedics. The purpose of the technical bulletin below is to advise residential facilities for groups, skilled nursing facility administrators and homes for individual residential care directors to properly assess their residents upon admission and throughout each resident’s stay to ensure the facility has the capacity and capability to provide routine care for residents without relying on EMS. To read all the details, download the PDF below.
Report provides information on barriers, sample policies Transgender people face many barriers to health care because of historic bias and discrimination. To support this population in Nevada, health facilities are encouraged to read the “Transgender Affirming Hospital Policies” report issued by Lambda Legal, the Human Rights Campaign Foundation, Hogan Lovells and New York City Bar. This report (available for download at the bottom of this blog post) provides sample policies addressing issues such as nondiscrimination, patients’ bill of rights, access to hormone therapy, protocols for staff interaction with transgender patients, room assignments and more. According to the report, in a survey of more than 6,000 transgender Americans, 19% of the respondents reported being refused health care due to their transgender or gender-nonconforming status. In addition, 28% had postponed necessary health care when sick or injured and 33% had delayed or had not sought preventive care because of experiences of health care discrimination based on their transgender status. “Adopting transgender-inclusive health care practices can reduce the costs associated with complications that arise when transgender patients are denied or delay medical treatment due to discrimination,” the report states. Nevada law addresses specific patient rights, including the right to “receive considerate and respectful care.” Although the attached report addresses hospitals, Nevada law applies to all health facilities in the state that are licensed and inspected by the Bureau of Health Care Quality and Compliance (HCQC). The report is available below in PDF. Also below is a presentation called, “Meeting the Health Care Needs of Transgender People,” from the Nevada organization Transgender Allies Group.
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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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