Officials with the Centers for Medicare & Medicaid Services (CMS) on Thursday said the number of nursing home residents who are up to date with her COVID-19 vaccines is “far too low.”
While COVID vaccination was at the top of the agenda, CMS officials also shared more information about coming MDS changes, including the timing of the draft RAI manual.
With regard to vaccination, an official stressed that the agency is “paying very close attention” to numbers coming out of the Centers for Disease Control & Prevention (CDC) related to the number of nursing home residents that are fully boosted — and improvement is needed.
“We need that to increase particularly as we go into these winter months when we are anticipating potential spikes of respiratory illness,” a CMS official said during today’s Open Door Forum call with operators and industry stakeholders.
CMS officials continued that vaccination and timely treatment of COVID-19 will be a top priority of the Biden administration as the country heads into winter. Officials directed providers to the twelve Quality Improvement Organizations which cover the country and can help communities get up-to-date on their vaccinations.
One provider on the call relayed that most of the infections at their communities were caused by visitors, who are not required to be tested per CMS guidelines.
“Why can’t we require testing for visitors before they come into the building?” the stakeholder asked. “The reality is we can give our residents as many boosters as they are eligible for but that’s not going to stop somebody from testing positive for COVID.”
It’s a balancing act between giving residents the right to see the people who they want to visit and the negative effects of isolation, although they would consider the feedback, a CMS official said.
Providers on the call also urged CMS to address vaccination at hospitals, saying that some hospitals are not offering vaccination to people who subsequently go to a nursing home.
“Vaccine fatigue” also came up on the call, with one caller describing difficulties in convincing residents to get another booster.
Being fully vaccinated, including with the most recent booster, has been shown to decrease the risk of hospitalization, a CMS official noted, saying, “Everybody wants to avoid being admitted, right? So I think that’s a very effective message that you can continue to hammer home.”
The official also emphasized the importance of oral antivirals in mitigating the severity of COVID infections, and recommended having a “small stockpile” on hand in facilities.
MDS timing
Stakeholders also had questions about updates to the Minimum Data Set (MDS).
In September, CMS released an updated draft with significant changes, including the removal of Section G, which is used to calculate RUG scores that many states still use in determining reimbursement rates.
A draft RAI manual likely will be available early in the second quarter of 2023, a CMS official said.
The fate of Section G has been in question since the transition to the Patient-Driven Payment Model (PDPM), which made the section unnecessary from a Medicare reimbursement perspective.
A caller asked if there will be resources related to quality measures, acuity in staffing, and the Five-Star rating system to help providers acclimate to the removal of Section G.
“The plan for a draft manual is probably early second quarter of 2023. The training will basically mirror what we already have out on the website,” a CMS official said.
They continued that training materialswill likely be released in mid-May and CMS will conduct live workshops in June.
“It’s going to have a tremendous impact on our industry from a state-level reimbursement [perspective],” Gloria Brent, president and CEO of MDS Consultant LLC, told SNN earlier this year.
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