Can residents at Senior Care Facilities go to state managed sites for their vaccination? HAN 31 implies they cannot and appears to be the most recent document addressing this concern.

If an individual has had both doses of the vaccine, and are exposed to COVID, would they still have to isolate for 10-14 day period?

When will DHHS release guidance on what activities are safe to do (visits, travel, inside dining at the facility) once all residents and a majority of staff are vaccinated and immunity has kicked in?

At one point we were told that we needed to wear face shields in addition to masks, is this still a universal recommendation?

do we need to wait the 14 days for indoor visits or can we proceed?

We have had one round of POC and PCR negative test results since our last positive, we are to POC test tomorrow, if all are negative do we have to wait until our PCR testing to be negative next week to start opening up to communial dining and indoor visits?

Do protocols change once residents and staff have been vaccinated? If so, how? I haven't seen on the website guidance as to how or whether protocols change with resident/staff vaccination? Interested in protocols when there is no positive case in the facility and when there is a known positive case in the facility.

for an admission we have been having them quarantine for 14 days upon admission with negative covid before arrival and another negative covid after the 14 days. Are we able to cut that time down to 10 days?

will ALF testing continue once per week through the end of March as well?

the county has to be under 10% for 2 consecutive weeks before transitioning to once a week testing, correct?

indoor visitations start when cases in the community are below 50- phase 2-correct?

Perhaps an ownership would have Testing guidelines..

We have staff who want to continue to test after the 14 days past vaccination.

I would not recommending stopping the weekly frequency until the vaccination program for our short term residents and new staff is resolved. It is not.

@Angela.c.Hawthorne that is correct, as long as the county rate has remained at the new rate for two weeks in a row, the following week the facility would be able to test at the new frequency tied to the rate

Hi everyone - its Joshua from Healthcentric Advisors. Just wanted to share an FYI a new pathway was added to NHSN last Friday to include Therapeutics. They want you to enter data related to therapeutics administered from Monday February 1 - onward.

@Dawn Rogers when a facility is required to perform outbreak/response testing, it supersedes the county testing frequency rates. For outbreak response, per CMS, you must test your full facility every 3-7 days until there has been 14 days of negative results

1. If multiple residents need to go out to the same medical office, can they all travel together in the same facility van? They are not able to be 6 feet apart (physically), and some may not wear a mask (especially dementia residents). The driver wears a respirator and eye protection. If not, is there any mitigation?

I did not pose the question on post-vac testing, but it may be because of the question of whether those vaccinated will still be able to carry and transmit the virus to others. For the time being, my community is going to continue to test staff and residents on a monthly basis because there isn't good data on this subject yet.

Can we stop testing fully vaccinated employees in LTC?

best source for getting number of cases/100K for each county?

We are receiving inquiries from family members who are inquiring once they are fully vaccinated can they take their fully vaccinated resident home for home visit or out to lunch. We are an Assisted Living community - can you provide guidance in this situation?

@Amy Rauert -For testing/visitation purposes, look for a link to data at data.cms.gov. Click on the Nursing Home Dataset and then about halfway down the page is a link under the Testing section.

ty

@Amy Rauert: https://www.nh.gov/covid19/dashboard/map.htm#dash - interactive map tab - Rate of New Cases per 100k population

yes...KUDOS to all of our NH LTCs staff and leadership for leading the nation in this.

*CORRECTION to my prior post: click on Rate of Active Cases per 100k

Does this assume all residents and staff are vaccinated? What is some of the residents and/or staff are not?

@Amy Rauert - Kristen posted the link to CMS County positivity re: testing frequency for LTC and as it relates to Reopening Guidance for all providers (https://www.dhhs.nh.gov/dphs/cdcs/covid19/documents/ltcf-visitation.pdf) in that indoor visitation can occur when county positivity rates are ≤ 10%.

You mentioned other resources for guidance on visitation and other activities while we wait for the CMC. Where is that guidance?

Are we saying that there is flexibility to the guideline of no indoor visits in a county with a positivity rate above 10%?

@jennifer McCalley there is no new guidance but I believe Sue is urging providers to pay close attention to what is currently allowed under the reopening guidance: https://www.dhhs.nh.gov/dphs/cdcs/covid19/documents/ltcf-visitation.pdf

Wouldn't it also depend upon the vaccine received? I know most facilities received the Pfizer, but moving forward other vaccines are not as effective. I am curious how this will be handled. I am also curious how unvaccinated residents and staff should be handled as this will be a factor since there is not plan for future clinics.

HAN 33 - https://www.dhhs.nh.gov/dphs/cdcs/alerts/documents/covid-19-update33.pdf

Can Kristie speak to the testing of staff/residents who are 14 days post vaccination? If CMS hasn't changed their guidelines, don't we still have to test per the CMS rules, vaccinated or not?

Is the recommendation from NH Public Health that Staff having the two vaccines and 14 days have passed, do not have to be tested weekly

Can we get the link again to the slide decks?

Belknap County Positivity Rate = 9.7%. We are more than two weeks with no new facility-onset cases of COVID-19. The September 28, 2020 Infectious Disease publication titled, "Reopening Guidance for Long-term Care Facilities (LTCF)" allows for indoor in-person visiting. Is this conclusion accurate?

A resident would like to travel two weeks after 2nd dose of vaccine. What precautions should be taken upon her return to the community?

Slides and recording posted following the call at https://www.nhhca.org/covid-19/ - past calls and recordings

I was told by our CS investigator that anyone who is 14 days after their 2nd vaccination will not need to quarantine upon admission. He referred me to HAN 33 as back up.

what happens after 3rd clinic w PPP? for new residents?

I think the question of AL communities continuing to test fully vaccinated staff is also noted in HAN #33: "It remains possible for people who are fully vaccinated or previously infected could still acquire asymptomatic SARS-CoV-2 infection or attenuated (milder) COVID-19."

how do you submit?

Vaccine Provider Agreement - middle of the page: https://www.nh.gov/covid19/resources-guidance/vaccination-planning.htm

CDC guidelines state to defer COVID vaccine for individuals who have current SARS-CoV-2 infection until they are no longer acutely ill and meet criteria for discontinuation of isolation. We are finding providers who are advising not to receive until 90 days have passed from onset pf postive case. Any thoughts on this given natural immunity wanes and emerging variants?

Thank you Rosemary- Assisted Living communities share your concerns

We have contacted our RPHN regarding vaccines for those with IDD who live in congregate residential settings and have not heard back. When can we expect to hear?

To move to the next phase- county positivity has to be less than 10% and the rate per 100,000 has to be at the correct number- so both must be satisfied-correct?

Given the potential for vaccinated residents and staff transmitting disease, what is the guidance for handling unvaccinated residents and staff. Should they be co-horted? Should there be additional precautions in place?

Good afternoon. We have a question regarding guidelines for Dialysis patients and whether they need to be isolated and remain on precautions indefinitely due to reoccurring exposure potential at dialysis facilities?? Does it make sense to keep them on isolation when the dialysis centers are screening and wearing PPE. Wouldn’t this be considered a protected exposure? We do not want to unnecessarily isolate any patients or their roommates in the facility but cannot find clear guidance to the contrary.

What if the patient was continuing to have a cough, shortness of breath and decreased oxygen levels? But the hospital stated they were ready for discharge to a SNF

What level of quarantine is recommened for a resident who is Covid positive and was transfered to the hospital and is now ready to be discharged back to the facility?

https://www.dhhs.nh.gov/dphs/cdcs/covid19/documents/ltcf-visitation.pdf

Review of "reopening guidance" and phases.

I am sorry, but I thought indoor visitations were not allowed in phase I? So if the county cases are not below 50, then we cannot progress to phase II, but yet we are under 10% positivity rate, which allows indoor visitation.

Thank you Taylor!

if in phase 1 we can have indoor visits, what about podiatrist, audiologist, dentist?

When can we do in person tours?

Can you clarify? In LTC, staff who are fully vaccinated past 14 days still have to test and quarantine if direct contact?

return to work: https://www.dhhs.nh.gov/dphs/cdcs/covid19/documents/covid-crisis-staffing-ltcf-alf.pdf

https://forms.gle/GHybqr13jua6M3vk7

IF a covid positive patient was past their 14 days in a hospital but ready for discharge however is still symptomatic what are the chances they would still be spreading the virus

@jnormand, see HAN 33 to answer your question! https://www.dhhs.nh.gov/dphs/cdcs/alerts/documents/covid-19-update33.pdf

DEFINE NON ESSENTIAL PERSONNEL

My email is jclodius@healthcentricadvisors if anyone has any questions

Can entertainers come back into the facility after all residents are fully vaccinated and so are the entertainers. The facility is in Phase 1 currently.

Discontinuing precautions: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html

Thank you