WHITE HOUSE:

The White House focused this week on the President’s public address on democracy, their Monkeypox vaccine distribution efforts, and the announcement of a public-private partnership to address the shortage of qualified K-12 teachers. Two specific items of note:

• They announced the distribution of $1 billion dollars to strengthen regional collaboratives aimed at creating stronger local projects that can create more jobs locally. If you’re located near one of the programs, a few of them may be looking for employment opportunities with local facilities. Several resources related to the announcement:

• Fact Sheet (PDF)
• In-depth profile on the 21 winners (PDF)
• The main US Economic Development Administration resource page.

• They created an “Apprenticeship Ambassadors Initiative” to create pathways to a more sustainable workforce across several industries. You can find more details and apply to be an Apprenticeship Ambassador here. The fact sheet is available here (PDF). There may be an opportunity to partner with the Department of Labor in building an apprentice program.

CONGRESS:

With Congress on recess till next week and a very limited timeframe to pass meaningful legislation, the conversation in DC is going to be entirely focused on government funding. In the meantime, some interesting items on the election and Congressional control front:

• In a continuing sign that the midterm elections may be closer than expected, a Democrat won a special election in Alaska, a historically very red state. What’s notable is that under the ranked choice system in Alaska, for that to happen, Republicans voters there chose not to support a second Republican (in this case Sarah Palin). In short, as we’ve mentioned many times, weak GOP candidates are having a real impact.

• 538 has an interesting piece on the path to Congressional control for each party, forecasting different races across the spectrum.

• Politico looks at how leadership roles can play out in the new Congress.

• As the GOP outlook continues to worsen, it is notable that both Politico and The Hill ran pieces on a brewing feud between Senator Rick Scott & Senator Mitch McConnell.

• Finally, the AFL-CIO announced their largest ever voter drive campaign in support of pro-union candidates.

AGENCIES:

CMS announced a major change to the enrollment process for Medicare & Medicaid applications, something that can have a major impact on redeterminations and renewals. They provided a fact sheet on the major changes, including:

• Limiting renewals to once every 12 months
• Prepopulating the required forms (thereby eliminating common paperwork errors)
• Providing a 90-day window for reconsideration following a termination

You can find the full 301-page rule here (PDF). It’s scheduled for publication at the federal register on Tuesday, at which point a 60-day comment period kicks off.

CMS issued an important update to their QSO related to temporary nurse aides (TNA’s), providing a formal process for facilities to request waivers related to keeping TNA’s in regions where they can’t access proper testing or training for their full licensure. The QSO can be found here (PDF). The website to request waivers is here. Please share with your clinical/operating teams.

CMS released version 4.0 of their quality metrics manual, the underlying tools that they rely upon when calculating quality measures. It will be effective October 1^st, 2022. The manual is here (PDF). They also provided several spreadsheets providing the underlying technical information. You can access all the material at the bottom of their central quality reporting page in the ‘downloads’ section.

Finally, CMS hosted a call this past week regarding their minimum staffing study. McKnight’s has a good summary of the call.

OTHER:

On the non-agency front:

1. JAMA published a study on the impact that Covid had on residents in facilities, even those that didn’t get Covid. This study confirms a key point made by z-INTEL cofounder Marc Zimmet in his comments to the CMS’ SNF2023 payment rule on SNF’s: every SNF resident, regardless of whether they had Covid, was significantly impacted by the pandemic and was at heightened risk of depression.
2. JAMA also released a study showing that telehealth was effective in opioid overdose treatment and that more flexibility is needed moving forward. CMS also publicized the study.
3. A new coalition focused on getting residents involved in advocacy has been launched by several organizations, including Leading Age and several of the authors of the NASM study earlier this year decrying the SNF system in the United States as broken. (The full 578-page NASM study is available here).
4. Altarum, a non-profit that works with CMS and state agencies on behalf of Medicare beneficiaries, released an analysis of on the impact of Covid on culture change at facilities. You can download it here (PDF).
5. Politico did a deep dive into HHS Office of Civil Rights, the agency responsible for HIPAA compliance and how it’s struggling with the mounting cybersecurity attacks against healthcare providers.
6. Finally, the NY Times had an article on an interesting practice being utilized by SNF’s in Japan: using babies to interact with residents. You can access it here (registration required).

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