The number of hospitalizations in Michigan due to confirmed and suspected cases of COVID-19 was the lowest since early November during the week of Jan. 31. However, with 2,882 adults and 70 children hospitalized Feb. 4 with confirmed and suspected COVID-19, some facilities in the state continue to be filled to or near capacity.
The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.
Application for Long-term Care Facilities to Care for COVID-19 Patients Extended
As a result of MHA advocacy, the state recently issued new guidance extending the application period for long-term care facilities to care for COVID-19 patients through Feb. 28. The guidance will ease the process of discharging COVID-19 patients from hospitals to nursing facilities. Additionally, in a change from previous policy, long-term care facilities that applied last year and remain in good standing are authorized to retain their status through the new application deadline.
The COVID Recovery Center and the COVID Relief Facility (CRF) programs were established under Michigan Public Act 231 of 2020. These programs were designed to ensure Michigan’s nursing homes were prepared to provide care to individuals who have tested positive for COVID-19 under transmission-based precautions within the guidelines and best practices from the Centers for Disease Control and Prevention. Michigan’s nursing homes must be reviewed by the Michigan Department of Health and Human Services (MDHHS) to ensure they meet the minimum criteria outlined within the legislation and associated MDHHS policies.
Michigan now has 54 Tier-2 CRFs able to take COVID-19 patients from hospitals at discharge if their normal nursing facility isn’t able to accommodate the patient, up from just 27 CRFs in late 2021. Members with questions may contact Adam Carlson.
The state of Michigan held a press conference Jan. 11 to discuss the rapid rise in case numbers, hospitalizations (especially pediatric hospitalizations) and positivity rates. Speakers urged all residents who are eligible to be both vaccinated and boosted as quickly as possible. Representatives from Children’s Hospital of Michigan joined the event to discuss the concerning rise in childhood case rates and hospitalizations.
The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.
The U.S. Supreme Court issued decisions Jan. 13 on the Centers for Medicare & Medicaid Services (CMS) and Occupational Safety and Health Administration (OSHA) vaccine mandates. As expected, the court blocked the Biden administration from enforcing the vaccine or test mandate issued under OSHA, but upheld the ability of the CMS to enforce the healthcare worker vaccine mandate.
The Supreme Court has repeatedly upheld the constitutionality of state vaccine mandates in a variety of settings, as well as mandates by private employers. These challenges were different because they presented the question of whether Congress had authorized the executive branch to institute the requirements through the agencies of OSHA and the CMS/Department of Health and Human Services.
Michigan was not one of the 26 states covered by the court injunction to the CMS mandate, and Michigan has no other state-issued prohibitions on enforcing federal or private vaccine mandates. Hence,the mandate and enforcement move forward. The currently posted deadline for completing the first required vaccine dose is Jan. 27, and the second dose is required by Feb. 28. Boosters are currently not part of the mandate.
The MHA responded to a number of media inquiries following the Supreme Court announcement, including from The Detroit News, Detroit Free Press and MiBiz. The association reiterated its long-standing position that mandates of this kind should be left up to local healthcare decision-makers and that hospitals and the MHA have always urged every resident who is eligible to get vaccinated to protect themselves and others. The MHA also stressed that, while the small number of hospital workers who have already ended their employment due to an organization’s mandate did not necessarily worsen the existing staffing shortages, the timing of a nationwide mandate amid this omicron surge could not be worse, as the shortages are more serious than ever. The association assured reporters that hospitals will proceed with compliance and that the MHA and its members will continue to strenuously advocate for staffing assistance from federal and state partners.
Members with questions about deadlines, enforcement or other elements of the mandate are encouraged to review the posted CMS guidance to ensure their organizations are prepared to comply.
MIOSHA: Hospitals May Currently Use CDC Quarantine Guidance Without Penalty
The MHA has continued to work with state regulators on securing updated guidance for hospitals and health systems as it relates to worker quarantine periods. Federal Occupational Safety and Health Administration (OSHA) rules have not yet been fully rescinded to allow for healthcare settings to confidently follow new, less restrictive Centers for Disease Control and Prevention (CDC) quarantine guidance.
However, the Michigan Occupational Safety and Health Administration (MIOSHA) has stated it was told OSHA is in the process of withdrawing the relevant rules and the state agency is preparing to update its rules to align with the revised federal rules. MIOSHA also indicated that, until updates are made at the federal and state levels, it will not issue citations specifically regarding quarantine and isolation requirements if an employer were following the Dec. 23, 2021, updated CDC guidance for healthcare personnel.
An existing OSHA provision recognizes the CDC’s ‘‘Strategies to Mitigate Healthcare Personnel Staffing Shortages.’’ This guidance allows elimination of quarantine for certain healthcare workers as a last resort if the workers’ absence would mean there are no longer enough staff to provide safe patient care, specific other amelioration strategies have already been tried, patients have been notified, and workers are using additional personal protective equipment at all times.
The MHA will continue to keep members apprised of developments on this issue. Members with questions may contact Laura Appel at the MHA.
Long-term Care Facility Capacity for COVID Care Increases
Michigan now has 50 Tier-2 COVID-19 Relief Facilities (CRFs) able to take COVID-19 patients from hospitals at discharge if their normal nursing facility isn’t able to accommodate them. This is an increase from just 27 CRFs late in 2021 and includes an Upper Peninsula facility in Hancock.
In addition, Michigan now has nine facilities designated as Care and Recovery Centers (CRC)s, including one in Escanaba in the Upper Peninsula.
The CRC and the CRF programs were established under Michigan Public Act 231 of 2020. These programs were designed to ensure Michigan’s nursing homes were prepared to provide care to individuals who have tested positive for coronavirus under transmission-based precautions within the guidelines and best practices from the Centers for Disease Control and Prevention. Michigan’s nursing homes must be reviewed by the Michigan Department of Health and Human Services (MDHHS) to ensure they meet the minimum criteria outlined within the legislation and associated MDHHS policies. Members with questions may contact Paige Fults at the MHA.
Red Cross Declares First Ever National Blood Supply Crisis
The American Red Cross declared a national blood supply shortage and operational crisis Jan. 10. This is the first time such a crisis has been declared, and it could impact hospitals’ ability to provide certain types of care or transfusions in the coming days and weeks. This is a result of the current COVID-19 surge causing canceled donation appointments, Red Cross staffing shortages and more.
The Red Cross chief medical officer sent a notification directly to hospital transfusion leaders outlining these operational challenges and how to plan for expected shortages. The Red Cross also urged the public to donate blood as soon as possible.
The MHA will be amplifying to the public the need for blood donors through its social and traditional media channels.
Michigan Sees Surge in Unemployment Fraud
Michigan has seen a recent surge in unemployment fraud claims, according to the MHA Unemployment Compensation Program (MHA UCP). The increase in unemployment fraud is related to identity theft that occurs when the state Unemployment Insurance Agency (UIA) system is penetrated. Over the past several weeks, the MHA UCP has seen fraud in about 15 to 20% of all new claims for its clients.
The MHA UCP has worked closely with the UIA on this issue and has mitigated the impact for clients, who have not been assessed charges on these claims. To learn more about the services available through the MHA UCP, contact Neil MacVicar at the MHA.
A full year after COVID-19 vaccines were made available in the U.S., the coronavirus continues to sicken and kill people, with nationwide deaths from the illness surpassing 800,000. As demonstrated in a collection of headlines, Michigan’s hospitals are being stretched to treat COVID-19 patients across the state.
The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.
Legislation Signed to Delay Sequestration Cuts
President Joe Biden signed legislation Dec. 10 to stop Medicare cuts to hospitals, physicians and other providers from going into effect early next year. As urged by the MHA and the AHA, both the U.S. Senate and House recently voted to pass the legislation.
Specifically, the bill would extend the moratorium on the 2% Medicare sequester cuts until March 31, 2022, and reduce the cuts from 2% to 1% from April 1 through June 30, 2022. The package also would stop the 4% statutory Pay-As-You-Go sequester from taking effect early next year. Other provisions in the package would mitigate a separate Medicare payment cut to physicians; delay payment cuts and private payer data reporting requirements for certain hospital laboratories; and more (see related article). Members with questions may contact Laura Appel at the MHA.
The state Legislature completed work Dec. 14 on Senate Bill 759, which allows healthcare workers licensed in another state to work in Michigan during times of great need (see related article). The MHA issued a media statement both thanking legislators for their support of licensing flexibility and encouraging Gov. Gretchen Whitmer to sign the bill into law as soon as it’s enrolled.
Members with questions may contact Adam Carlson at the MHA.
State Approves Additional Tier-2 COVID Relief Facilities
Fifteen additional Tier-2 COVID Relief Facilities(CRFs) were recently approved by the state at a time when post-acute placements are critically needed.
Tier-2 CRFs can keep their own COVID-19-positive residents and are able to admit new residents who test positive only if additional capacity is needed and the nearest COVID Recovery Center (CRC) is more than 25 miles away or at maximum capacity with patients positive for the disease.
With the additional facilities, there are currently 27 CRFs in the state. While this is a positive development, the number is significantly lower than the more than 100 CRFs the state had approved before starting its annual renewal process in October. That process took nearly a month to approve the additional facilities. The MHA continues to advocate that the state not use an annual application process for approving CRFs due to the time involved and the delays it causes for hospital transfer.
In addition, Michigan currently has no Tier-2 CRFs north of Grayling. Therefore, the MHA isurging the state to work with facilities in the northern Lower Peninsula and Upper Peninsula to quickly approve them as CRFs. Members with questions may contact Paige Fults at the MHA.
Changes Continue with Legal Action on Vaccine Mandates
The U.S. Court of Appeals for the Fifth Circuit issued a ruling Dec. 15 ordering the Centers for Medicare & Medicaid Services (CMS) vaccine mandate rule to resume in about half of the country while saying 24 states are not subject to the mandate. This means that the mandate is back in place for Michigan, requiring healthcare workers to be fully vaccinated.However, the suspension of enforcement of the mandate continues.
The Fifth Circuit upheld the Louisiana district court’s preliminary injunction as applied to facilities in the 14 states that are plaintiffs in the case. An additional 10 states that are plaintiffs in a Missouri case do not need to comply with the mandate while the injunction stands. Michigan is not a plaintiff in either lawsuit.
The American Hospital Association (AHA) provides a blog with the latest details of the CMS vaccine mandate cases, as well as an update on an appeals court ruling challenging the Occupational Safety and Health Administration vaccine mandate.
The recent court actions are additional steps toward the suits eventually being appealed to the U.S. Supreme Court. These legal actions do not impact individual organizations’ vaccine policies. Members with questions should contact Amy Barkholz at the MHA.
The number of hospitalizations in Michigan due to confirmed and suspected cases of COVID-19 was the lowest since early November during the week of Jan. 31. However, with 2,882 adults and 70 children hospitalized Feb. 4 with confirmed and suspected COVID-19, some facilities in the state continue to be filled to or near capacity.