Latest Insights and Updates

The requirement for the "Daily Entry" with the NHSN has gone through four to five massive iterations over the past six months. These fields are constantly changing; sometimes being removed, sometimes returning to the required dataset. We've done our best to document these fields so there's more clarity around what the NHSN is actually asking for. It has been common that customers don't understand what the calculated value of each of these fields is. This information is accurate as of the writing of this article. As always, please refer to the NHSN's COVID-19 Module for the most recent information.

• Resident Fields
• Staff Fields
• Supplies Fields
• Ventilator Fields
• Therapeutic Fields

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Resident Fields

This list of resident fields does not include the growing array of vaccine fields. For brevity and focus, we've omitted those fields. For reference, here is the NHSN's official guide for the resident fields as of the publishing of this article.

Res Pos

Key: numrespostest

Required: Optional

POSITIVE TESTS: Number of residents with a new positive COVID-19 viral test result.

Range: 0 to 3000

Instructions: Must be a whole number

Res Susp

Key: numressuspc19

Required: Optional

SUSPECTED: Residents with new suspected COVID-19

Range: 0 to 3000

Instructions: Must be a whole number

Admitted

Key: numresadmc19

Required: Optional

ADMISSIONS: Residents admitted or readmitted from another facility who were previously diagnosed with COVID-19 and continue to require transmission-based precautions. Excludes recovered residents.

Range: 0 to 3000

Instructions: Must be a whole number Must be <=3000

Deaths

Key: numresdied

Required: Optional

TOTAL DEATHS: Residents who have died for any reason in the facility or another location

Range: 0 to 10000

Instructions: Must be a whole number Must be <=10000

C19 Deaths

Key: numresc19died

Required: Optional

COVID-19 DEATHS: Of the number of reported Total Deaths, report the number of residents with COVID-19 who died in the facility or another location.

Range: 0 to 10000

Instructions: Must be a whole number Must be <=10000

Beds

Key: numltcfbeds

Required: Optional

ALL BEDS (FIRST SURVEY ONLY): Total number of beds within the certified Medicare and/or Medicaid long-term care facility

Range: 0 to 3000

Instructions: Must be a whole number Must be <=3000

Census

Key: numltcfbedsocc

Required: Optional

CURRENT CENSUS: Total number of beds that are occupied on the reporting calendar day

Range: 0 to 3000

Instructions: Must be whole number Must be <= All Beds, if populated, or <=3000

Testability

Key: staffc19testability

Required: Optional

TESTINGSTAFF: Does the LTCF have the ability to perform or to obtain resources for performing SARS-CoV-2 viral testing (NAAT [PCR] or antigen) on all staff and facility personnel within the next 7 days, if needed?

Instructions: Y for Yes N for No

Testability

Key: resc19testability

Required: Optional

TESTINGRESIDENT: Does the LTCF have the ability to perform or to obtain resources for performing SARS-CoV-2 viral testing (nucleic acid/PCR or antigen) on all current residents within the next 7 days, if needed?

Instructions: Y for Yes N for No

POC Res

Key: resc19poctestperf

Required: Conditionally Required

Since the last date of data entry in the Module, how many COVID-19 point-of-care tests has the LTCF performed on residents

Range: 0 to 3000

Instructions: Must be a whole number Required if perfC19Test = Y

POC Staff

Key: staffc19poctestperf

Required: Conditionally Required

Since the last date of data entry in the Module, how many COVID-19 point-of-care tests has the LTCF performed on staff and/or facility personnel?

Range: 0 to 3000

Instructions: Must be a whole number Required if perfC19Test = Y

Antigen

Key: numrespostestposag

Required: Conditionally Required

TEST TYPE: Of the number of reported residents above with a Positive Test, how many were tested using positive SARS-CoV-2 antigen test only (no other testing performed)

Range: 0 to 3000

Instructions: Must be a whole number Required if numResPosTest > 0. If entered, sum of all 4 numResPosTest tests must = numResPosTest

PCR

Key: numResPosTestPosNAAT

Required: Conditionally Required

TEST TYPE: Of the number of reported residents above with a Positive Test, how many were tested using positive SARS-CoV-2 NAAT (PCR)

Range: 0 to 3000

Instructions: Must be a whole number Sum of all 4 numResConfC19 tests must be <= numResConfC19

Antigen/PCR

Key: numResPosTestPosAgNegNAAT

Required: Conditionally Required

TEST TYPE: Of the number of reported residents above with a Positive Test, how many were tested using positive SARS-CoV-2 antigen test and negative SARS CoV-2 NAAT (PCR)

Range: 0 to 3000

Instructions: Must be a whole number Sum of all 4 numResConfC19 tests must be <= numResConfC19

Other

Key: numResPosTestOther

Required: Conditionally Required

TEST TYPE: Of the number of reported residents above with a Positive Test, how many were tested using any other combination of SARS-CoV-2 NAAT (PCR) and/or antigen test(s) with at least one positive test

Range: 0 to 3000

Instructions: Must be a whole number Sum of all 4 numResConfC19 tests must be <= numResConfC19

Reinfected

Key: numResPosTestReinf

Required: Required

RE-INFECTIONS: Of the number of reported residents above with a Positive Test, how many were considered as re-infected?

Range: 0 to 3000

Instructions: Must be a whole number Must be <= numResPosTest

Reinfect Symp

Key: numResPosTestReinfSymp

Required: Optional

SYMPTOMATIC: Of the number of reported residents with Re- Infections, how many had signs and/or symptoms consistent with COVID-19?

Range: 0 to 3000

Instructions: Must be a whole number numResPosTestReinfSymp + numResPosTestReinfAsymp must be <= numResPosTestReinf

Reinfect Asymp

Key: numResPosTestReinfASymp

Required: Optional

ASYMPTOMATIC: Of the number of reported residents with Re- Infections, how many did not have signs and/or symptoms consistent with COVID-19?

Range: 0 to 3000

Instructions: Must be a whole number numResPosTestReinfSymp + numResPosTestReinfAsymp must be <= numResPosTestReinf

Flu

Key: numresconfflu

Required: Optional

INFLUENZA: Number of residents with new influenza (flu).

Range: 0 to 3000

Instructions: Must be a whole number

Other Resp

Key: numresothresp

Required: Optional

RESPIRATORY ILLNESS: Number of residents with acute respiratory illness symptoms, excluding COVID-19 and/or influenza (flu).

Range: 0 to 3000

Instructions: Must be a whole number

Coinfection

Key: numresconffluc19

Required: Optional

INFLUENZA and COVID-19: Number of residents with a confirmed co- infection with influenza (flu) and SARS-CoV-2 (COVID-19).

Range: 0 to 3000

Instructions: Must be a whole number

Viral Tests

Key: perfc19test

Required: Optional

Since the last date of data entry in the Module, has your LTCF performed SARS-COV-2 (COVID-19) viral testing?

Instructions: Y for Yes N for No

Non POC Res

Key: resc19nonpoctestperf

Required: Conditionally Required

Since the last date of data entry in the Module, how many COVID-19 NON point-of-care tests has the LTCF performed on residents

Instructions: Must be a whole number Required if perfC19Test = Y

Non POC Staff

Key: staffc19nonpoctestperf

Required: Conditionally Required

Since the last date of data entry in the Module, how many COVID-19 NON point-of-care tests has the LTCF performed on staff and/or facility personnel?

Instructions: Must me a whole number Required if perfC19Test = Y

Latency

Key: c19nonpoctestresults

Required: Optional

During the past two weeks, on average, how long did it take your LTCF to receive SARS-CoV-2 (COVID-19) viral test results of staff and/or facility personnel?

Instructions: <1 DAY for Less than one day 1-2 DAYS -for 1-2 days 3-7 DAYS for 3-7 days >7 DAYS for More than 7 days NOTEST for No testing performed in the past two weeks on residents or staff and/or facility personnel

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Staff Fields

You will notice that some of the staff fields are actually in the resident file. For reference, here is the NHSN's official guide for the staff fields as of the publishing of this article.

Staff Pos

Key: numStaffPosTest

Required: Optional

POSITIVE TESTS: Number of staff and facility personnel with a new positive COVID-19 viral test result.

Range: 0 - 1000

Instructions: Must be a whole number

Antigen

Key: numStaffPosTestPosAg

Required: Optional

TEST TYPE: Of the number of reported staff and facility personnel above with a Positive Test, how many were tested using positive SARS- CoV-2 antigen test only (no other testing performed)

Instructions: Must be a whole number Required if numStaffPosTest > 0. If entered, sum of all 4 numStaffPosTest tests must = numStaffPosTest

PCR

Key: numStaffPosTestPosNAAT

Required: Conditionally Required

TEST TYPE: Of the number of reported staff and facility personnel above with a Positive Test, how many were tested using positive SARS- CoV-2 NAAT (PCR) [no other testing performed]

Instructions: Must be a whole number Required if numStaffPosTest > 0. If entered, sum of all 4 numStaffPosTest tests must = numStaffPosTest

Antigen/PCR

Key: numStaffPosTestPosAgNegNAAT

Required: Conditionally Required

TEST TYPE: Of the number of reported staff and facility personnel above with a Positive Test, how many were tested using positive SARS- CoV-2 antigen test and negative SARS-CoV-2 NAAT (PCR)

Instructions: Must be a whole number Required if numStaffPosTest > 0. If entered, sum of all 4 numStaffPosTest tests must = numStaffPosTest

Other

Key: numStaffPosTestOther

Required: Conditionally Required

TEST TYPE: Of the number of reported staff and facility personnel above with a Positive Test, how many were tested using any other combination of SARS-CoV-2 NAAT (PCR) and/or antigen test(s) with at least one positive test

Instructions: Must be a whole number Required if numStaffPosTest > 0. If entered, sum of all 4 numStaffPosTest tests must = numStaffPosTest

Reinfected

Key: numStaffPosTestReinf

Required: Conditionally Required

RE-INFECTIONS: Of the number of reported staff and facility personnel above with a Positive Test, how many were considered as re-infected?

Instructions: Must be a whole number Required where numStaffPosTest > 0. Must be <= numStaffPosTest

Reinfect Symp

Key: numStaffPosTestReinfSymp

Required: Optional

SYMPTOMATIC: Of the number of reported staff and facility personnel with Re-Infections, how many had signs and/or symptoms consistent with COVID-19?

Instructions: Must be a whole number

Reinfect Asymp

Key: numStaffPosTestReinfASymp

Required: Optional

ASYMPTOMATIC: Of the number of reported staff and facility personnel with Re-Infections, how many did not have signs and/or symptoms consistent with COVID-19?

Instructions: Must be a whole number

C19 Deaths

Key: numStaffC19Died

Required: Optional

COVID-19 DEATHS: Number of staff and facility personnel with COVID- 19 who died.

Range: 0 - 1000

Instructions: Must be a whole number

Flu

Key: numStaffConfFlu

Required: Optional

INFLUENZA: Number of staff and facility personnel above with new influenza (flu).

Range: 0 - 3000

Instructions: Must be a whole number

Other Resp

Key: numStaffOthResp

Required: Optional

RESPIRATORY ILLNESS: Number of staff and facility personnel with acute respiratory illness symptoms, excluding COVID-19 and/or influenza (flu).

Range: 0 - 3000

Instructions: Must be a whole number

Coinfection

Key: numStaffConfFluC19

Required: Optional

INFLUENZA and COVID-19: Number of staff and facility personnel with a confirmed co-infection with influenza (flu) and SARS-CoV-2 (COVID-19).

Instructions: Must be a whole number Must be <= numStaffConfC19 and <= numStaffConfFlu

Short Nurse

Key: shortNurse

Required: Optional

Does your organization have a shortage of Nursing Staff: registered nurse, licensed practical nurse, vocational nurse?

Instructions: Y for Yes N for No

Short Clinic

Key: shortClin

Required: Optional

Does your organization have a shortage of Clinical Staff: physician, physician assistant, advanced practice nurse?

Instructions: Y for Yes N for No

Short Aide

Key: shortAide

Required: Optional

Does your organization have a shortage of Aide: certified nursing assistant, nurse aide, medication aide, and medication technician?

Instructions: Y for Yes N for No

Short Staff

Key: shortOthStaff

Required: Optional

Does your organization have a shortage of Other staff or facility personnel, regardless of clinical responsibility or resident contact not included in the categories above (for example, environmental services)?

Instructions: Y for Yes N for No

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Supplies Fields

For reference, here is the NHSN's official guide for the supplies fields as of the publishing of this article.

N95 Masks Today

Key: n95maskadeqtoday

Required: Optional

Do you have an adequate supply: N95 Masks

Range: Y or N

Instructions: Y for Yes or N for No

N95 Masks Week

Key: n95maskadeqweek

Required: Optional

Do you have enough for next week: N95 Masks

Range: Y or N

Instructions: Y for Yes or N for No

Sugical Masks Today

Key: surgmaskadeqtoday

Required: Optional

Do you have an adequate supply: Surgical Masks

Range: Y or N

Instructions: Y for Yes or N for No

Surgical Masks Week

Key: surgmaskadeqweek

Required: Optional

Do you have an adequate supply: Surgical Masks

Range: Y or N

Instructions: Y for Yes or N for No

Eye Protection Today

Key: eyeprotectadeqtoday

Required: Optional

Do you have an adequate supply: Eye protection, including face shields or goggles

Range: Y or N

Instructions: Y for Yes or N for No

Eye Protection Week

Key: eyeprotectadeqweek

Required: Optional

Do you have an adequate supply: Eye protection, including face shields or goggles

Range: Y or N

Instructions: Y for Yes or N for No

Gowns Today

Key: gownadeqtoday

Required: Optional

Do you have an adequate supply: Gowns

Range: Y or N

Instructions: Y for Yes or N for No

Gowns Week

Key: gownadeqweek

Required: Optional

Do you have an adequate supply: Gowns

Range: Y or N

Instructions: Y for Yes or N for No

Gloves Today

Key: gloveadeqtoday

Required: Optional

Do you have an adequate supply: Gloves

Range: Y or N

Instructions: Y for Yes or N for No

Gloves Week

Key: gloveadeqweek

Required: Optional

Do you have an adequate supply: Gloves

Range: Y or N

Instructions: Y for Yes or N for No

Sanitizer Today

Key: sanitizeradeqtoday

Required: Optional

Do you have an adequate supply: Alcohol-based hand sanitizer

Range: Y or N

Instructions: Y for Yes or N for No

Sanitizer Week

Key: sanitizeradeqweek

Required: Optional

Do you have an adequate supply: Alcohol-based hand sanitizer

Range: Y or N

Instructions: Y for Yes or N for No

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Ventilator Fields

Vent

Key: ventunit

Required: Required

Do you have a ventilator dependent unit in your facility

Range: Y or N

Instructions: Must be Y for Yes or N for No

Total

Key: numvent

Required: Optional

Mechanical Ventilators: Total number of available in your facility

Range: 0 to 2000

Instructions: Must be a whole number Must be <= ALL BEDS, or <=2000

C19 Num

Key: numventc19

Required: Optional

Mechanical Ventilators in Use: Total number of mechanical ventilators in use for residents that have suspected, or lab confirmed COVID-19

Range: 0 to 2000

Instructions: Must be a whole number Must be <= ALL BEDS, or <=2000

Supp Today

Key: ventadeqtoday

Required: Optional

Ventilator Supplies: Do you have an adequate supply?

Range: Y or N

Instructions: Must be Y for Yes or N for No

Supp Week

Key: ventadeqweek

Required: Optional

Ventilator Supplies: Do you have enough for one week?

Range: Y or N

Instructions: Must be Y for Yes or N for No

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Therapeutics Fields

For reference, here is the NHSN's official guide for the therapeutics fields as of the publishing of this article.

Bamlan This

Key: therapeutic_0

Required: Optional

Total residents treated with Bamlan therapeutics at this facility.

Range: 0 to 2000

Instructions: Must be a whole number

Bamlan Other

Key: therapeutic_1

Required: Optional

Total residents treated with Bamlan therapeutics at other facilities.

Range: 0 to 2000

Instructions: Must be a whole number

Casimdev This

Key: therapeutic_2

Required: Optional

Total residents treated with Casimdev therapeutics at this facility.

Range: 0 to 2000

Instructions: Must be a whole number

Casimdev Other

Key: therapeutic_3

Required: Optional

Total residents treated with Casimdev therapeutics at other facilities.

Range: 0 to 2000

Instructions: Must be a whole number

Bametes This

Key: therapeutic_4

Required: Optional

Total residents treated with Bametes therapeutics at this facility.

Range: 0 to 2000

Instructions: Must be a whole number

Bametes Other

Key: therapeutic_5

Required: Optional

Total residents treated with Bametes therapeutics at other facilities.

Range: 0 to 2000

Instructions: Must be a whole number

CMS has published updated ICD-10 codes for providers to start using effective January 1st, 2021. This update subsequently aligns with when providers will start rolling out COVID-19 vaccinations. There are two branches in these updates:

• New COVID-19 Diagnosis Codes
• New COVID-19 Procedure Codes

Some of the notable ICD-10 codes in this update:

• J12.82 Pneumonia due to coronavirus disease 2019
• M35.81 Multisystem inflammatory syndrome
• M35.89 Other specified systemic involvement of connective tissue
• Z11.52 Encounter for screening for COVID-19
• Z20.822 Contact with and (suspected) exposure to COVID-19
• Z86.16 Personal history of COVID-19

At EasyReporting we're actually excited about these new codes. The more specificity we can detect about the resident the more accurate data we can provide the NHSN. With the release of these new ICD-10 codes it's hard to imagine the NHSN not tracking COVID-19 vaccinations. We're expecting a NHSN update early January with more data points in the reporting requirements.

Interested in using EasyReporting? Check out our product page.

On November, 23 the NHSN released a new set of CSV templates for the required weekly COVID-19 reporting. These changes came as a surprise and left many providers scrambling. After reviewing the changes the EasyReporting team identified that 26 of the 38 fields had changed. Either the field name had changed or it was a new value being tracked. Here are some of the notable data points the NHSN is now requiring:

• numrespostest Number of residents with a new positive COVID-19 viral test result. This number is all inclusive of all testing; not just POC tests. That means providers need to marry outsourced test results and internal POC test results.
• resc19poctestperf Since the last date of data entry in the Module, how many COVID-19 point-of-care tests has the LTCF performed on residents As per all data points on this report, these numbers are calculated in the context of just the reporting window. In talking with our customers, it is proving difficult to keep track of all POC test results, let alone determine which go into the current reporting window.
• numrespostestposag Of the number of reported residents above with a Positive Test, how many were tested using positive SARS-CoV-2 antigen test only (no other testing performed) If you take the dataset of positive residents within the reporting window, how many were only tested with an antigen test? Pretty tricky to keep track and calculate.
• numResPosTestReinf Of the number of reported residents above with a Positive Test, how many were considered as re-infected?"
• numresconfflu Number of residents with new influenza (flu)
• numresothresp Number of residents with acute respiratory illness symptoms, excluding COVID-19 and/or influenza (flu). Again, this seems a little difficult for a provider to calculate this hand. EasyReporting pulls ICD-10 codes from your EHR and separates out residents with business logic.
• c19nonpoctestresults During the past two weeks, on average, how long did it take your LTCF to receive SARS-CoV-2 (COVID-19) viral test results of staff and/or facility personnel? This metric is part of the old data set. I list it because customers have mentioned calculating this value is pretty meticulous, and the end value submitted to the NHSN is often times inaccurate. With EasyReporting this value is simple to calculate, format, and transmit to the NHSN.

Providers are grappling with how to respond to these rolling changes due to the high frequency and lack of any heads up. One customer had built an internal web application to manage the data collection. When the Nov 23rd update rolled in it was very defeating because the application no longer worked. That seems very discouraging. One things for certain, these rolling updates are not going to go away. At EasyReporting we've developed a system that allows us to adjust to changes of this nature within a business day or two. Our hope is to alleviate the headache of future changes for our customer, so no matter how many updates the NHSN publishes they can sleep well knowing their data is accurate and in compliance.

Curious to read more on the Nov 23rd update? Check out the NHSN's COVID-19 module page.

The Department of Justice (DOJ) announced Wednesday it was expanding an investigation into whether New York is undercounting the number of nursing home residents who are dying from COVID-19.

The inquiry comes in part because New York, unlike other states, only counts coronavirus-related deaths of residents who have died on nursing home properties, not ones who were taken to the hospital, The Associated Press reported Wednesday.

The DOJ has asked for data from hundreds of nursing home facilities, a request Gov. Andrew Cuomo’s (D) administration has refused. The DOJ sent a similar letter requesting nursing home data from New Jersey Gov. Phil Murphy (D).

This article was originally found on thehill.com