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Important Updates and Resources for Long-Term Care Providers


COVID-19 Updates, Preparation and Resources

We are closely monitoring the news and guidance concerning COVID-19 and are working with the Governor’s office, the Indiana Department of Health and AHCA/NCAL, to ensure our member providers receive the necessary guidance to care for the most vulnerable Hoosiers during this public health emergency. Visit this webpage daily to access the latest updates.

June 17:  Qsource Tip Sheet for NHSN COVID-19 Reporting



June 11:  IDH Releases Updated Visitation Guidelines, Visitation Signage, and FAQs Document

Please Note:  On June 11, 2021, this article was updated to include the Indiana Department of Health’s (IDH) FAQ Document on the recently updated Visitation Guidelines.  The Visitation Signage was also updated to clarify that indoor visitation can be limited in certain circumstances and that residents in semi-private rooms are permitted more than one (1) visitor, if social distancing allows.  If the roommate is present, then the curtain should be pulled during the visit.  As a reminder, the Visitation Signage must be posted conspicuously for both residents and visitors to see (i.e., at the entrance and next to other required notices) in both nursing facilities and residential care facilities (licensed assisted living).  In addition, all resident families / designated representatives must receive this signage as a notification.  This can be done electronically or in line with a facility’s current family notification procedure.  IDH surveyors will check to make sure each facility has posted the sign as required, along with confirming that visitation is being provided as outlined by the Visitation Guidelines.

This article was previously updated on June 4 based on the updated Visitation Guidelines are as follows:

  • Visitation Hours:  Per CMS, visitation should be allowed at all times, unless otherwise outlined below.  A facility’s normal visitation hours should be visibly posted (12 hours are required of residential care facilities and 9 hours are required of nursing facilities per state regulations), but facilities should work with residents to allow visitation at all times if their visitors are not able to visit during normal visitation hours, including for compassionate care situations.  Any visitation denials should be well documented regarding the reason for denial (i.e., visitor did not pass COVID-19 screening questions, resident did not want visitation at that time, etc.).
  • Length of Visits:  The length of visits should not be limited.  Additionally, there should be no limit on the number of visits a resident can have per day or per week, including if it is the same visitor coming daily.
  • Number of Visitors:  The number of visitors can be restricted to allow social distancing in semi-private rooms, but at least two (2) visitors must be allowed at any one time.  In other words, a visitor in a semi-private room may have more than one (1) visitor; if the roommate is present, the curtain should be pulled during the visit.  In a private resident’s room, a vaccinated resident may have any number of vaccinated visitors at one time as space allows.

Read more


June 11:  HHS Releases Updated PRF Reporting Requirements

On June 11, 2021, the U.S. Department of Health and Human Services (HHS) released updated reporting requirements for recipients of Provider Relief Fund (PRF) payments.  With this announcement, HHS expands the amount of time providers will have to report information and extends key deadlines for expending PRF payments for recipients who received payments after June 30, 2020.  Highlights of the updated reporting requirements are as follow:

  • The period of availability of funds is based on the date the payment is received, as outlined in the chart below, rather than requiring all payments to be used by June 30, 2021, regardless of when they were received.



June 11:  Reminder:  Enforcement of COVID-19 Vaccine Rule Requirements Begins June 14

As a reminder, enforcement of CMS’s Interim Final Rule on COVID-19 Vaccine Requirements will begin Monday, June 14.  A summary of the Interim Final Rule can be found here.  Most importantly, nursing facilities, at a minimum, should have reported their vaccination data for the week of May 31 – June 5 by Sunday, June 13 at midnight to avoid a Civil Monetary Penalty (CMP).

Also, please note that CMS will publicly release facility-level resident and staff COVID-19 vaccination data collected through NHSN on Thursday every week.  As of May 30, only 28.5% of nursing facilities across the country had reported data, and 29.6% of nursing facilities in Indiana had reported data.


June 11:  OSHA’s Emergency Temporary Standard for Health Care Workers

On June 10, 2021, the federal Occupational Safety and Health Administration (OSHA) released new requirements for frontline health care workers through an Emergency Temporary Standard (ETS).  The full ETS rule can be found here, and a helpful summary of the ETS can be found here.  The rule is effective immediately and applies to all health care workers, including long-term care facilities (except for off-site corporate and medical billing locations).  We encourage you to review the requirements of the ETS with counsel.



June 4:  IDH Issues Updated COVID-19 LTC Infection Control Guidance Standard Operating Procedure

Please Note:  On June 4, 2021, this article was updated to reflect recent changes to the Indiana Department of Health’s (IDH) Infection Control Standard Operating Procedure based on the National Institute for Occupational Safety and Health’s (NIOSH) new ​​guidance that health care providers should only use N-95 respirators, rather than K-95 respirators (when N-95 respirators are required), and should not be using crisis standards, as availability of N-95 respirators is sufficient.  Accordingly, IDH’s Infection Control Standard Operating Procedure was updated to state:

  • Facilities should transition away from the use of K-95s; and
  • When possible, by supply and lower transmission in the facility, mask use can return to conventional usage and NIOSH-approved N-95 respirators.

IDH has verbally clarified that facilities do not have to return to conventional N-95 use immediately and may use up any remaining K-95 supply, but going forward, facilities should start only obtaining N-95 respirators (and not K-95 respirators) and transition to that supply.  As a reminder, N-95 respirators should be worn in Red and Yellow units, and the NIOSH Certified Equipment List may be utilized to identify all NIOSH-approved respirators.  IHCA/INCAL’s PPE Conservation Toolkit is also a helpful tool to track inventory and transition between conservation and conventional PPE use, including a Burn Rate Calculator.

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June 1:  Indiana Extends Public Health Emergency to July 1, 2021

On  May 28, 2021, Governor Eric Holcomb issued Executive Order 21-14, which extends Indiana’s public health emergency until July 1, 2021.  Indiana’s public health emergency was set to expire on June 30, 2021, and can be extended in 30-day increments at a time under state law.   The federal public health emergency has been extended through July 20, 2021, and is expected to be extended for 90 days at a time through the end of 2021.

Due to the extension of the state’s public health emergency, Indiana’s emergency orders and waivers are also extended until July 1, 2021.  For a summary of Indiana’s current emergency orders and waivers, please click here.

May 28:  Updated:  CARES Act COVID-19 Relief for A&D Waiver Assisted Living Providers – Applications Due by July 31, 2021

Please Note:  On May 28, 2021, this article was updated to reflect recent clarifications from the Indiana Family and Social Services Administration (FSSA), including an example calculation of a COVID-19-related expense, clarification that the loss of revenue due to a decline in census will not be considered a direct expense for purposes of this application, and an estimated approval timeline as outlined further below.

On May 19, 2021, FSSA released a bulletin outlining relief for COVID-19-related expenses for Aged & Disabled (A&D) Waiver assisted living providers utilizing Coronavirus Aid, Relief and Economic Security (CARES) Act funding.  The deadline to apply is July 31, 2021.

Please note, this relief utilizing CARES Act funding is separate and distinct from the enhanced FMAP that has been made available to states through the American Rescue Plan.

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May 28: Indiana’s Nursing Home ECHO Program – Phase II Starting August 26, 2021

Phase II of Indiana’s Nursing Home ECHO Program is starting August 26 – 31, 2021, for approximately 20 weeks.  Each cohort includes regularly scheduled meetings consisting of presentations that address emerging COVID-19 issues affecting long-term care and collaborative case-based learning.



COVID-19 Vaccine Updates

IHCA/INCAL has developed this page to list relevant COVID-19 vaccine resources. As we receive more information, we will continue to update this page with latest information.

Latest Updates

Vaccine Guidance & Resources


Indiana Department of Health




American Medical Directors Association

Pharmacy Partnerships for LTC Providers




Janssen COVID-19 Vaccine Information (Revised to include information about the risk of thrombosis-thrombocytopenia syndrome)

Moderna COVID-19 Vaccine EUA Issued

The Food and Drug Administration issued the Emergency Use Authorization (EUA) for Pfizer’s COVID-19 vaccine on December 18, 2020.  This EUA Fact Sheet is now available and will help you communicate with residents, family and staff regarding the vaccine.

Pfizer COVID-19 Vaccine EUA Issued

The Food and Drug Administration issued the Emergency Use Authorization (EUA) for Pfizer’s COVID-19 vaccine on December 12, 2020.  This EUA Fact Sheet is now available and will help you communicate with residents, family and staff regarding the vaccine.

Testing Guidance & Updates

Latest Updates

Regulatory Requirements and Important Resources

Important Contacts

  • Probari Phone number: Please call 317-804-4102 with any questions/issues.
  • ZOTEC Help Desk:  Please call 866-254-4628 with any questions/issues related to registration.
  • Patients Choice Laboratories (PCL): PCL, based in Indianapolis, Indiana, is a leading provider of comprehensive laboratory testing services throughout the United States. For more info, please visit

IDH Guidance & Resources

Infection Control and Surveys

Visitation Guidance

General Guidance

Quarantine Guidance

Signage and Forms

Essential Family Caregiver

Reporting and Testing

Cohorting Guidance

Weekly Webinars

Upcoming Webinar | June 17, 2021 from 12-1 p.m. EST

As of April 15 the Indiana Department of Health will be unable to participate in the webinars on a weekly basis.  However, IHCA/INCAL staff will continue to host the webinars to answer your questions and provide guidance.  IHCA/INCAL will engage IDOH on issues that cannot be answered during each webinar and also plan with IDOH on the times that they can participate in some of the webinars.


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Webinar Recordings and Handouts

June 17, 2021


ACCESS FAQs 6.11.2021


June 10, 2021



June 3, 2021






May 27, 2021



May 20, 2021



May 13, 2021



May 6, 2021



April 29, 2021



April 22, 2021




April 15, 2021



April 8, 2021


April 1, 2021





To access archive recordings from 2020, please click here.


EMResource is a web-based resource management and communication tool used to monitor and notify changes in resources statuses. IDH is asking you to update your PPE supplies daily in this tool so that resources can be distributed efficiently.

Coordinate account registration with your facility administrator.  We recommend designating at least two individuals that can track and input data into EMResource.


Project ECHO is actively recruiting nursing homes around the country to join an interactive community of practice to advance improvements in COVID-19 preparedness, safety and infection control. Supported by the federal Agency for Healthcare Research and Quality (AHRQ), and in collaboration with the Institute for Healthcare Improvement (IHI), the AHRQ ECHO National Nursing Home COVID-19 Action Network is open to any nursing home across the country at no cost. Explore Project ECHO’ website and resources here and download an informational flyer here.

Project ECHO Resources

Payment & Reimbursement Resources

General Resources



CARES Act Provider Relief Fund

Latest Updates

Federal Reporting Requirements

NHSN Reporting

Related Regulatory Requirements


Waivers & Emergency Orders

Public Health Emergency


Personal Protective Equipment (PPE)


EMResource is a web-based resource management and communication tool used to monitor and notify changes in resources statuses. IDH is asking you to update your PPE supplies daily in this tool so that resources can be distributed efficiently.

Coordinate account registration with your facility administrator.  We recommend designating at least two individuals that can track and input data into EMResource.


Using and Conserving PPE

FEMA COVID-19 Pandemic Response: Nursing Home PPE Packages



CMS Guidance & Resources

LTC Operations

Infection Control



CDC Guidance & Resources

Post-Vaccine Considerations

Return to Work Guidance

Infection Control & PPE Conservation Guidance

Confirmed Case Management Guidance

Testing Guidance


Archive Daily Updates

Please see the daily updates below:

Feb. 25: Hospital to Post-Acute Transfer Assessment and Guidance

December 20: Post COVID-19 Vaccine Considerations for LTC Residents

December 20: Post COVID-19 Vaccine Considerations for Healthcare Personnel

December 11: COVID-19 Vaccine Updates from IHCA/INCAL President Zach Cattell and AHCA President & CEO Mark Parkinson

December 11: CMS Issues Guidance on Visitation in Nursing Facilities & Use of CMP Funds

December 11: IDH Issues Updated Quarantine Guidance for LTC Staff

December 9: LTC Data Dashboard Shows Prolonged COVID-19 Case Increases

December 8: Nursing Home Quality Incentive Program Methodology

December 8: BinaxNOW™ Request Guidance for Long-Term Care Facilities & Assisted Living Memory Care Unit Testing

December 2: Infection Prevention FAQs on Close Contacts, Exposure, & More

December 1: COVID-19 Guidance for NEMT Drivers Transporting Nursing Facility Residents

December 1: HHS Publishes Facility-Specific List of COVID Quality Incentive Payments

December 1: Indiana’s PHE Extended until December 31, 2020

November 30: Opportunity to Participate in a Free One-Time PCR Testing

November 24: Important: Essential Family Caregiver Program Reminder

November 23: Criminal History and Fingerprinting Requirements during the PHE

November 22: NHSN Reporting Changes Effective Nov. 23rd

November 20: PPE Shipments & Outbreak Testing for ALs

November 20: Students Step Up 2 Serve Initiative

November 20: IDH COVID Clinical Checklist

November 19: Three new roles approved for Guard Members: Indiana National Guard Assistance for Nursing Facilities

November 18: IDH & CMS Issues Holiday Guidance for LTCF Residents

November 17: CARES Act Quality Incentive Payment Program

November 17: NHSN To Update Reporting Pathways

November 17: OSHA Releases Frequently Cited Standards Related to COVID-19 Inspections

November 16: Mass Adjustment for Certain $115 Add-on Claims

November 15: Marion County to Require Negative COVID-19 Tests Prior to Indoor Visitation Starting November 25th

November 13: Governor Holcomb Issues Executive Order 20-48 – LTCFs Should Continue to Adhere to CMS & IDH Visitation Guidelines

November 13: COVID-19 Vaccine – LTC Prioritized – Survey Coming

November 13: IDH Issues Updated Visitation Guidelines – 14-Day Quarantine Required for All Excursions

November 10: New Update: HHS NHSN Reporting Requirements

November 9: OSHA Releases Respiratory Protection Guidance for LTCFs

November 9: Bed Changes, Relocations, Use of Unlicensed Space – COVID-19 Facility Emergencies

November 6: IDH Issues Certified Nurse Aide Training Program Orders

November 2: Summary of COVID-19 Emergency Orders and Waivers for Comprehensive Care Facilities from ISDH

November 2: Summary of COVID-19 Waivers, Guidance, and Emergency Orders for Residential Care Facilities from ISDH

October 29: Important: IDH Updates COVID-19 Data Submission Guidelines

October 29: POC Antigen Test and PCR Test Decision Tree

October 27: New Infection Prevention and Control Tools from IDH

October 25: Indiana Department of Health Provides PPE Shipment Details for the Week of October 25

October 22: Updated Reporting Requirements to the Provider Relief Fund

October 21: PPE Vendors and Assistance

October 20: IDH Issues Updated Visitation Guidance

October 19: Indiana Health Care Reserve Workforce

October 16: New Pathway to Report POC Test Results through Electronic Lab Reporting Process

October 9: Continuing Appropriations Act Modifies Accelerated Payment Program & CMS Issues Corresponding Guidance

October 5: Federal Public Health Emergency Extended until January 22, 2021

October 5: Important: Phase 3 General Distribution from the HHS Provider Relief Fund – All Providers Encouraged to Apply

October 2: CMS Issues Guidance on Exemption from Conducting Full-Scale Emergency Preparedness Testing Exercises

October 1: [UPDATED] CMS Issues Guidance on COVID-19 Testing of NF Staff & Residents

September 30: Extension of Temporary Health Care Licenses

September 25: 4.2% Medicaid Nursing Facility Rate Increase Extended

September 25: ISDH Provides Antigen Testing Guidance

September 24: Indiana’s Public Health Emergency Extended until November 1, 2020

September 23: HHS Releases Provider Relief Fund Reporting Guidance

September 23: CMS Updates County COVID-19 Positivity Data | Sept. 3-16, 2020

September 22: Reporting False Positives in COVID-19 Testing

September 18: CMS Issues Visitation Guidance for Nursing Facilities

September 18: New Details on Incentive Payments for Nursing Facilities

September 17: ISDH Renews Blanket Waivers for Comprehensive and Residential Care Facilities

September 16: BinaxNOW COVID-19 Cards – REDCaps Reporting Required

September 15: Assisted Living Funding Allocation Deadline Extended to Sept. 21

September 14: Update to Paid Leave Requirements of the Families First Coronavirus Response Act

September 9: HHS Announces $2 Billion Quality Incentive Program for Nursing Homes

September 8: Point of Care COVID-19 Test Reporting Guidance

September 8: UPL Q4 Interim Payment and COVID-19 add-ons

September 8: Nursing Facility COVID-19 Rate Enhancements

September 8: New COVID-19 Positive $115 Add-on Billing Instructions

September 4: POC test results tracking form and update on ISDH’s reporting mechanism for lab results

September 2: Provider Relief Fund Allocation for Private Pay Assisted Living

September 2: Antigen Tests for Assisted Living Communities

September 2: Updates to NHSN LTCF COVID-19 Module Resident Impact and Facility Capacity Pathway

August 31: Urgent: CMS Issues Guidance on COVID-19 Testing of NF Staff & Residents – Routine Testing to Start September 2,  2020

August 27: Return to Work Decision Tree

August 27: Important: County Positivity Data for NF Staff Testing Now Available

August 27: Requirements of Reporting by CLIA Laboratories

August 25: Important: CMS Issues Interim Final Rule on COVID-19 Testing of NF Staff & Residents – Additional Guidance to Come Before Implementation (Updated August 26, 2020)

August 25: Targeted COVID-19 Training for Frontline Nursing Home Staff & Management

August 17: Important Updates from ISDH on COVID-19 Testing for Nursing Facility Staff

August 13: Updated CDC Guidance on Return to Work Criteria and Discontinuation of Transmission-Based Precautions

August 12: New NHSN Data Elements on Testing

August 12: Changes to Medicaid Tranche Eligibility – Applications Due August 28, 2020

August 12: OSHA Increases Scrutiny on Long-Term Care Facilities

August 10: HHS Opens CHOW Portal

August 7: AHCA Update on HHS CARES Distribution to Nursing Facilities

August 7: Updated – COVID-19 Testing of Nursing Facility Staff Required in August/September

July 31: Deadline Extended: Medicaid Applications for Provider Relief Fund Due August 28, 2020

July 31: CMS Issues FY 2021 SNF Final Payment Rule

July 30: Point-of-Care COVID-19 Antigen Test Kits

July 24: State and Federal Government Extend Waivers for Long-Term Care Facilities

July 24: Updated ISDH COVID-19 LTC Facility Infection Control Guidance and SOP

July 23: ISDH Issues Clarifications on Resident Excursions

July 23: Initial Long-Term Care Data Released

July 17: Four Hours of Visitation Required Starting July 17, 2020

July 11: Update: Long-Term Care COVID-19 Data Reporting and EHR Survey

July 2: Urgent: Long-Term Care Data Required by July 14, 2020, 6PM EDT

July 1: NHSN Reporting Problems, Tags, and Penalties

July 1: Nursing Licensure Compact – Effective July 1, 2020

June 30: ISDH Issues Updated “Back on Track” Guidelines – Outdoor Visitation Required & Indoor Visitation Permitted July 4, 2020

Sustainable COVID-19 Planning for Long-term Care Facilities

June 26: Updated CARES Act Funding for Waiver Assisted Living Providers

June 26: Updated Visitation Guidance Expected – Outdoor Visitation Required and Indoor Visitation Permitted on July 4, 2020

June 26: CMS Ends Blanket Waiver on Staffing Data – Q2 Staffing Data Due August 14, 2020

June 19: ISDH Guidance on Environmental Steps to Reduce Indoor COVID-19 Transmission

June 18: Announcement Regarding Upcoming Medicaid Cost Report

June 18: Nursing Facility Staff Testing Portal to View Results and Report Tests

June 18: HHS Offers Medicaid Allocation Application Tutorials

June 15: ISDH FAQs – Outdoor Family Visitation at LTCFs

June 15: Updated COVID-19 Specimen Collection and Submission Guidelines

June 11: NHSN Reporting Compliance Tips – Avoid CMPs and Nursing Home Compare Points

June 11: OIG Audit of Nursing Facilities for Infection Control and Emergency Preparedness

June 8: Indiana Medicaid Clarifies How to “De-Attest” COVID-Ready Status

June 8: Nursing Facility Staff COVID-19 Testing Registration

June 2: COVID-19 Survey Activities and Enhanced Enforcement for Infection Control Deficiencies

June 2: June 3 Attestation Deadline Applies Only to Medicare FFS Provider Relief Payment

June 1: Contact Tracing Calls

May 29: IHCA/INCAL Guidelines for Resident Voting at a Public Polling Site During COVID-19 Pandemic

May 29: IHCA/INCAl’s Letter to ISDH on Nursing Facility Staff Testing Effort

May 26: NHSN Reporting Update and FAQs

May 26: Revised OSHA COVID-19 Policies

May 26: CARES Attestation Window Extended

May 19: CMS Nursing Home Reopening Recommendations and AHCA Memorandum on COVID-19 Testing in LTCFs

May 18: Updated COVID-19 Specimen Collection and Submission Guidelines

May 18: Updated ISDH Strategies for Memory Care Units

May 18: Equal Employment Opportunity Commission COVID-19 Testing Guidance

May 18: ISDH Asks Nursing Homes for Feedback on Testing of Staff

May 15: New Temporary Rate Increases for COVID-19 Ready Units and COVID-19 Positive Residents in Nursing Facilities

May 13: APIC Indiana Long-Term Care COVID-19 Networking and Open Forum Sessions

May 11: Additional COVID-19 Emergency Declaration Waivers for Nursing Facilities

May 11: Hospital to Post-Acute Care Transfer COVID-19 Assessment Form

May 11: NHSN: Accurately Report Staffing & PPE Shortages

May 10: COVID-19 Testing Strategies

May 10: Required IOSHA COVID-19 Safety Plans

May 8: Fire Safety Considerations for Hand Sanitizers

May 6: COVID-19 Waivers, Guidance, and Emergency Orders for Residential Care Facilities from ISDH

May 6: COVID-19 Emergency Orders and Waivers for Comprehensive Care Facilities from ISDH

May 6: CMS Releases Memo on Interim Final Rule Updating Requirements for Reporting and Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes

May 3: CMS Issues Additional Blanket Regulatory Waivers

May 3: Effective Date of CMS Interim Final Rule on COVID-19 Reporting for Nursing Homes

May 3: CMS Issues Additional Blanket Regulatory Waivers

May 1: CMS Issues Interim Final Rule with New Requirements for COVID-19 Reporting for Long-Term Care Facilities

April 29: Indiana COVID-19 Testing Sites

April 27: AHCA/NCAL Grant & Loan Management Resource Guide

April 27: COVID-19 Related Loss and Cost Calculator

April 27: Updated – Accelerated and Advance Payments FAQs

April 25: Five Star Updates, Nursing Home Staff Counts, and FAQs

April 25: CMS Updates COVID-19 FAQs on Medicare FFS Billing

April 24: CMS Releases CMP Reinvestment Application for Communication Technologies

April 23: Available “Quickinar” on Best Practices for Transition of Care between Nursing Facilities and Dialysis Centers

April 20: IHCA/INCAL Summary on Fifth Blanket Waiver for Residential Care Facilities and Additional Temporary Nurse Aide Guidance

April 20: Reminder: New RedCap Survey for COVID-19 Reporting – Effective Monday, April 20, 2020

April 20: Stay-at-Home Order Extended until May 1, 2020

April 18: ISDH Issues Additional CNA Flexibilities

April 17: Updated CDC Guidance for Return to Work Criteria and Source Control

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