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Important Updates and Resources for Long-Term Care Providers


COVID-19 Latest News, Guidance & Resoruces

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.


September 24: Pfizer Booster Dose Information

On September 24, 2021 the Centers for Disease Control and Prevention (CDC) as well as the Food and Drug Administration (FDA) approved a booster shot of the Pfizer-BioNTech COVID-19 vaccine for certain groups of individuals, including residents and health care workers in long-term care. This decision by the CDC and DFA offers another layer of protection that we need to fight the coronavirus that uniquely targets our vulnerable long-term care population.

The Indiana Department of Health (IDH) also supports the administration of Pfizer vaccine booster dose to people 18 years and older who completed the Pfizer COVID-19 vaccine as their primary series, and it has been at least six months since receiving the second dose, and they attest to meeting CDC guidelines as outlined here.




September 20: Indiana Medicaid Announces New Reimbursement for COVID-19 Ready Nursing Facilities

On the afternoon of September 20, 2021, Indiana Medicaid released a new policy increasing reimbursement for COVID-19 Ready nursing facilities.  The policy is in response to the need to ease the growing stresses on the state’s hospital capacity by helping nursing facilities offset the growing and large costs for operating COVID-19 units.  The effective dates for qualifying providers are dates of services between September 20, 2021 and October 16, 2021.

The temporary increases are 4% per patient day (all Medicaid patients in the facility) for facilities that attest to being COVID-19 Ready and an additional $230 per COVID-19 positive resident.




September 16: Additional Details for Provider Relief Fund (PRF) Phase 4 and Rural Distribution

Yesterday, the Health Resources and Services Administration (HRSA) released additional details on the $25 billion September 10th announcement composed of the $17 billion Phase 4 distribution and the $8.5 billion rural distribution.  The announcement yesterday also provided information on Phase 3 distribution reconsiderations and a PRF grace period for reporting.



September 16: NHSN LTCF Updates Set for September 18

The Centers for Disease Control and Prevention (CDC) National Health Safety Network issued this summary of updates coming to the LTCF Module beginning Saturday, September 18, 2021. Key updates are listed below:

  • Resident Impact and Facility Capacity Pathway Updates: Enhancements to the POC test reporting tool and COVID-19 pathway data reporting are included in the updates.  Revised forms, instructions, FAQs and CSV templates are part of the updates.  NHSN will hold as webinar on Monday, September 20, 2021 from 1-2pm ET to discuss these updates.  You can register in advance for the webinar.


  • Vaccine Data Module Updates: In addition, the NHSN notice included changes to the COVID-19 vaccination data modules and listed new categories that would be required to be reported.  A webinar reviewing these changes for long-term care facilities will be held on September 23, 2021, from 2-3 PM ET.  Facilities can register at the link below:


Read the full update here.


September 16: IDH Reminder on Monoclonal Antibody Distribution and Use

IDH’s LTC Medical Director, Dr. Vuppalanchi, provided a reminder on the distribution and use of monoclonal antibody treatments.  Please see below for Dr. Vuppalanchi’s article:

The U.S. Department of Health and Human Services (HHS) transitioned from the direct ordering process for MAB to a state-coordinated distribution system, similar to that used from November 2020 to February 2021.

LTC facilities or pharmacies with capability to provide monoclonal antibody (MAB), please complete this REDCap survey to be added to the Indiana Department of Health’s monoclonal antibody therapeutics distribution list.




September 10: Indiana Department of Health Issues Important Updates to Guidance Documents for Long-Term Care Providers Health

The Indiana Department of Health has updated the COVID-19 Clinical Guidance document, COVID-19 Regulatory Visitation and Activities Guidance and COVID-19 LTC Infection Control Guidance.  All three of these new guidance documents have also been incorporated into the COVID-19 LTC Toolkit. The  IHCA/INCAL team has summarized the key reminders as reflected in the updated documents for our member providers. To access IHCA/INCAL guidance summaries, please click on the links below:

IDH Updates LTC COVID-19 Clinical Guidance

IDH Updates LTC COVID-19 Infection Control Guidance

IDH Issues Updated Visitation and Activities Guidance


September 10: HHS Distributes Phase 4 Provider Relief Fund

Today, the U.S. Department of Health and Human Services (HHS) announced it​ will be releasing Phase 4 of the Provider Relief Fund (PRF). Phase 4 consists of $17 billion for providers who can document revenue loss and expenses associated with the pandemic. HHS has also created an option for reconsideration of Phase 3 awards and extended the due date for the first PRF Reports, formerly due on September 30, 2021, by 60 days. It is also possible rural SNFs and assisted living communitie​s may be eligible for the $8.5 for rural providers.​


September 10: Prior Authorization Waiver Re-instated for Indiana Medicaid

Effective for dates of service (DOS) on or after Sept. 8, 2021, and until further notice, the Indiana Health Coverage Programs (IHCP) is reinstating temporary changes in the skilled nursing facility (SNF) prior authorization (PA) requirements for Medicaid managed care health plans. This change is in response to the recent increase of coronavirus disease 2019 (COVID-19) cases and hospitalizations across the state of Indiana.

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September 10: CMS Updates Medicare COVID-19 Billing Guidance

On September 8, 2021, the Centers for Medicare and Medicaid Services (CMS) Updated MLN Matters Article SE20011 titled Medicare FFS Response to the PHE on COVID-19. In the billing guidance CMS DID NOT change the longstanding blanket 3-day qualifying stay or spell-of-illness waivers for beneficiary eligibility for SNF Part A coverage.

Read more




September 9: CMS to Require Vaccination for all Medicare and Medicaid-Certified Health Care Facilities

On September 9. 2021,  the Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC) announced that the emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others, as a condition for participating in the Medicare and Medicaid programs.

Read more




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.

FDA Emergency Use Authorization for REGEN-COV2

The federal Food & Drug Administration (FDA) has issued an emergency use authorization (EUA) to permit the use of REGEN-COV2 (Casirivimab and Imdevimab together) for post exposure prophylaxis of COVID-19 in individuals who are at high risk for progression to severe COVID-19, including hospitalization and death.  It is expected to be effective against circulating variants, including the Delta variant.  REGEN-COV2 is not a substitute for vaccination against COVID-19 and is not authorized for pre-exposure prophylaxis.  Helpful links on REGEN-COV2 are as follows:

Testing Guidance & Updates

Ordering Testing Supplies – Langham Portal

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

Clinical Guidance


Infection Control and Surveys

Visitation and Activities Guidance

General Guidance

Quarantine Guidance

Signage and Forms

Essential Family Caregiver

Reporting and Testing

Cohorting Guidance

Weekly Webinars

Upcoming Webinar | September 30, 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

September 23. 2021






September 16, 2021





September 9, 2021






September 2, 2021




To access archive recordings of the webinars, 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.

  • Please request your user account here.
  • Please access the user manual at this link.
  • EMResource Troubleshooting – Email Eric Shelley at the Indiana Department of Health –

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.

  • Please request your user account here.
  • Please access the user manual at this link.
  • EMResource Troubleshooting – Email Eric Shelley at the Indiana Department of Health –

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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