The Importance of Timely Use of COVID-19 Therapeutics

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

CMS issued QSO-23-03-All on November 22, 2022 – same title as this blog.

Some excerpts from this 2-page Memorandum:

“The purpose of this memo is to highlight the importance of providing timely access to available COVID-19 therapeutics to patients who test positive for the virus. Treatments, including both monoclonal antibodies and oral antiviral drugs, can prevent serious illness and save the lives of high-risk individuals who would otherwise be at risk of severe complications. Every patient who tests positive for COVID-19 should be evaluated to determine whether the use of an available therapeutic is appropriate.

Nursing homes, in particular, should review and reinforce their infection control protocols as we move into fall and winter, when respiratory infections are more commonly transmitted. In addition to mitigating opportunities for transmission of COVID-19, nursing homes should ensure residents receive (in consultation with their physician and family) appropriate treatment when tested positive for COVID-19.

Nursing homes, in particular, are encouraged to review the latest updated information from the National Institutes of Health for use of clinically appropriate therapeutics here:–therapeutic-management/.   

CMS reminds providers and suppliers that, even when a patient’s symptoms may not initially present as severe, individual risk levels should be considered when deciding whether to prescribe an appropriate course of treatment. Patients who have multiple preexisting comorbidities, who live in a community setting like a nursing home, or who engage with services like the Program of All-Inclusive Care for the Elderly (PACE) may be particularly important to start on appropriate COVID-19 treatments before their condition deteriorates.

In addition to providing timely access to available COVID-19 therapeutics to patients who test positive for the virus, staying up to date with COVID-19 vaccinations, including boosters, is the best defense against severe illness, hospitalization, and death from the virus. CMS requires nursing homes to educate residents and staff on the risks and benefits of the vaccines, offer to administer the vaccine, and report resident and staff vaccination data to CDC’s National Healthcare Safety Network. CMS posts this information on the CMS COVID-19 Nursing Home Data website along with other COVID-19 data, such as the weekly number of COVID-19 cases and deaths.”

CMS also issued a News Alerton November 22, 2022.  Some excerpts from this Alert include:

“Since COVID vaccines first became available in late 2020, CMS has worked hard to ensure their availability to nursing home residents, and almost 87% of nursing home residents have completed the initial series of COVID-19 shots. However, CMS is concerned that recent data shows that only about 44% of nursing home residents are up-to-date on their current recommended vaccines. The agency is particularly disappointed that some facilities are reporting that zero residents have received the updated bivalent vaccine, and we will be looking closely at these facilities.

Working in conjunction with our Quality Improvement Organizations (QIOs), CMS has offered individualized assistance in providing vaccinations to residents in over 85% of the country’s skilled-nursing facilities. As part of the agency’s work to promote vaccination uptake, CMS will be meeting with QIOs later this month to bolster their outreach efforts and to set up more vaccination clinics at nursing homes across the country.

Moving forward, CMS will also continue to look closely at outbreak status and where poor outcomes are occurring at the nation’s nursing homes.”

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