Josh Peterson

On Wednesday, the Tennessee Department of Health announced state-specific visitation restrictions for long-term care facilities will end effective February 28, 2021. Facilities should use the federal Centers for Medicare and Medicaid Services guidance for safe operation and visitation with limited visitation restrictions no longer in place at the state level.

The Tennessee Department of Health recognizes the extraordinary challenges long-term care facilities, their residents and the family members and caregivers of these particularly vulnerable Tennesseans have faced during the COVID-19 pandemic. As a result of the federal long-term care facility pharmacy partnership, 100 percent of Tennessee’s nursing homes and skilled nursing facilities have completed both doses of COVID-19 vaccinations, and Tennessee’s assisted care living facilities and residential homes for the aged are projected to be completed this week.

“The health and safety of vulnerable Tennesseans, especially our long-term care residents, remains our top priority, and our comprehensive and persistent efforts to protect this population from COVID-19 have saved lives,” said Tennessee Health Commissioner Lisa Piercey, MD, MBA, FAAP. “Now that vaccinations at all long-term care facilities are nearing completion, we are ready to transition to a more sustainable approach of following these best practices for safe operation of long-term care facilities in Tennessee.”

Guidance for Visitation
The guidance issued by CMS provides reasonable ways a nursing home can safely facilitate in-person visits to address residents’ social and emotional needs. Certified Medicare and Medicaid facilities should continue to follow the Centers for Medicare and Medicaid Visitation Guidance. Per this guidance, nursing homes may allow indoor visitation when there has been no new onset of COVID-19 cases in the last 14 days and the facility is not currently conducting outbreak testing.

Long-term care facilities licensed by the state, which include Tennessee assisted care living facilities, residential homes for the aged and any nursing home not certified by CMS, should reference industry best practices including CMS Visitation Guidance and review related laws and rules when developing their own facility-specific visitation policies and procedures.

The CMS guidance outlines how facilities may expand communal dining and other group activities, provided infection control policies are followed. Even as COVID-19 case counts decline, facilities should remain vigilant in monitoring for COVID-19 cases among residents and staff members through appropriate screening and testing. Facilities may test visitors, which is encouraged, but not required. Additional resources on infection control practices are available from the Centers for Disease Control and Prevention.

The following resources are available for long-term care facilities when updating and developing their visitation policies and procedures.

CMS Visitation Guidance:
www.cms.gov/files/document/qso-20-39-nh.pdf

CDC Infection Control Resources:
www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html

The Tennessee Department of Transportation has completed a
year-long Statewide Aviation Economic Impact Study, finding Tennessee’s
public-use airports contribute $40 billion to the state’s economy and
support 220,936 jobs in Tennessee. There are 6 commercial service airports
and 72 general aviation airports in Tennessee.

The study analyzed the economic impacts at Tullahoma Airport and found the
airport contributes $21,000,000 to the state’s economy. The study analyzed
the economic impacts of on-airport activities, off-airport activities,
multiplier impacts, and freight/cargo. Examples of on-airport activities
include economic impacts from business tenants, airport construction
spending, and airport employment. Off-airport impacts include visitor
spending. Visitor spending at Tullahoma Airport generated $1,500,000 in
revenue to the state in 2019. Analysis found that on-airport impacts
generated 149 jobs, $7,500,000 in payroll, and $11,500,000 in business
revenue.

“I am very happy to see the economic impact the Airport contributes to
Tullahoma. I look forward to the Airport attracting more business and
employees for our area with the 100 – acre Airport Business Park,” said
Tullahoma Mayor Ray Knowis.

Tullahoma Airport falls in Region 2 of the state’s airports, which stretches
from the Kentucky border to the Georgia and Alabama line, with 24 counties
and 19 airports. Tullahoma Airport ranks 2nd behind Chattanooga’s Lovell
Field in Economic impact in Region 2.

This Economic Impact Study represents the 2019 annual economic impact of the
aviation system on the state’s economy. Therefore, the study is a good
representation of the annual economic impact of the aviation system during a
non-pandemic world.

Tennessee’s 78 public-use airports are critical components of the state’s
transportation network, linking and providing access to regional, national
and global transportation systems – TDOT Commissioner Clay Bright.

“A safe, secure, efficient and resilient aviation system is essential to our
state’s physical, economic, and social health. This report recognizes
aviation as a driver of the economy, including economic recovery,” said TN
Aeronautics Director, Michelle Frazier.

Tullahoma Airport is an asset to our local community and Tennessee’s $40
billion aviation industry. Airports serve as a catalyst for people to
conduct business, serve clients, and ship cargo. Having a well maintained
and diverse aviation system supports a robust economy.

The United States Department of Agriculture (USDA) Thursday announced it is investing $42.3 million to help rural residents gain access to health care and educational opportunities. Rural areas are seeing higher infection and death rates related to COVID-19 due to several factors, including a much higher percentage of underlying conditions, difficulty accessing medical care, and lack of health insurance. The $42.3 million in awards includes $24 million provided through the CARES Act. In total, these investments will benefit 5 million rural residents. Tennessee Rural Development Acting State Director Dan Beasley is excited to announce that three projects will receive funding to expand its distance learning and telemedicine opportunities.

“The expansion of rural education and health care access significantly advances the quality of life for students and residents,” Beasley said. “Today’s investments will allow citizen’s in rural areas to benefit from telemedicine and distance learning opportunities that would otherwise not be available.”

A recent report by the Rural Policy Research Institute’s Center for Rural Health Policy Analysis found infection and death rates in rural America due to COVID-19 are 13.4 percent higher than in urban areas. A recent report from USDA’s Economic Research Service, USDA ERS – Rural Residents Appear to be More Vulnerable to Serious Infection or Death From Coronavirus COVID-19, underscored the challenges facing rural Americans amidst the COVID-19 pandemic with even greater detail. Due to a confluence of factors, including higher percentages of underlying conditions, lack of health insurance, and lower access to medical facilities/care than urban counterparts, ERS analysts found rural Americans are suffering more severe illness or death due to COVID-19.

In Tennessee:
• East Tennessee State University will use a $121,069 grant to establish a telemedicine system linking five clinics in Hancock, Johnson and Washington counties. The project will provide access to behavioral and substance misuse telehealth counseling. It will also provide primary care and specialty care telemedicine support for patients who are unable to travel to one of seven nurse-managed clinics in the three counties.

• Grundy County Department of Education will use a $274,768 grant to establish a distance learning program to assist students from grades Pre-Kindergarten to 12th Grade in Grundy County. Services and equipment will be provided to students at all seven schools in the district and will operate as hub/end-user sites. The schools are Coalmont Elementary School and Grundy County High School in Coalmont, North Elementary School in Altamont, Palmer Elementary School in Palmer, Pelham Elementary School in Pelham, Swiss Memorial Elementary School in Gruetli-Laager, and Tracy City Elementary School in Tracy City.

• Hardin County Regional Health Center will use a $296,352 grant to establish a telemedicine system for residents in Hardin, Wayne and McNairy counties. Six hub/end user sites will connect patients to primary care, behavioral health providers and to substance use disorder counselors. Portable telehealth units will link patients in their homes, students in school and people at other community settings to providers at hub sites. These telemedicine services are expected to improve patient safety by reducing their risk of exposure to COVID-19 and by encouraging social distancing.

To learn more about investment resources for rural areas, interested parties should contact their USDA Rural Development state office.