This issue covers some of the most significant news from July. Topics include CMS penalties, vaccine reporting, high-level disinfection, OSHA, Delta variant, vaccine mandates, and outpatient antibiotic use.

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CMS Per-Incident Penalties for Providers Soar — And Could Be Headed Higher — The total amount of fines CMS has collected through per-incident penalties has increased more than eight-fold from 2016 to 2020, and the figure is projected to reach new heights by the end of 2021.

Burdensome Vaccine Reporting Requirements Overwhelming Providers Dealing With COVID Outbreaks, Staff Shortages — Short-staffed long-term care providers are struggling to respond to COVID-19 outbreaks at their facilities and comply with a federal requirement to report COVID vaccination data.

How to Document the High-Level Disinfection Patient Connection — Insight from Phenelle: "Endocavitary or ultrasound probes have been highlighted for many years as an important component of medical device reprocessing. These devices require high-level disinfection, and strict use of manufacturers' instructions is imperative to the safety and wellbeing of patients. This article highlights the importance of monitoring for appropriate disinfection and tracing the individual probe used to a specific patient. The ability to link a specific piece of equipment or device to each patient allows for confirmation of high-level disinfection and a much smoother process should an issue arise."

Too Much, Too Late: Health Groups Pan OSHA Rule on COVID Precautions — It comes as no surprise to see this reaction to the new rule from the Occupational Safety and Health Administration (OSHA) intended to protect healthcare workers from COVID-19.

Larger Staff Size Increased Risk of COVID Outbreaks, Study Finds — Operators that had more staff coming in and out of a skilled nursing facility, while maintaining comparable direct care hours to those with fewer staff, had increased susceptibility to COVID-19 outbreaks last year.

Unvaccinated Nursing Home Staff in the Hot Seat as CDC Investigates COVID-19 Breakthrough Cases — Several Colorado senior care facilities are at the center of a CDC COVID-19 investigation, and public health officials there are zeroing in on unvaccinated staff as the cause of breakthrough cases.

Why the Delta Variant is Hyper-Contagious: A New Study Sheds Light — After months of data collection, scientists agree: The delta variant is the most contagious version of the coronavirus worldwide.

V.A. Issues Vaccine Mandate for Health Care Workers, a First for a Federal Agency — Employees who provide direct patient care have eight weeks from the issuing of the mandate to get inoculated against the coronavirus or face penalties including possible removal.

National Organizations in Epidemiology and Infection Prevention Say COVID-19 Vaccines Should Be Required for Healthcare Personnel — Seven leading organizations issued this important joint statement, including APIC, SHEA, and IDSA.

AMA, 56 Other Groups Back Mandatory COVID Vax for Healthcare Workers — Major medical groups joined the call for healthcare and long-term care employers to require vaccination.

Nurses Urge CDC to Reinstate Universal Masking to Reduce the Spread of COVID-19 and Protect RNs, Essential Workers, and the Public — The National Nurses United sent a letter to CDC, urging the agency to update its Covid-19 guidance and reinstate "the recommendation for everyone to wear masks in public or in physical proximity to others outside their own household."

Urine Culture Stewardship Linked to Reduced Catheter Infections — Researchers reported that a urine culture stewardship initiative at a teaching hospital reduced overuse of urine cultures and was associated with a significant decline in catheter-associated urinary tract infections.

VA Study Spotlights Decline in Outpatient Antibiotic Use — It's encouraging to see improvement in this critical yet often overlooked area, but as the story notes, there's much work left to be done.