High-Risk Patients Benefit from National Home Infusion Association’s Pilot Program as part of Operation Warp Speed

MURFREESBORO, Tenn., and BIRMINGHAM, Ala., Jan. 19, 2021 — The impact that COVID-19 has had on long-term care facilities (LTC) has been a difficult journey to witness, with the Centers for Disease Control (CDC) reporting that 100,033 patients and staff have died across the United States as of November 24, 2020. The evolution and introduction of new treatments and vaccines for long-term care patients have been imminent.

National HealthCare Corporation (NYSE American: NHC), a leading senior care provider including almost 100 nursing centers and assisted living communities across ten states, and ContinuumRx, a regional leader in specialized home infusion and infusion suites with partnerships across over 40 hospitals and skilled nursing facilities, have received approval to collaborate and treat COVID-19 patients in six NHC centers in the Knoxville market with Eli Lilly’s bamlanivimab, an infusion-based antibody therapy geared to treat high-risk populations, especially patients 65+ who are susceptible to hospitalization or death.

On November 10, 2020, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) to permit the emergency use of infusion-based bamlanivimab, and on December 8, 2020, the National Home Infusion Association (NHIA) announced a pilot program, in conjunction with the Department of Health and Human Services (HHS) and Operation Warp Speed, to increase the drug’s accessibility through qualified home infusion providers. ContinuumRx is one of 30 NHIA-approved infusion providers who have partnered with long-term care facilities like National HealthCare Corporation to identify, assess, coordinate, dispense, and administer this monoclonal antibody therapy to high-risk COVID-19 patients. With only 500 vials being distributed weekly across its national channels, bamlanivimab provides a unique and specialized benefit for both companies to increase the quality of care of their patients and provide valuable, medical data points around the therapy that currently are not available.

“For the past 50 years, National HealthCare Corporation has been a senior care leader with the vision of caring in a better way day by day. COVID-19 has heightened this commitment even further as we seek the opportunity to have bamlanivimab readily available in the Knoxville market for our high-risk patients to reduce hospitalizations and preserve life,” stated Stephen F. Flatt, President and Chief Executive Officer of National HealthCare Corporation. “Our partnership with ContinuumRx is a historical opportunity to contribute to Operation Warp Speed and protect our 65+ community even further.”

Keith Hartman RPh., Chief Executive Officer of ContinuumRx added, “Being placed in a leadership role by the NHIA, collaborating with NHC, and supporting the accessibility of new therapies like bamlanivimab is an honor and a pivotal opportunity in our industry. We have the potential to save lives safely, curtail the impact of COVID-19, and provide valuable data to the NHIA and Health and Human Services (HHS). The anecdotal outcomes are promising and we look toward expanding the accessibility of this service ever further.”

Why is there a need for bamlanivimab? According to the Centers for Disease Control (CDC), 8 out of 10 COVID-19 deaths reported in the U.S. have been in adults 65 years or older. Additionally, compared to younger adults ages 18-29, adults 65-74 years of age are 5x more likely to be hospitalized and 90x higher more likely to die. When cross-compared with adults 75-84 years of age vs. younger adults, hospitalization jumps to 8x higher and death rates to 220x higher1.

Bamlanivimab is an investigational medicine used for the treatment of COVID-19 in non-hospitalized adults and adolescents 12 years of age and older with mild to moderate symptoms who weigh 88 pounds (40 kg) or more, and who are at high risk for developing severe COVID-19 symptoms or the need for hospitalization. Bamlanivimab is investigational because it is still being studied.

High risk is defined as patients who meet at least one of the following criteria:

  • Have a body mass index (BMI) ≥35
  • Have chronic kidney disease
  • Have diabetes
  • Have immunosuppressive disease
  • Are currently receiving immunosuppressive treatment
  • Are ≥65 years of age

Infusion companies who have been approved by the National Home Infusion Association to administer bamlanivimab are required to follow clear responsibilities which include:

  • Make every effort to perform infusions within 24 hours of receiving a qualified patient referral.
  • Administering 700mg/200ml of bamlanivimab within 2 days of a positive test and within 10 days of symptom onset.
  • Clinically monitor patients during administration and observe patients for at least 1 hour after infusion is complete.
  • Continue to self-isolate patients treated with bamlanivimab and use infection control measures (e.g., wear mask, isolate, social distance, avoid sharing personal items, clean and disinfect “high touch” surfaces, and frequent handwashing) according to CDC guidelines.
  • Collect and submit required data to the NHIA/HHS as per established guidelines.

Patients and/or family members that are managing the long-term care of a high-risk patient should visit National HealthCare Corporation’s website @ nhccare.com for additional information, and medical providers seeking access to bamlanivimab infusion treatments should email info@ContinuumRx.com.

1Centers for Disease Control and Prevention. (2020, December 13) Older Adults At greater risk of requiring hospitalization or dying if diagnosed with COVID-19. https://bit.ly/35oSabP

home infusion

Currently, Medicare only covers certain home infusion drugs and biologicals administered intravenously, or subcutaneously, while commercial payors cover patients for an expansive array of intravenous and subcutaneous drugs. Lifting Medicare regulations, will ensure that Medicare enrollees in need of home infusion therapy can receive the care they need in a more comfortable environment and at a more reasonable cost to the federal government. This would provide increased access to care for patients with immune diseases, cancer, serious infections, heart failure, and other conditions that might otherwise force patients to receive their care in a more expensive and less convenient hospital, outpatient clinic, or skilled facility. This legislation is vital to home infusion patients, allowing them to safely receive treatment in the setting they overwhelmingly prefer—their homes.

“Home infusion providers have the capacity to treat hundreds-of-thousands of patients as hospitals and nursing facilities are being pushed to capacity,” said National Home Infusion Association (NHIA) Board Chair Logan Davis, PharmD, MBA. “Regardless of any change in policy, the home infusion community is working with health care providers to bring their resources to bare and keep the most vulnerable patients at home. While this can be a challenge for patients in traditional Medicare — where coverage is limited — the home infusion community is committed to playing a vital role in addressing this public health emergency.”

As per the NHIA, more than 160 hospitals, patient groups, and other stakeholders are calling on Medicare to lift restrictions on home infusion. They have announced their support for concept legislation that would: 

  • Cover Home Infusion Equipment, Supplies, and Professional Services.
  • Adequately Reimburse Providers.
  • Maintain Current Drug and Home Health Reimbursement.

“Our focus has always been to improve post-acute care coordination and care management, to help reduce gaps in patient care, and to enhance the overall patient experience,” said Keith Hartman, RPH, COO of ContinuumRx. “As a response to the pandemic, we have seen the rapid shift from moving care out of the hospital to home, are experiencing and measuring the success rates, and foresee that this is the model for the future. By lifting the current Medicare restrictions the door is opened to offer a higher quality of care and reduction in rehospitalization rates.”

ContinuumRx is committed to to doing our part to #FlattenTheCure, #DeliverHope, and heighten a patient’s quality of care while providing solutions to your staff and patients that require home infusion therapy. Our priority is to work with your team to identify patients that can be moved to the safety of their home not only to decrease their risk of hospitalization/re-hospitalization, but also to free up hospital beds for COVID-19 needs. 

We are actively monitoring the CDC guidelines related to the coronavirus (COVID-19) outbreak and updating our plans, policies, and guidelines as needed. We continue to accept and service new patients and operate under the highest standards.

ContinuumRx is dedicated to these guidelines to protect our healthcare providers and patients:

General Guidelines:

  • Complying with existing standard operating procedures (SOPs) and disaster emergency plans, and updating as needed for PPE modifications, social distancing, and compounding procedures.
  • Establish remote working capabilities for pharmacy staff where possible.

Patient Guidelines:

  • Providing bedside education and instruction via FaceTime, Zoom and Skype: 
    • For resumption of patient care 
    • For patients that are teachable remotely
    • Patient and caregiver education via video library
  • Requiring patients to wear face masks.
  • Maintain social distancing.
  • Comply with local health department screening, patient contact, and reporting requirements.

Patient Delivery:

  • Employ delivery strategies that limit patient/employee exposure:
    • Leave packages at the patient’s home and call the patient to alert them to delivery.
    • Utilize photo confirmation rather than obtain signatures.
    • Use common courier services (UPS, FedEx) whenever possible.
    • Do not allow courier or shipping personnel into your household.

Nursing Staff:

  • Limit nursing time in the home.
  • Medical-grade masks, gowns, and shoe covers.
  • Hand sanitizer upon initial entry and during glove change processes.
  • Instruct patients to have supplies needed for procedures ready prior to the nurse entering the home.
  • Nursing bags are prohibited in the patient’s home.
  • Limit non-disposable supplies taken into home.
  • Use disposable supplies, such as BP cuffs, stethoscopes and thermometer when possible.
  • Complete non-physical assessment telephonically.
  • Complete all documentation outside the home.
  • Patient Screening Tool to Identify COVID-19 Patients.
  • COVID-19 testing recommendations.
  • Isolation guidelines when employees develop symptoms.
  • Quarantine guidelines when exposure is suspected.
  • Return to work guidelines per CDC Criteria for Return to Work for Healthcare Personnel with Confirmed or Suspected COVID-19.

We will continue to implement innovative ways to maintain the same level of service that you expect as we all work together during this difficult time.