Weekly Update

September 11, 2026

National Preparedness Month Tips & Resources to Support LTC Emergency Planning – suggestions taken from FHCA Communications, September 2^nd

September is National Preparedness Month, and a timely reminder of the critical role providers have in protecting the health and safety of residents and staff. Planning ahead and strengthening relationships during moderate temperatures and blue skies are key to your success during emergency. Below are a few key reminders for long-term care centers:

Get to Know Your Local Contacts

Find the name and phone number of your Emergency Statewide Response Contact (below), so you have that information in the event of an emergency or disaster.

Northwest Region:

Counties:  Divide, McKenzie, Mountrail, Williams

Contact:  Dana Brekhus (701) 774-6400

Northwest Central Region:

Counties:  Bottineau, Burke, McHenry, McLean, Renville, Sheridan, Ward

Contact:  Zach Bruns (701) 852-1376

Northeast Central Region:

Counties:  Benson, Cavalier, Eddy, Pierce, Ramsey, Rolette, Towner

Contact:  Awaiting Assignment, please call DOC at 701-328-0707 for assistance

Northeast Region:

Counties:  Griggs, Grand Forks, Nelson, Pembina, Walsh

Contact:  Marcus Lee (701) 787-8100

Southeast Region:

Counties:  Cass, Ransom, Richland, Sargent, Steele, Traill

Contact:  Hunter Hubrig (701) 241-1360  (for 24-hr reporting, call 701-793-1327)

Southeast Central Region:

Counties:  Barnes, Dickey, Foster, LaMoure, Logan, McIntosh, Stutsman, Wells

Contact:  Frank Balak (701) 252-8130 (for 24-hr reporting, call 701-952-8196)

Southwest Central Region:

Counties:  Burleigh, Emmons, Grant, Kidder, Mercer, Morton, Oliver, Sioux

Contact:  Crystalynn Kuntz (701) 355-1540

Southwest Region:

Counties:  Adams, Billings, Bowman, Dunn, Golden Valley, Hettinger, Slope, Stark

Contact:  Sherry Adams (701) 483-0171 (for 24-hr reporting, call 701-290-6110)

If you are not able to reach the SRT member or need additional information, please call the ND HHS Department Operations Center at 701-328-0707, as they can assist you with questions and with contacting a Statewide Response Team member to get in touch with you or visit your facility.

Take advantage of the resources offered through NDDHHS, CISA, CDC, FEMA

Vendor Availability

Confirm your transportation, fuel and other vendors are not “overcommitted” to multiple providers, so they are truly available to provide services in the event of an emergency.

Staffing for Emergencies

Educate staff on your building’s plan for pre- and post-event, including protocols and expectations for continuing care through an emergency. Communicate with entire staff roster so they are informed and confident during a crisis.

Ensure your staff has their own personal emergency plan that includes their loved ones and pets when a shelter-in-place at work is required. Stress your building capabilities for them, if they are required to stay at work.

Communications Backup

Make sure all staff members have access to ReadyOp, and ensure the ladder of responsibilities is in place. Exercise events build confidence and will assist you with a relaxed and smooth communications reporting routine. Be sure staff know how to report status on your building’s behalf should your building lose power. Review and update staff data entered into ReadyOp routinely. Ensure utility company account numbers, meter number and generators are recorded in your Emergency Operations Plan (EOP).

For multi-facility organizations, identify out-of-state corporate contacts who are to be contacted and/or will be available to your center, should you need assistance.

Emergency Heat

If your Emergency Operation Plan (EOP) requires the use of heating zones, make certain ALL staff know the plan. This includes calling the NDDHHS DOC at (701) 328-0707, knowing what area(s) of the building(s) will be heated, where to move residents and staff, etc. It will also include confirming appropriate ventilation, routine care and load tests of your generator(s), and having fuel, food, and other supplies on hand in accordance with your EOP. Schedule routine exercises, inviting the NDDHHS EPR Unit, NDLTCA Director of Emergency Planning, and your local Statewide Response Team (SRT) Contact to build confidence if an emergency or disaster finds its way to your building(s).

Structured Pain Management Intervention Effective For Nursing Home Residents With Dementia, Study Finds – per Provider Daily, September 8^th

McKnight’s Long-Term Care News (9/4, Stubbs) reports, “A structured pain management intervention for people with dementia in the nursing home showed the potential to enhance health care personnel competence, structure pain management and integrate residents’ resources,” according to a study published in Frontiers in Pain Research.

Communicating Under Pressure: Best Practice for Service Providers – per Dawn Lehrmann email, September 8^th  

Source: CISA

The CISA and Federal Bureau of Investigation (FBI) joint guidance outlines best practices for communicating during IT and operational technology (OT) outages caused by cyber incidents, human error, equipment failures, or natural hazards. It emphasizes clear, timely, accurate, and transparent communication to reduce uncertainty, limit speculation, maintain public trust, and coordinate messaging with legal, security, law enforcement, and incident-response needs.

CISA’s CI Fortify initiative complements this guidance by helping critical infrastructure organizations prepare to isolate and recover essential OT systems during major incidents. Organizations should maintain crisis communication plans that include backup communication methods, since telecommunications may be disrupted, and establish expectations for how service providers will communicate during outages or deliberate service isolation.

Latest CISA Vulnerability Summary – per Dawn Lehrmann email, September 8^th

The latest CISA Vulnerability Bulletin summarizes new vulnerabilities added to the NIST National Vulnerability Database (NVD) over the past week. Some entries may not yet include Common Vulnerability Scoring System (CVSS) scores; please refer to the NVD for updates as scores become available. CISA uses Stakeholder-Specific Vulnerability Categorization (SSVC), a vulnerability analysis methodology that accounts for a vulnerability’s exploitation status, impacts to safety, and the prevalence of the affected product within a system, to assess and prioritize vulnerabilities. For more information, see CISA SSVC resources and the CISA SSVC Guide.

CMS Starts Implementing New Inspection Process For Nursing Homes – per Provider Daily, September 9^th

HealthcareFinanceNews (9/8, Bender) reports CMS “has begun implementing a new inspection process that will give certain higher-performing nursing homes shorter, more focused recertification surveys with a start date of Sept. 8, the agency announced in July.” The story adds, “The nationwide rollout of the risk-based survey process follows a pilot conducted across 22 states.”

OIG Releases Report on CMS’ Oversight of Contract Surveyors – per Capitol Connection, September 9^th

In the report, OIG concluded that CMS did not provide adequate oversight of States’ use of contract surveyors, including ensuring contract surveyors followed memo directives released during this period. Read More

CDC Issues Interim Guidance for the 2026-2027 Flu Season – per Capitol Connection, September 9^th

The guidance confirms that recommendations from the July 2025 immunization schedule remain in effect for the 2026–2027 flu season. Read More

Higher Air Quality Brings Better Financial Performance – per Capitol Connection, September 9^th

Most LTC administrators have optimized staffing, supply chains, and clinical resource allocation. But until recently, few fully appreciated the importance of indoor air quality not just for patient health, but for the facility’s financial well-being.  Read More

Immunization Unit Update: 2026 – 2027 Respiratory Immunization Recommendations – per Abbi Berg email, September 9^th

IMMUNIZATION UPDATES

FDA Announces Approval and Authorization of Updated COVID-19 Vaccines

On August 27, 2026, the U.S. Food and Drug Administration approved COVID-19 vaccines for the 2026–2027 season manufactured by Moderna, Pfizer, and Sanofi/Novavax. Details about these approvals can be found online at Coronavirus Disease 2019 (COVID-19) | FDA. At this time, CDC and ACIP are not expected to issue formal recommendations.

COVID Codes

All new 2026-2027 COVID-19 vaccines have been added to the NDIIS. The list of codes and names are available below. Providers should ensure that their EHRs are set up with the correct vaccine codes for the 2026-2027 season.

The NDIIS forecaster has not yet been updated for the current respiratory season immunization recommendations. The forecaster will not have the rules for the new 2026-2027 COVID-19 vaccines until after the vendor can get the necessary changes made. Doses of 2026-2027 COVID-19 vaccine administered may temporarily show as invalid in the NDIIS based on previous vaccination history until the forecaster updates are complete in the NDIIS. The NDHHS Immunization Unit will provide an update as soon as the forecaster has been updated.

Updated Respiratory Vaccine Science

The Vaccine Integrity Project of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP) released data from its comprehensive review on the safety and efficacy of influenza, respiratory syncytial virus (RSV), and COVID-19 vaccines. The focus of their work was the safety and efficacy of these vaccines in pregnant women, children, and those with weakened immune systems. After reviewing nearly 300 new studies researchers found no new safety concerns for COVID-19, RSV, or influenza vaccines.

COVID-19 Vaccines and Adults

The Americal Academy of Family Physicians released updated clinical guidance regarding respiratory vaccines and non-pregnant, immunocompetent adults ≥19 years and health care personnel (HCP).

Their COVID-19 vaccine recommendations are as follows.

All adults ≥19 years should receive an updated COVID-19 vaccine, with particular emphasis on:

• Adults ≥65 years
• Adults at increased risk for severe COVID-19
• Adults who have never received a COVID-19 vaccine
• HCP should receive an updated COVID-19 vaccine.

COVID-19 Vaccines and Immunocompromised individuals

The Infectious Disease Society of America updated clinical guidance regarding vaccination for Immunocompromised individuals. In adults and children with compromised immunity, the IDSA guideline panel recommends administering age-appropriate 2026-2027 COVID-19 vaccinations (strong recommendation, moderate certainty of evidence).  See Table 1 for risk group and timing.

Other Respiratory Immunization Recommendations for the 2026 – 2027 Season

Professional medical societies have released their 2026–2027 respiratory immunization recommendations to help clinicians protect patients against influenza, COVID-19, and respiratory syncytial virus (RSV). The guidance addresses children, adults, pregnant patients, and people at increased risk of severe illness. The CDC has released interim influenza considerations for the 2026–2027 season but has not yet released its 2026–2027 COVID-19 clinical considerations; the prior season’s COVID-19 guidance is included below for reference.

• AAP RSV Vaccine Policy Statement
• AAP Flu Vaccine Policy Statement
• AAP COVID-19 Vaccine Policy Statement
• AAFP Fall Immunization Recommendations
• ACOG Maternal Vaccination Schedule
• IDSA Respiratory Vaccine Recommendations
• AMA Consolidated Recommendations Chart
• CDC Interim 2026–2027 Influenza Vaccine Considerations
• CDC 2025–2026 COVID-19 Vaccine Clinical Considerations

Please see the attached documents summarizing previous season recommendations and any changes for the upcoming 2026 – 2027 respiratory season.

Educational Opportunities

NDHHS Immunization Unit Lunch and Learn: 2026 – 2027 Respiratory Season Update

• September 9^th at 12:00 PM CT
• Join: https://teams.microsoft.com/meet/224564248672188?p=mRfq39XjTF8q3QM0Pd

NFIS Annual Respirator Season Kick-Off: NFID will convene leading infectious disease and prevention stakeholders, medical experts, public health officials, patient advocates, and media for a discussion offering timely insights on respiratory disease trends and what to expect for the 2026-2027 respiratory season. The briefing will feature evidence-based prevention strategies, the latest findings from NFID’s annual respiratory survey, and the launch of the National Respiratory Communications Initiative (NRCI).

• September 24^th at 8:00 AM CT
• Register here

For any questions, please email vaccine@nd.gov.

Protecting the Well-Being of Responders Webinar – per ASPR TRACIE email, September 9^th

Responders often face significant stress during and after critical incidents, yet many report feeling unprepared for the emotional and operational challenges that follow. Limited routine staff support, cultural and societal reluctance to discuss response experiences, and the use of well-intended but often ineffective support strategies can amplify this stress.

The U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response, Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) and the American College of Emergency Physicians (ACEP) invite you to attend this webinar focused on protecting the well-being of healthcare and public health workers during disasters and other critical incidents. Panelists will discuss how to recognize and respond to the effects of acute stress and share practical approaches for creating healthy work environments that strengthen staff resilience in day-to-day operations and during disasters.

NOTE: CMEs will be offered through ACEP; participants will receive a post-event survey from ACEP following the webinar.

Space is limited–register today!

Partner Alert: Brief Updates from CDC’s Emergency Response Activities and Other Information for Your Situational Awareness – per Juli Sickler email, September 10^th

Ebola Updates (Please check the website as the situation is rapidly evolving.)

• Ebola Disease: Current Situation | Ebola | CDC ─ As of September 6, there are reports of 6,686 confirmed cases and 3,226 confirmed deaths in the Democratic Republic of the Congo (DRC). Investigation of additional cases is ongoing. As this is a rapidly evolving situation, case counts are expected to change as new information becomes available.
• Webinar Library | Council of State and Territorial Epidemiologists ─ On August 25, the Council of State and Territorial Epidemiologists (CSTE), CDC, the Administration for Strategic Preparedness and Response (ASPR), and the Colorado Department of Public Health and Environment updated attendees on the ongoing response to the Ebola Bundibugyo Virus outbreak in the DRC. Topics discussed include the REDCap risk assessment form for healthcare and community exposures, public health checklist updates, and 2026 lessons learned from Colorado. The recording is available online.

Measles Updates

• Measles Cases and Outbreaks | Measles (Rubeola) | CDC ─ As of September 3, a total of 3,134 confirmed measles cases have been reported in the United States in 2026, an increase of 231 measles cases since August 27. These cases include 3,118 cases reported by 47 jurisdictions and 16 cases among international visitors to the United States. There have been 38 outbreaks reported in 2026, with 95% of confirmed cases (2,969 of 3,134) associated with outbreaks. 94% of cases were unvaccinated or had unknown vaccination status and 8% have been hospitalized.
• Preparing and Responding to Measles: Checklist for Early Care and Education Centers  ─ CDC’s Be Ready for Measles Toolkit includes resources to help congregate settings prepare for and respond to measles. This checklist provides practical steps early care and education settings can take before and during a measles case.  Health departments can share this resource with early care and education partners in their jurisdictions.
• Preparing and Responding to Measles: Checklist for Congregate Shelters  ─ During National Preparedness Month, health departments can use and share this checklist to help congregate shelters prepare for and respond to possible measles cases, including during emergency response and sheltering operations associated with hurricanes, wildfires, and other disasters.

Cyclosporiasis Update

• Surveillance of Cyclosporiasis | Cyclosporiasis | CDC ─ Since May 1, 2026, CDC has received reports of 19,595 laboratory-confirmed cases of cyclosporiasis acquired in the United States. There are 9,355 laboratory-confirmed cases of cyclosporiasis reported to CDC requiring further investigation to determine whether they were acquired in the United States or during travel. CDC is aware of at least 6,149 additional cases of cyclosporiasis, which include those that are not laboratory confirmed, or are pending patient interview and submission to CDC.  CDC is working closely with states to update surveillance data as additional cases are confirmed. For additional updates, see Cyclospora Outbreak Linked to Iceberg Lettuce | Cyclosporiasis | CDC and Investigation of 15-State Outbreak of Cyclospora Illnesses: Iceberg Lettuce (July 2026) | FDA.

New World Screwworm (NWS) Updates

• USDA Launches New World Screwworm Wildlife Page for Hunters, Wildlife Professionals, and Outdoor Enthusiasts | Animal and Plant Health Inspection Service  ─ On September 1, the U.S. Department of Agriculture (USDA) launched a NWS wildlife pagedesigned specifically for hunters, wildlife professionals, and outdoor enthusiasts. The page brings together easy‑to-use resources on NWS in wildlife, helping communities stay informed and prepared.
• FDA Issues Emergency Use Authorization for Drugs to Prevent and Treat New World Screwworm in Dogs and Cats | FDA ─ The U.S. Food and Drug Administration today issued an Emergency Use Authorization (EUA) for Capstar (nitenpyram) tablets and revised the EUA for Nitenpyram tablets, the generic version of Capstar, to authorize both products for the prevention and treatment of NWS infestations (myiasis) in dogs, puppies, cats, and kittens that weigh at least two pounds and are at least four weeks old. Nitenpyram tablets were initially authorized in June 2026 for treatment only.

 Upcoming Meeting

• CDC Response All-STLT Update Call ─ Join CDC at 2:00 p.m. EDT on Monday, September 21, to hear from subject matter experts who will provide updates on CDC’s emergency response-related activities. A portion of the time will also be allotted to answer questions regarding the topics presented.

‘Tsunami’ of Behavioral Health Challenges Amid OIG’s Antipsychotics Work Plan Seen Impacting QMs and Reimbursement in Nursing Homes – per Skilled Nursing News, September 11^th

Nursing homes have only reached the tip of the iceberg when it comes to mental health challenges in the sector, with such challenges affecting QMs and reimbursement.  Read More

As Special Needs Plans Surge, CMS Weighs Consolidating Plan Types Against Specialized Care in Nursing Homes – per Skilled Nursing News, September 11^th

CMS appears to be in an info-gathering stage when it comes to the future of SNPs, using requests for information (RFI), discussions with experts and other avenues to inform the agency’s direction on policymaking.  Read More