Here are the latest need-to-know updates for Monday, March 30 regarding the COVID-19 pandemic.
In his Saturday press conference, DeWine made an appeal to Ohioans to contribute any remaining PPE to the health systems, and shared a list of Ohio’s “top 10” PPE items needed in anticipation of the COVID-19 surge. The Administration asked Ohio manufacturers to consider whether they can retool their operations to produce any of the necessary equipment, which included surgical and N95 masks, goggles, face shields, gowns and gloves, and noted that the need was not limited to health systems, but also post-acute and long-term care, as well.
DeWine noted that on Friday, he had asked each of Ohio’s eight regional healthcare coalitions to deliver their preliminary draft plan on how they would dramatically expand capacity, delivered to him by 9:00 a.m. on Saturday, and expected the final draft by noon on Monday. Addressing the regional coalitions, DeWine stressed that teamwork was critical and that health systems that would normally be competitors should work together, and that they should look to their community partners for support, notably post-acute care settings.
DeWine noted that plans would be shared once they were finalized. LeadingAge Ohio, along with the Ohio Hospital Association and other groups, have been working with the Administration to process map how hospitals and aging services providers would best coordinate, so we look forward to understanding how the regional planning will incorporate this work.
Responding to a question during the press conference, Director of Health Dr. Amy Acton shared that they are working on additional guidance for nursing homes, noting that several of the long-term care-based clusters were caused by healthcare workers who transmitted the virus to residents. While ODH has not yet released this guidance, Acton noted that it would be coming “very soon” and that it would include requirements for workers to be wearing masks while interacting with residents.
In an unplanned press conference yesterday, the Governor fielded questions related to the FDA’s cautious approval of Battelle’s new technology that would sterilize PPE for reuse. On Sunday, the FDA approved the technology for use, but limited it to a single site and only 10,000 masks per day. Battelle had hoped to send the technology to other states, and estimated that at full capacity, the technology could sterilize as many as 160,000 masks per day. Following a call to the President, the FDA expanded their initial permit late Sunday to allow Battelle to fully deploy the technology, sharing it with hard-hit states like New York.
Yesterday Abbott Labs received approval for a COVID-19 test that produces results in five minutes.
The American Association of Service Coordinators (AASC), in partnership with the Pangea Foundation, has created a Resident Vulnerability Tool that considers the key data points that may indicate a resident is at higher risk of having negative outcomes linked with COVID-19.
The purpose of the assessment is to help service coordinators identify residents who may require additional supports and resources; especially, as the impact of COVID-19 increases within our country. The Resident Vulnerability Tool may also be used as a tool to distribute to local health and emergency professionals if COVID-19 were to become active at your property. Ultimately, this report will help service coordinators and local health professionals understand which resident needs should be prioritized throughout this pandemic.
AASC Online subscribers may access the easy-to-use tool, user guide and risk factor score breakdown in the data management software. Non-AASC Online users may use the Excel spreadsheet.
The Centers for Medicare and Medicaid Services (CMS) has issued an electronic toolkit regarding telehealth and telemedicine for Long Term Care Nursing Home Facilities. Under President Trump’s leadership to respond to the need to limit the spread of community COVID-19, CMS has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility.
This document contains electronic links to reliable sources of information regarding telehealth and telemedicine, including the significant changes made by CMS over the last week in response to the National Health Emergency. Most of the information is directed towards providers who may want to establish a permanent telemedicine program, but there is information here that will help in the temporary deployment of a telemedicine program as well.
There are specific documents identified that will be useful in choosing telemedicine vendors, equipment, and software, initiating a telemedicine program, monitoring patients remotely, and developing documentation tools. There is also information that will be useful for providers who intend to care for patients through electronic virtual services that may be temporarily used during the COVID-19 pandemic.
CMS, responding to questions about flexibility in the hospice benefit, provided a statement to LeadingAge in response to a request for blanket waivers related to hospice.
CMS said the following in an email:
We are aware of the need to issue additional guidance to hospices about the flexibilities already included in the CoPs when it comes to determining on a case-by-case basis how a visit should be made. As we stated on the call, the hospice CoPs don’t specify how or how often direct clinical visits are made. Hospice providers are required to provide services that meet the needs of the patient based on the plan of care that is person-centered and individualized. CMS encourages hospices to address these issues on a case-by-case basis and make sure to document how the hospice is meeting the goals of care in a safe and appropriate manner. We are working on issuing revised guidance, but do not have a projected release date at this time.
LeadingAge encourages members to use their best judgment and to document all interactions, including visit refusals and rationale for using telehealth-enabled visitation instead of in-person.
LeadingAge Director of Hospice, Palliative & Home Health Policy Mollie Gurian has provided a flow chart that describes how to explain visitor questions related to hospice. The flow chart depicts inpatient hospice visitor guidance; and screening and guidance for nursing homes related to hospice workers and other visitors in end-of-life situations.
April 1 is the effective date of the Families First Coronavirus Response Act (“FFCRA”) and the Department of Labor has issued critical new guidance defining which employees can be considered a “health care provider” and thus exempted by employers from the provisions of the FFCRA making employees eligible for paid sick leave and paid leave for employees unable to work because of the closure of their child’s school or care provider.
LeadingAge Connecticut's legal counsel Wiggin and Dana provided a helpful memo on the FFCRA and FMLA exceptions. We are grateful for the sharing of information between states during this challenging time.
On Friday, March 27, President Trump signed the CARES act into law. Many provisions in the bill apply to LeadingAge Ohio providers and business members.
Some key pieces include:
LeadingAge has provided a summary of the bill.
Please send all questions to COVID19@leadingageohio.org. Additionally, members are encouraged to visit the LeadingAge Ohio COVID-19 Working Group Facebook Group to pose questions to peers and share best practices.