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07/31/2020

Today's COVID-19 Report: Friday, July 31, 2020

Friday, July 31, 2020

Here are the latest need-to-know updates for Friday, July 31 regarding the COVID-19 pandemic.

State’s Staff Re-Testing Plan: Questions Answered        

While many unanswered questions related to the state’s plan for staff re-testing remain, several important funding questions were answered today. 

Who pays for testing?

The associations learned that the state will be the payor of last resort for all staff testing, and Administration officials confirmed that this includes paying for staff testing costs for self-insured organizations.  In order for the state to do its part in covering testing costs, Ohio nursing homes must ensure that insurance information is accurately submitted for all employees – including for employees where a spouse or parent provides insurance or when Medicaid is the insurer.  The Administration reports that 80% of Ohio’s nursing facilities had incomplete data for their employees in the testing process just completed.  In this next round, if information is not entered accurately and completely, the labs will return the testing invoices to the facility for payment.

Employees covered by self-insured plans should enter the insurance information as they would with another insurer, and the only situation in which “no insurance” should be checked is if there truly is NO insurance for the employee.  The state is still determining whether invoices for uninsured individuals will go directly to the state or to facilities first.  

If the forms are properly completed, labs will bill third-party payers directly. For self-insured organizations, the bill from the lab will go to their third party administrator, which will then route the bill to the state for payment. Self-insured members should alert their third-party administrators of this change, to make sure they have the information needed to route the bill appropriately. This information is still forthcoming from the Administration, and LeadingAge Ohio will include it in a future daily alert.

Will providers have to re-enter employee data for each test?

The associations have asked that the state consider alternatives that would alleviate the need for employee information to be re-input for each test.  Administration officials confirmed that, until an alternative is found, the facility can replicate the employee’s information multiple times when first entered.  For example, if the first test date is August 4, a facility could enter the employee information for August 4, and replicate at time of entry, i.e. the entry could be completed three times.  This was not an option with the prior portal but is available now. 

Where would I find out if my county is one that will require me to pick up testing kits?

Since the webinar earlier this week, the Administration has decided that facilities will NOT be required to pick up supplies from a central location as previously discussed.  Instead, each facility will receive a shipment for three rounds of staff testing.  The testing kits do NOT need to be refrigerated upon receipt, but will need to be refrigerated after the specimen is collected. The kits should only be used for employee testing.

How will specimens be delivered to labs?

On the webinar earlier this week, test specimens were to either be picked up by the the Ohio National Guard (ONG) or by courier on the date identified for each facility.  On today’s call, the Administration confirmed that ONLY the ONG will be used. In order to maximize infection control, the ONG will not enter the facility; this pick-up will be curbside.  At this point, the exact timing of that pick-up cannot be confirmed.  Facilities should be prepared for the pickup at ANY time after 8 am on the specified pick-up date.

Can I change my organization's testing date?

Administration officials strongly discouraged changes in testing dates, but noted that it could be done under extreme circumstances. Facilities have been scheduled for testing based on lab capacity and routing the Ohio National Guard to facilities.  As a result, should a facility wish to change its scheduled date, advance approval MUST be provided by the state, and it may be necessary for the facility to arrange their own delivery of specimens to the lab. 

How many will be tested the first week?

The list of facilities scheduled for next week reflects just 160 nursing facilities. The list for the second week of August will contain a significantly higher number of facilities.  These two lists are likely NOT to contain every nursing home in the state.  The state expects that a third list will be distributed for subsequent weeks.  However, if a facility is opting out of the state program, the first round of testing must be completed between August 1 and August 14.

The Administration is finalizing an FAQ based on questions received to-date and promises its release before re-testing begins.

CORRECTION: Medicaid-only Relief Funds  

On Wednesday, LeadingAge Ohio included an article in its COVID-19 Daily Update entitled “Medicaid-only Providers Registering for PRF” which conflated the $471 million provider relief funds being distributed directly from the state of Ohio with the third tranche of provider relief being distributed directly from the Department of Health and Human Services (HHS).

We offer the following clarifications:

If you have any questions related to the original article, this correction notice, or the provider relief funds that may be available to your organization, do not hesitate to reach out to Susan Wallace at swallace@leadingageohio.org.

ODH Shares Guidance on Nursing Home Staff Testing

With the requirement to test staff on a regular basis in nursing homes, the Congregate Care Unified Response Team (CCURT) has developed the first week of the testing schedule.  Specimen kits will be shipped to providers, and the Ohio Department of Health (ODH) shared that there will be enough samples for providers to test 3 times for the staff identified in the survey.  

Providers are directed to only use these specimen kits for the twice-per-month testing for staff. It is critical that all staff are tested on the state-assigned date and all samples are ready for pick-up by 8:00am the following day. The Ohio National Guard will be picking up the specimens.

ODH plans to host a webinar for facilities on Monday, August 3 from 10:30am-11:00am to further clarify its plans and answer questions it has received. Facilities not identified for this first week of testing will be included in the testing schedule for the week of August 9, which will be released next week. Questions related to this process can be sent to CCURT@odh.ohio.gov.

ODH shared three documents to assist providers with this process:

Nursing home testing map and schedule. Facilities testing without state support should start testing every other week, with the first testing occurring between August 1 and August 14. Facilities participating in the state-supported process will also start testing every other week in August. Due to the rollout of the schedule, some facilities may begin after August 14.

Checklist for COVID-19 Test Specimen Storage & Transport. ODH prepared a checklist to assist nursing home staff to properly store and transport the completed test kits to the lab. ODH stated that for the collected specimens/swabs to be accurately processed at the nursing facility’s assigned testing lab, the checklist must be followed to preserve the integrity of the specimen.

Clinical Checklist for Specimen Collection of COVID-19 Test. ODH prepared a checklist to assist appropriate nursing home clinical staff in collecting specimens for a COVID-19 test. All nursing home testing will be utilizing anterior nares testing, a non-invasive form of COVID-19. 

State Announces Assisted Living Testing Initiative

The Ohio Department of Aging (ODA) and the Ohio Department of Health (ODH) have announced a statewide COVID-19 testing initiative for Ohio’s assisted living facilities. 

To support Ohio’s facilities, ODH and ODA have secured a testing provider who is able to offer baseline saliva testing to all assisted living staff and residents at no cost to the facilities. The tests can be self-performed or performed with assistance, under the observance of licensed medical staff. The tests are minimally invasive and provide reliable results in about 48 hours upon the lab’s receipt.

The state will ship tests and pre-paid shipping supplies directly to providers. Providers will be given access to a web-based test portal to enter basic information and to track results, and will receive training. ODH and ODA have also contemplated and developed contingency plans for situations that may arise during testing.

Next week, informational webinars are planned for facility leaders and for licensed staff members who will monitor the self-administered tests. 

List of Facilities Receiving POC Testing Machines Available

As reported in last week’s COVID-19 Alert ("HHS Testing Announcement: LeadingAge Issues Q&A"), the U.S. Department of Health and Human Services (HHS) has created a plan for shipping point-of-care rapid response testing instruments to facilities across the nation. Yesterday HHS released the list of facilities next in line to receive the devices. While the first mailing included no Ohio facilities, this next mailing includes 51 Ohio facilities and several LeadingAge Ohio members.   

HHS Considers PRF for Private-pay AL/Memory Care, Data Needed

Argentum, ASHA, NCAL, and LeadingAge are assisting the U.S. Department of Health and Human Services (HHS) in an effort to collect data for a possible distribution of CARES Act Provider Relief Funds to private-pay assisted living/memory care providers that are stand-alone or part of a CCRC/Life Plan Community. Please see the following message and data portal from LeadingAge. 

The U.S. Department of Health and Human Services (HHS) is considering a possible distribution of CARES Act Provider Relief Funds to private-pay assisted living/memory care providers that are stand-alone or part of a CCRC, located in the U.S states and territories. Argentum, ASHA, NCAL, and LeadingAge are assisting HHS in an effort to collect the necessary information from these providers through a private, secure data collection portal to help ease a potential future distribution of application funds. At this time, we have no guarantee such a distribution will happen, nor are we aware of an allocation methodology, if such a distribution were to occur. However, providing HHS with this data is an important step forward, and we appreciate your help in being responsive to their request. Providers should submit the relevant data into this portal by Monday, August 3 at 5 pm ET

Data Submission Portal Information

Who is eligible to submit information?

We encourage private-pay assisted living and memory care providers that are stand-alone or those part of a CCRCs in the U.S. states and territories to submit their data. Please note that some states may use different terminology (e.g. personal care homes, supportive living facilities, etc.) to describe their licensed assisted living-type providers. All of these providers are encouraged to submit their information. For purposes of this portal, the term licensure also includes assisted living and memory care communities registered or certified by the state. Submitting your data does not guarantee you will receive or be eligible to receive a payment. You do not need to be a member of one of our senior living trade associations to participate in this secure and confidential data-collection effort. 

What data must be submitted?

Where do I submit the data?

All of the above information should be submitted either manually or by uploading a specific file (see instructions for details) in the secure data collection portal. You will need to create an account. Please complete all the fields to ensure your submission will be accepted. Incomplete submissions will likely result in a delay in their inclusion.

What is the deadline to submit data?  
Please submit the requested data into the secure data collection portal by Monday, August 3 at 5pm ET.

Thank you for your quick action in support of this vital aid to our industry. If you have any questions, please contact us at: leadingage@leadingage.org  

CMP Applications – Grant Funding Likely by End of August

On a call with the Ohio Department of Medicaid (ODM) earlier this week, LeadingAge Ohio learned that 598 applications were filed for the $3,000-per-facility technology grants made through Ohio’s civil monetary penalty fund. This information was shared with members in an alert on April 29. 

While it is not too late to file applications, most providers have completed the application process. Facilities will receive a confirmation email from ODM acknowledging receipt of the application. In this email, facilities will receive directions on how to submit for a reimbursement of their technology expense.  

ODM stressed that it is important for all correspondence to go to NFCMP@medicaid.ohio.gov. Do not mail original applications or reimbursement receipts to ODM staff directly or to the ODM office through the USPS. All correspondence should also go to the NFCMP electronic mailbox.  Also, ODM reports that many emails are arriving with a request for status updates—they note that these email requests are hard to get to and have a lower priority compared to COVID initiatives. The repeated status update requests are causing the entire CMP reimbursement process to slow down.

Ohio House Elects New Speaker

After a dramatic week and a half following the news of the arrest of former Speaker Larry Householder, Ohio now has a new Speaker of the House. It is Representative Bob Cupp from Lima, Ohio, representing the 4th Ohio House District. 

The House met yesterday to remove Larry Householder from his role as speaker - the vote was unanimous. A motion by Representative Jeff Crossman to expel him from the chamber was tabled, with House Republicans choosing to let the impending court decision dictate Representative Householder's future in the Ohio House. A caucus meeting was held, where majority members chose Representative Cupp over Representative Jim Butler. A floor vote followed, and Speaker Cupp was sworn in. 

A former Ohio Supreme Court Justice, Speaker Cupp grew up working on his family’s farm in rural Allen County. He would go on to earn political science and law degrees from Ohio Northern University. Speaker Cupp has served as an Allen County commissioner, a four-term state senator, a court-of-appeals judge, and a justice of the Supreme Court of Ohio. He also served as a city prosecutor and as Chief Legal Counsel to former Ohio Auditor of State, Dave Yost.

Speaker Cupp brings decades of experience and a calm, kind demeanor to the Speaker's chair. He is universally respected on Capitol Square and in his hometown of Lima, and he stated to the Columbus Dispatch that he promises "to bring transparency to the speaker’s office."

LeadingAge Ohio will be eager to build a relationship with the new House Speaker and his leadership team, and will be working to assess the status of HB 606 - the civil liability legislation. Speaker Cupp visited LeadingAge Ohio member Willow Ridge in 2018, charming residents with gardening stories. 2021 promises to see a lot of power concentrated in Lima - both Speaker Cupp and the next Senate President Matt Huffman call it home. 

LeadingAge Need to Know: COVID-19 – July 31, 2020

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured a reminder that today is the final day to day to complete an application for the Larry Minnix Leadership Academy and a reminder that HHS is requesting specific information on licensed providers, including assisted living, memory care, and life plan communities/CCRCs.

Check out the full report here.

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Questions

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. LeadingAge is continuing its daily calls for all members.  To participate in these daily online updates, members should register here.  

LeadingAge Ohio is working to ensure that the information in our daily alerts, on our website, and all coronavirus-related communications is as accurate as possible. However, LeadingAge Ohio makes no guarantees about the accuracy of the information. 

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