06/10/2020

Today's COVID-19 Report: Wednesday, June 10, 2020

Wednesday, June 10, 2020

Here are the latest need-to-know updates for Wednesday, June 10 regarding the COVID-19 pandemic.

All-member Call - Thursday, June 11

LeadingAge Ohio is holding an all-member COVID-19 update call tomorrow, Thursday, June 11 at 10:30 am. This week’s call will highlight the Infection Control Surveys now underway, offsite vs. onsite considerations, including policies (especially the importance of E24), record reviews, observations and interviews of both residents and staff. Most of the call will be devoted to Q&A related to the surveys, but all questions welcome!

Call-in registration is as follows:

For best call quality, we encourage using your computer audio.  This also allows callers to easily send questions to the speakers via the "chat" function.  Questions can also be sent to the COVID19@leadingageohio.org email address.

Please click the following link to join the webinar on your computer:

https://easyconnecthd.zoom.us/j/92530958609

Or iPhone one-tap: 

+13126266799,,92530958609#

Or Telephone:

US: +1 312 626 6799  

Webinar ID: 925 3095 8609

LeadingAge Ohio Members Testify in House Aging & Long-Term Care Committee

During today’s meeting of the Ohio House Aging & Long-Term Care Committee, LeadingAge Ohio President/CEO Kathryn Brod joined Judy Budi, President/CEO of Graceworks Lutheran Services, and Mike Ray, President/CEO of Green Hills Community, to testify on the impact of COVID-19 on Ohio nursing homes and long-term care providers.  Written testimony was also provided by Brett Kirkpatrick, President/CEO of Community First Solutions.

The testimonies included: first-hand experiences in serving on the frontlines of the coronavirus pandemic; detailed information regarding the challenges long-term care, post-acute care, and other services have experienced thus far; reactions to the handling of the coronavirus pandemic by the Administration and General Assembly; and potential solutions to explore that will ease the burden of providers, support long-term care staff, and continue to support vulnerable elders.

Representatives serving on the committee posed thoughtful questions to the group, including:

• What would success look like for providers in terms of PPE and testing?
• What are the challenges associated with hospital discharges?
• What is the appropriate way to combat social isolation?
• Are the costs of tests coming down?
• How difficult was the Post-acute Regional Rapid Testing (PARRT) program to get up and running?

The interest of this committee and willingness to engage offer hope that state efforts to combat the coronavirus and assist long-term care providers will continue to improve. You can view the full hearing on the Ohio Channel website. 

Preparing for ODH Infection Control Assessment Response Reviews

The Ohio Department of Health (ODH) has completed 182 Infection Control Assessment and Response reviews. These reviews are not regulatory in nature. The purpose is to assess nursing homes preparedness in identifying and controlling the spread of COVID-19.

The Infection control assessment and response (ICAR) tool was developed by the Centers for Disease Control (CDC). The assessment includes a combination of staff interviews and direct observations and can be conducted in-person or remotely. ODH will evaluate if the information a facility reports from the tool is consistent with practices occurring within the facility. This tool can be utilized by facilities as a self-assessment and/or auditing tool. Additional information can be found on the CDC Nursing Home and Long-Term Care website.

If you have a question about the ICAR review, email LeadingAge Ohio Quality & Regulatory Specialist - Long Term Care Stephanie DeWees at sdewees@leadingageohio.org.

Infection Control Survey Tip of the Week: Alcohol-Based Hand Rub

The Centers for Disease Control & Prevention (CDC) recommends using Alcohol-Based Hand Rub (ABHR) over handwashing unless hands are visibly soiled. Hand washing has been the standard of practice for many years. Prioritizing the use of ABHR over handwashing can create confusion. Explaining the rationale behind this approach can assist with compliance.

The CDC Hand Hygiene website states the following:

CDC recommends using ABHR with greater than 60% ethanol or 70% isopropanol in healthcare settings. Unless hands are visibly soiled, an alcohol-based hand rub is preferred over soap and water in most clinical situations due to evidence of better compliance compared to soap and water. Hand rubs are generally less irritating to hands and are effective in the absence of a sink.

If you have a question about infection control, email LeadingAge Ohio Quality & Regulatory Specialist - Long Term Care Stephanie DeWees at sdewees@leadingageohio.org.

LeadingAge Submits Comments on Proposed SNF PPS Rules

LeadingAge submitted comments yesterday to the Centers for Medicare & Medicaid Services (CMS) on the FY 2021 SNF Prospective Payment System Value Based Purchasing rules.

While the 2.3% market basket update was appreciated, both LeadingAge and LeadingAge Ohio note that it will not be sufficient to reflect the new reality of the types and amounts of costs SNFs will still be reckoning with in FY 2021 due to COVID-19.

HHS Announces new Targeted Medicaid/CHIP Distribution from Provider Relief Fund, Application Portal Opens Wednesday, June 10

Today, HHS announced its next round of Provider Relief Funding it intends to distribute. This time it is going out to Medicaid and CHIP providers but through a time-limited  application process vs. automatic payment. Nick Uehlecke from Secretary Alex Azar’s office will join LeadingAge on its Friday 3:30 call to answer member questions. To register for the daily calls, click here.  LeadingAge Ohio members with questions for Nick should direct them to Nicole Fallon at nfallon@leadingage.org.  LeadingAge provided the following summary and known facts to date:

Who is eligible?

Providers who: 1) did NOT receive a General Distribution payment (these went to Medicare providers who may also provide Medicaid) AND 2) participate in Medicaid and/or CHIP programs AND billed Medicaid FFS or Medicaid Managed care between 1/1/2018 and 5/31/2020.

How will providers get the payment?

Unlike prior Provider Relief Fund distributions, for this distribution, providers must apply by submitting required information through a new “Enhanced Provider Relief Fund Payment Portal”, which will go live Wednesday, June 10. HHS has said providers will need to submit the following: annual patient revenue and # of Medicaid patients/beneficiaries served.

How much will a provider receive?

HHS reports providers will be eligible to receive payments of at least 2% of reported gross revenue from patient care.

The portal to apply will remain open for applications until JULY 3

Act for Older Lives Campaign

LeadingAge has released its June letter to Congress outlining LeadingAge/VNAA requests for the next relief bill.  This next bill is now expected in mid- to late-July; there may also be another bill in August.  The letter frames LeadingAge’s requests using the Five Essential Actions and the rubric of the Act for Older Lives Campaign.  The campaign has been launched to bring the elements of the aging services continuum together and increase recognition of the comprehensiveness of LeadingAge’s visibility.  The letter was sent to members of Congress this morning. 

You Asked...We Answered

You Asked: I am a hospice medical director and I have a patient with advanced cancer who moved to Ohio two days ago from Indiana.  His long-term oncologist from Indiana University referred him to hospice as the oncologist is not a licensed physician in Ohio.  The patient does not have a primary care physician in Ohio.  Our team met the patient and his family and they presented the case to me.  He is hospice appropriate with a life expectancy of less than 6 months.  Can I admit the patient to hospice even though the patient is not actively dying at this time (note: he chose the hospice medical director as his attending physician)? 

We Answered: As a hospice medical director, you can act as both the patient’s attending physician and medical director if you believe the patient is appropriate for hospice.  The patient does not have to be actively dying for you to act in that capacity, the patient must just be appropriate for hospice.

In this case, you will sign the certification of terminal illness either in two locations indicating you are both the attending physician and medical director or you can sign in the medical director area and put a note on the certification of terminal illness stating you are also acting as the patient’s attending physician.  Either way, Palmetto will know you are acting in both capacities.

Below is the citation from the hospice CoP’s that addresses this situation:

418.22   Certification of terminal illness

(c) Sources of certification. (1) For the initial 90-day period, the hospice must obtain written certification statements (and oral certification statements if required under paragraph (a)(3) of this section) from—

(i) The medical director of the hospice or the physician member of the hospice interdisciplinary group; and

(ii) The individual's attending physician, if the individual has an attending physician. The attending physician must meet the definition of physician specified in §410.20 of this subchapter

(2) For subsequent periods, the only requirement is certification by one of the physicians listed in paragraph (c)(1)(i) of this section.

EPA-Certified Disinfectant Available Through Apollo Bath

LeadingAge Ohio Associate Firm Apollo Bath currently has an EPA-certified disinfectant in stock. The disinfectant meets the criteria for use against SARS-COV-2, the novel coronavirus that causes COVID-19. Additional details on the product can be viewed by clicking here. Cid-A-L is a concentrate and one gallon will make 128 gallons of disinfectant. Members may order the items by accessing this link.

State Offers Three New Funding Opportunities for Businesses

Ohio Governor Mike DeWine has recently put into action three new funding opportunities for small and medium-sized businesses in Ohio. Two of the programs offer grants to businesses that either manufacture personal protective equipment (PPE), or are owned and operated by minorities or women.  The third will make loans available to businesses in Ohio’s Appalachian region, which covers 32 counties that span from the edge of Cincinnati to the eastern border of Ohio, up to Lake Erie.

Learn more about the Ohio PPE Retooling and Reshoring Grant Progam, the Ohio Minority Micro-Enterprise Grant Program, and the Appalachian Region Loan Program in this write up by LeadingAge Ohio partner HW&Co.

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 at here.