07/23/2020

Today's COVID-19 Report: Thursday, July 23, 2020

Thursday, July 23, 2020

Here are the latest need-to-know updates for Thursday, July 23 regarding the COVID-19 pandemic.

Federal Government to Double COVID-19 Nursing Home Funding

The Trump Administration announced yesterday that the federal government will more than double COVID-19 funding dedicated to nursing homes. President Trump announced an additional $5 billion on Wednesday to be sent directly to skilled nursing facilities around the country, taking the total investment to $10 billion. 

As reported by McKnight's in a breaking article yesterday, providers will become eligible by completing an online training program focused on infection control. As stated in the article, "Twenty-three learning modules in the program will teach, among other things, cohorting strategies and promote the use of telehealth, the Centers for Medicare & Medicaid Services (CMS) explained in a statement Wednesday."

CMS elaborated on the funding further, stating:

"The U.S. Department of Health and Human Services (HHS) will devote $5 billion of the Provider Relief Fund authorized by the Coronavirus Aid, Relief, and Economic Security (CARES) Act to Medicare-certified long term care facilities and state veterans’ homes (“nursing homes”), to build nursing home skills and enhance nursing homes’ response to COVID-19, including enhanced infection control. This funding could be used to address critical needs in nursing homes including hiring additional staff, implementing infection control “mentorship” programs with subject matter experts, increasing testing, and providing additional services, such as technology so residents can connect with their families if they are not able to visit. Nursing homes must participate in the Nursing Home COVID-19 Training (described below) to be qualified to receive this funding. This new funding is in addition to the $4.9 billion previously announced to offset revenue losses and assist nursing homes with additional costs related to responding to the COVID-19 public health emergency (PHE) and the shipments of personal protective equipment (PPE) provided to nursing homes by the Federal Emergency Management Agency (FEMA)."

During a briefing yesterday, President Trump also stated that:

• The Administration is sharing with Governors lists of high-risk nursing homes so they can take action.
• The CDC and Public Health Service (PHS) are providing enhanced technical assistance and support to the highest risk nursing homes (vis-à-vis the “strike teams”).
• CMS and CDC are putting an infection control training program in place, targeted at the highest risk nursing homes which “we have pinpointed.”
• If a nursing home has three or more COVID cases, “we alert the state and check on it very quickly."

LeadingAge will search for clarification on a number of these statements and will share information as it becomes available.  

Increased Testing Mandates Previewed

During the same briefing, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced that nursing facilities in states with a 5% COVID-19 positivity rate or higher will be required to test all staff each week, elevating the previous CMS "recommendations" to "requirements". 

LeadingAge received more information on the HHS testing program. HHS will send the first round of shipments out this week. It is sending testing instruments and tests to 600 nursing homes to begin with. HHS anticipates sending out instruments and tests over the next 14 weeks with a goal of reaching all nursing homes with a CLIA certificate of waiver.

CMS provided a dedicated email address for inquiries and will be able to look up an organization's CLIA number to verify an active CLIA certificate of waiver.

Nursing homes in the first group are prioritized according to the following criteria:

• Active CLIA certificate of waiver
• 3 or more new cases reported in the past 7 days or 1 new case reported in the past 7 days after having no cases
• Inadequate access to testing reported in the past 7 days
• 1 new death reported among residents in the past 7 days
• 1 new confirmed or suspected case reported among staff in the past 7 days

Nursing homes will be divided into five groups to determine how many testing instruments/tests they will receive. CMS did not provide info on how the facilities were classified. LeadingAge Ohio will continue to provide additional information on this as it becomes available. 

Statewide Mask Mandate, Travel Advisory to Take Effect Today

Governor Mike DeWine announced Wednesday that Ohio residents will be required to wear facial coverings in public, beginning at 6:00 pm today. DeWine had been hinting at a possible mask order for some time, and cited evidence that shows the powerful effect facial coverings have on preventing the spread of COVID-19. 

The order will be directed at people inside a building that is not a residence and those who are outdoors but cannot maintain 6 feet of distance from people outside of their households. 

Exceptions to the mandate will include:

• People with a disability or medical condition.
• Communicating with a person with a disability.
• People playing sports or exercising.
• People overseeing religious services.
• People engaging in public safety activities.
• People who are eating or drinking.
• People who are younger than 10 years old. 

The Governor also announced a travel advisory for individuals coming into Ohio from states where coronavirus testing positivity rates are at 15% or higher. It is recommended that those individuals quarantine for 14 days. Under these rules, the advisory would pertain to people traveling to Ohio from Alabama, Arizona, Florida, Georgia, Idaho, Mississippi, Nevada, South Carolina and Texas.

HUD Releasing $215M for COVID-19 Funding:  Application Deadline of August 5

This morning the U.S. Department of Housing & Urban Development (HUD) released notice 2020-08 describing a two-tier process for how the bulk of HUD’s remaining $215M of CARES Act funding will be released for Section 8, 202 and 811 COVID-19 expenses.  The first tier will be formula based (with attributes such as community type, unit count, service coordination, etc. considered) and distributed per a flat amount/community based on the attributes; this tier has a $12,000 cap per community and will require documentation of COVID-19 related activities and purchases. Owners that wish to apply for the second tier of the funding must “prove” need.  (Note: HUD has reported early this afternoon that the link within the 2020-08 notice for the submission form is malfunctioning; they are working to fix.)

Applications for these funds are due to HUD by August 5. According to a HUD representative who presented on today’s call with the Ohio Preservation Network (OPN), HUD will reply within two weeks of the application date, so these funds will move quickly.  While LeadingAge Ohio members are encouraged to apply as early as possible (so that questions or issues can be identified early), all pre-August 5 entries will be treated equally.

Note: there is a grace period for applications until August 12, but applications received after August 5 will be considered only if HUD has money remaining after funding applications received by August 5.

On LeadingAge’s Housing Advisory Group call next Monday, July 27, at 12:30 pm, a representative from HUD’s multi-family program will discuss today’s notice.  For members who wish to join the Housing Advisory Group, please contact Linda Couch at lcouch@leadingage.org.

Feedback Needed: Hospital Relationships

On a weekly call with the Ohio Medical Director’s Association (OMDA), physicians shared the changing expectations around testing and quarantine of newly admitted residents, especially in light of the increasing delays in testing results.

LeadingAge Ohio encourages members to reach out to the COVID-19 mailbox to share how partnership with your local hospital is working, particularly related to common understanding of testing and other protocols for discharge/admissions.

ODA Posts Provider Relief Funds Information

Today, the Ohio Department of Aging (ODA) posted an announcement regarding Provider Relief Funds on its website, and also sent the same information to all providers.  There is a webinar scheduled next Monday, July 27 at 1:30 pm to cover details of how to access the provider relief funds. LeadingAge Ohio strongly encourages all members to attend.

LeadingAge Asks Providers to Contact Congress

LeadingAge has asked that providers urge Congress to provide immediate relief to aging services providers. With the U.S. House and Senate back at work negotiating the next big relief package, LeadingAge has been advocating this summer for five essential actions and is pushing to get these over the finish line. 

LeadingAge has asked members to share with Congress how provider communities are struggling to obtain enough personal protective equipment, sufficient testing, and resources to keep the older adults they serve safe and healthy. The negotiations are happening now and decisions will be made fast. 

Providers can send a message to Congress through the LeadingAge Action Alert portal. 

Federal Civil Liability Protections

Although the U.S. Senate has not released specific civil liability protection language, LeadingAge and its coalition has worked to get the broadest language inserted into the bill to help protect providers across the aging services continuum.   

LeadingAge is making contacts with both parties in the Senate and House. Leader McConnell has publicly stated his support of broad civil liability protections and that they will be included in the package, including threatening that there will be no bill passed unless liability protections are included.

LeadingAge is ready to launch a specific grassroots alert to Congress on this issue if that becomes necessary.

ODM Episodes of Care Suspended During Calendar Year 2020 and 2021

Due to the COVID-19 pandemic, the Ohio Department of Medicaid (ODM) is suspending the Episodes of Care program for calendar year 2020 and 2021. ODM will not conduct reporting or assess positive and negative incentive payments during this time. ODM intends to restart episodes of care for calendar year 2022. Please visit https://medicaid.ohio.gov/PROVIDER/PaymentInnovation/Episodes for more information and updates. Providers may also sign up for the listserv to receive email updates.

If you have any questions, please contact the ODM provider assistance team via the IVR at, 1-800-686-1516, option 5. Providers must enter two of the following: tax ID, 7 digit Medicaid ID, or NPI in order to authenticate and speak with a representative.

UnitedHealthcare Community Plan of Ohio Seeks Facilities Accommodating COVID+ Cases

As previously reported, UnitedHealthcare Community Plan of Ohio is collaborating with the other managed care plans to streamline transition of care processes.  One resource the Unitedhealthcare Community Plan is looking to develop is a listing of nursing facilities that are able to accommodate and accept COVID positive cases and PUI (Persons Under Investigation) patients. 

The main information UnitedHealthcare is compiling is:

• Facility Name, Address
• Contact Name, Title, Telephone number, Email Address
• Number of isolation beds designated for COVID+/PUI patients
• If the facility is accepting COVID+/PUI patients from:
• Hospitals
• Assisted Livings
• Community
• Other Nursing Facilities

Please share any information or questions with Matthew Shula at MATTHEW.SHULA@UHC.COM by Tuesday, July 28. 

CLA Blog Post: Reporting Details For Provider Relief Fund Use

LeadingAge Ohio Associate Firm CliftonLarsonAllen (CLA) posted a helpful blog post on its website regarding information released by the Department of Health & Human Services (HHS) on July 21.

LeadingAge Need to Know: COVID-19 – July 23, 2020

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured a statement from LeadingAge CEO Katie Smith Sloan and new tools and insights. 

Check out the full report here.

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.