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09/10/2020

Today's COVID-19 Report: Friday, September 11, 2020

Friday, September 11, 2020

Here are the latest need-to-know updates for Friday, September 11, 2020 regarding the COVID-19 pandemic.

Nursing facility state-supported staff testing schedule September 14 to September 20; DO NOT USE BARCODE STICKERS

The Nursing Home testing schedule for specimen collection (swabbing) dates September 14 through September 20 can be found at this link.

All facilities that were previously assigned to Battelle have been reassigned to the Ohio Department of Health Lab. No other changes in lab assignments have been made.

Facilities that switched from Battelle to ODH that already filled out their lab requisitions do not need to fill out new forms; the ODH lab will accept your forms with the incorrect lab assignment.

ALSO, late today the CCURT team sent this important update to facilities: "if you received kits from the ODH warehouse (for use at ODH, OSU, Dayton Children's, UC Health, or Battelle) that contained barcode stickers, please DO NOT use these. Use of these barcodes will result in sample rejection. You must follow our original instructions for labeling your vials: include both the full name (first and last) and the date of birth on each tube. These fields must exactly match the name and date of birth on each of your lab requisitions forms."

Reopening of adult day centers approaching

On a webinar today, Director of Aging Ursel McElroy and Director of Health Lance Himes provided an overview of the adult day reopening, noting that each adult day provider will need to assess whether they can open safely within the guidelines outlined in the Director’s Order, and that some providers may not be able to open safely, due to the vulnerable population they serve. 

During the webinar, Director McElroy shared that adult day providers must either test or verify that staff and participants have been tested at least once every other week.  While the ADS providers will do the specimen collection the state will provide training, test kits, and lab capacity for the baseline and repeat testing.

The webinar, which is planned to be added to the ODA website later today, provided an overview of the specific guidance, walking participants step-by-step through the Director’s Order. In addition, two surveys were described that providers should complete immediately - one is focused on provider plans for reopening and the other on PPE inventory. 

ODA is not proposing changes to how services are authorized or paid for under PASSPORT program but all providers should complete as soon as possible a survey that is currently live on the ODA website.  Providers will be asked to provide their restart date, what capacity will be, and available services. Providers were also reminded of the availability of provider relief funds via the Ohio Budget & Management grants partnership program.

The second survey is focused on personal protective equipment. ODA is asking providers to complete this survey by September 16, which will include an inventory of each adult day center’s PPE supplies.

Last week, LeadingAge Ohio assembled the concerns of adult day providers from across the state, particularly related to areas where the order lacked sufficient clarity. We will continue to advance these concerns, given the guidelines will make reopening challenge for most adult day providers. 

OBM says $220 million disbursed as of today; home care applications lag

Today, LeadingAge Ohio met with representatives from the Ohio Office of Management and Budget (OBM) and the Ohio Department of Medicaid (ODM) for an update regarding Ohio’s efforts to pay out its portion of CARES Act funding. To date, 915 nursing homes 513 assisted living, 269 home health, and 158 MyCare providers have applied. In addition, 256 PASSPORT providers and 133 Ohio Home Care waiver providers have applied. OBM has agreed to share a list of providers that have not yet applied—meaning their Medicaid ID number does not match any within the Medicaid system—with LeadingAge Ohio. Zip code fields continue to be common field for mismatches, and for assisted living facilities, often the name entered may not match the one on file in the Medicaid system. Furthermore, Medicaid affirmed that the data they are using comes from multiple sources, and because of this, one provider’s application may match to data from one system, triggering the disbursement, while not matching data from another system which will delay the disbursement while the information is manually verified.

Another round of disbursements were made yesterday and today, and as of this week, roughly $220 million has been disbursed to providers. Checks are in the mail for those without electronic funds transfer capability. Those provider types with low levels of applications are, not surprisingly, smaller agencies such as home health and behavioral health centers who may not have heard about the opportunity. OBM noted that their response to questions sent to the CRF mailbox has been delayed, but that is still the best place for inquiries. When emailing, providers should include their Medicaid ID number in the subject field of the email, to allow for easy sorting by OBM staff. In addition, the content of the email should identify the organization’s NPI, street address, corporate street address (if part of a multi-site system), and D/B/A. 

ODH Issues Reporting Requirements for Antigen Devices

LeadingAge Ohio reached out to the Ohio Department of Heath (ODH) regarding the reporting requirements for tests administered using a point-of-care (POC) antigen test. ODH confirmed that as nursing homes begin conducting their own antigen testing on-site, they will be required to register as a lab and report aggregate test results via the lab reporting portal on the ODH website, in addition to reporting positive results to the local health department (LHD).  The aggregate reporting is due daily by 11am, and the positive case/line level reporting must be made within 24 hours of case identification. 

Previously, providers had been accustomed to reporting positive cases to the local health department, but with the advent of the POC devices, they now fall under a second reporting requirement in Ohio, outlined in a May 13 Director’s order.

Once providers have registered, they will receive a confirmation email from ODH, which will include the following instructions:

For the case/line level reporting, your facility must report positive and inconclusive results to the local health department (LHD) where the patient resides within 24 hours of case identification (i.e. time the test is resulted). This is generally completed by faxing the confidential case report form to the LHD.  To identify the LHD where the patient resides, you may use the LHD address tool.  If the patient resides out of state (e.g. staff person), you must report those results to the appropriate state health department where that person resides. ODH will alert all facilities when they are ready to start receiving negative test results as the case level. Once negatives are required to be reported, ODH recommends that you setup an electronic laboratory reporting (ELR) data feed to reduce burden on the LTCF, LHD, and ODH to receive your data daily, securely, and most efficiently.  This involves setting up a secure connection with ODH and working on a CSV format to send COVID results electronically.  If interested, complete the attached SFTP request form.

For aggregate count reporting, your facility must report ALL COVID results daily by 11 am ET.  You do not need to start the daily reporting until you start testing in-house.  If you collect specimens in your facility, but then send them for testing to a reference lab (e.g. Quest, LabCorp, local hospital, etc.), then you do NOT report these counts.  The performing laboratory is responsible for reporting those aggregate counts. 

The confirmation email will also include a screenshot of the data entry field, with notes on areas where a provider should be meticulous in data entry. Notably, since there is no authentication to enter the portal, they should ensure they select the correct lab from the drop down. Furthermore, all test results from the Quidel and BD machines should be recorded as non-diagnostic tests. A nursing home will NOT enter any data for PCR test results they receive, as these would be recorded by the lab processing the tests. The form requires this field to be filled out, though, so a nursing home should enter ‘0’ in each of the five fields pertaining to diagnostic tests before entering the information on antigen tests in the fields for non-diagnostic tests.

Some additional resources include:

New Long-term Care Project research studies family experience during COVID-19

Scripps has just released research findings from an online survey of families of residents in long-term care settings during the COVID-19 suspension of visitation. The research summary notes that “Overall, despite the difficult situation, the majority of families had a positive view about the facility where their family or friend resided. Facilities played a critical role in helping families stay in touch; their communication strategies--or lack thereof-- were related to family perceptions about the facility.” Click here for the study.

Antigen testing updates and advice for use of BD machines

LeadingAge has learned of several of its members who have experienced false positive test results using the BD machine. Colleagues at Agency for Health Care Administration (AHCA) are hearing similar reports – seven so far. The total number heard to date is still in the single digits, but is still cause for deep concern, since positive results often precipitate a move to a COVID-19 dedicated unit, where an uninfected person would be at higher risk of infection. LeadingAge is working with Assistant Secretary for Health, Admiral Brett P. Giroir's office and they are deeply concerned and focused on addressing this terrible problem. If you have experienced false positive results with BD machines, please email Kathryn Brod at kbrod@leadingageohio.org.

Advice for use of BD machines.

It’s important for members who have BD machines:

  • to review the Instructions for Use at this link.
  • to add three full drops to the well for each test;
  • to know that tests should not be done outdoors, especially if it’s hot;
  • and they can’t hold samples, they need to analyze samples immediately (i.e. do not hold).

LeadingAge is arranging, hopefully by next week, a BD-led demonstration and live question and answer session for nursing home members who have received a BD machine. 

LeadingAge will record the session for members who miss it or want to review it. BD is also running its own webinar series, more information here.

Tools for supporting staff during COVID-19 and beyond

This week HR team members and other administrative staff from LeadingAge Ohio members gathered for an early morning dialogue with their colleagues and consultant Nancy Pettigrew on creating a Healthy Workplace. The discussion emphasized the importance of doing some introspection in order to more effectively create a workplace with trust, compassion, courage and gratitude. The topic is particularly appropriate for the breadth of workforces challenges long-term care settings are facing. LeadingAge, too, has worked to provide insights;  Susan Hildrebrandt, LeadingAge’s Vice President of Workforce Initiatives worked with membership to create a brief collection of concepts for how leadership can support staff during COVID-19.

The next virtual LeadingAge Ohio member HR/Executives gathering for interested team members is scheduled for October 8. October’s early morning meeting (7:30 am) will include Danielle Willis, Senior Vice President-Human Resources for National Church Residences, and Lois Mills, Vice-President/Chief People Officer for Otterbein SeniorLife, leading a discussion on “Journey to Equity and Inclusion”. Additional details and registration for this meeting will be available soon.

CDC Guidance for affordable housing providers

Yesterday CDC released COVID-19 recommendations regarding infection control and operation procedures for affordable senior housing providers.  The recommendations, developed through input from LeadingAge, cover a wide range of scenarios including:

  • Unit turn-over and move-ins
  • Visitors, service providers, and prospective tenants
  • Loneliness and social isolation among older adult residents
  • Resident communication systems
  • Protections for at-risk residents and staff
  • In-unit maintenance and Inspections
  • Safe communal spaces
  • Cleaning and disinfection
  • Property signage and messaging
  • Mask policies and social distancing
  • Confirmed COVID-19 cases

Next Wednesday’s Housing Happenings will review the recommendations as well as continue the exploration of Dementia-Inclusive communities with Episcopal Retirement Services' CEO, Laura Lamb. Register for the call here.

Don't miss the Advocacy in Action call this coming Monday

Join the LeadingAge Ohio advocacy team for the Advocacy in Action call at 10:00 am on Monday, September 14. 

Advocacy in Action calls are held at 10 a.m. on the second Monday of each month; the call features LeadingAge Ohio advocacy staff and member advocates sharing the latest news from the statehouse, and how your dues are being used to advance aging services in Ohio. This month’s call will include an update on Ohio’s CARES Act funding, legislation that will impact Ohio providers, and actions you can take in advance of the November election to elevate our sector.

To join the call, dial: (646) 558-8656; meeting ID: 915-089-7248.

One-touch dial:16465588656,9150897248#,,,,#

eServices scheduled outage

Palmetto GBA will conduct a scheduled outage on the eService provider portal on Saturday, September 12, 2020. Certain eServices functions will be affected. The outage is expected to last from 1:00 pm Saturday until 8:00 am ET Sunday.

Services Impacted: Review Choice Demonstration functionality in eServices will be unavailable beginning Saturday, September 12, 2020 at 1:00 pm through Sunday, September 13, 2020 at 8:00 pm ET. 

LeadingAge Need to Know: COVID-19 – September 11, 2020

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured a reminder on the upcoming Collaborative Care & HIT Summit and an update on Monday's Online Coronavirus Policy Update.

Check out the full report here.

                Linkage                         Buerger


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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Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.