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Today's COVID-19 Report: Wednesday, September 30, 2020

Wednesday, September 30, 2020

Here are the latest need-to-know updates for Wednesday, September 30 regarding the COVID-19 pandemic. 

ECHO National Nursing Home COVID-19 Action Network to start next week

The HHS Agency for Healthcare Research and Quality (AHRQ) has asked LeadingAge Ohio to share this flyer with all nursing home members regarding webinars scheduled for tomorrow, October 1. AHRQ is funding this initiative, in collaboration with Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC). Funds from the Provider Relief Fund will be used to pay the stipends to participating nursing homes.

Project ECHO, a collaboration between AHRQ, the Institute for Healthcare Improvement (IHI), and the ECHO institute was introduced to LeadingAge and American Health Care Association state executives on yesterday. AHRQ, IHI and Echo Institute executives introduced Project ECHO, a 16-week free virtual learning opportunity for nursing facilities (NF), which via ‘hubs’ (i.e. small groups), NFs can work with quality improvement and domain experts and other NFs to implement evidence-based practices to address COVID-19. LeadingAge state execs as well as AHCA’s had many questions; a Question and Answer document from the call was created that links to the ECHO website. A facility must sign up to participate and the Q&A document takes a NF directly to sign up materials. 

NHSN security upgrade

Nursing homes are encouraged to upgrade their security level in National Healthcare Safety Network (NHSN) as soon as possible.  When nursing homes first began reporting to Centers for Disease Control and Prevention (CDC) through NHSN back in the spring, many opted for the expedited enrollment process that gave them access at Level I and did not require a Secure Access Management Services (SAMS) grid card. In late summer, CDC began encouraging nursing homes to upgrade to Level III, which requires the SAMS grid card, in order to be able to report patient-level data, such as COVID-19 test results, rather than simply reporting facility-level data as they currently do. This is a step toward streamlining reporting requirements. 

This process will take a few weeks from start to finish. Providers will still be able to submit weekly reports to NHSN using their level I enrollment while they complete the process of upgrading to level 3. Providers can find instructions on the NHSN site by clicking here. Ohio’s QIN-QIO, IPRO, is able to help; email

STNA/CNA staffing summit on October 20

The National Association of Health Care Assistants (NAHCA) and CNAs for Quality Care are sponsoring a CNA Staffing Summit to be held on October 20 from 1:00 to 4:00 ET. A panel of nine career CNAs from nursing homes around the country will be moderated by NAHCA CEO Lori Porter and Skilled Nursing News Editor Alex Spanko. Harvard Professor David Grabowski, PhD, will examine the state of the research on COVID-19 and direct care staff. Medical Epidemiologist for Long-Term Care at the Centers for Disease Control and Prevention Nimalie Stone, MD, is invited to speak. In addition to education, CNAs and others will address what matters most to direct care staff: engagement, recognition, and recruitment.  For more information and to register, please click here.

Hospice VBID Medicare Advantage Organizations Identified

The Centers for Medicare & Medicaid Services announced in January 2019 that beginning in CY 2021, through the VBID (Medicare Advantage Value-Based Insurance Design) Model, participating MAOs could include the Medicare hospice benefit in their Part A benefits package.

Under the Model in CY 2021, nine MA organizations, through 53 PBPs, will participate in the Hospice Benefit Component of the VBID Model. These PBPs will test the Hospice Benefit Component in service areas that cover 206 counties.

A downloadable list of PBPs with service area and contact information can be found by clicking here. The only MA plan that is participating in the Hospice Medicare Carve-in VBID Model in Ohio is Humana.

By including the Medicare hospice benefit in the MA benefits package, CMS will test the impact on service delivery and quality of MA plans providing all original Parts A and B Medicare items and services required by statute. Additionally, CMS is testing how the hospice benefit component can improve beneficiary care through greater care coordination, reduced fragmentation, and transparency in line with recommendations by the Office of Inspector General (OIG), the Medicare Payment Advisory Commission (MedPAC) and others. CMS will require that MAOs provide beneficiaries with broad access to the complete original Medicare hospice benefit. MAOs participating in the hospice benefit component will be required to outline how they will provide palliative care to eligible enrollees, irrespective of the election of hospice, and may make transitional, concurrent care services as well as hospice-specific supplemental benefits available to enrollees who elect hospice through network hospice providers.

More information about VBID generally (including which plans are participating in the broad demo and not the carve-in) and the hospice benefit component can be found on CMMI’s VBID home page. If you have additional question about the Hospice Medicare Carve-in VBID model, please reach out to Anne Shelley, Director of Home Health and Hospice Regulatory Relations, LeadingAge Ohio at

Abbot BinaxNOW training session slides now available

The United States Department of Health and Human Services (HHS) and Abbott partnered to offer a training on the Abbott BinaxNOW tests for home health and hospice organizations. The slides from the webinar can be found here. LeadingAge is working with HHS to determine next steps for their distribution plan for the test kits. As with nursing homes and other providers, a CLIA certificate of waiver will be necessary to receive and administer these tests intended for staff of home health and hospice organizations.

MDS Exception Reviews begin on November 2

MDS will resume exception reviews, tentatively scheduled to begin on November 02, 2020.  A more detailed update will be sent as the Ohio Department of Medicaid (ODM) gets closer to this anticipated date. The exception reviews will be performed from remote locations.

Medical records upload rule

Beginning October 1, 2020 federal regulations under FY2021 Final Rule: CMS-1735-F  will now require all providers to transmit medical records and other documentation (e.g. the Notices of Non-Coverage) to the Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIOs) electronically using an electronic submission method determined by the QIO.  Providers will now be reimbursed a flat rate of $3.00 per case for the electronic submission.

CMS will now require all documentation sent to them be sent electronically and be sent via Livanta. Livanta will accept medical records electronically in two ways. Providers may choose which method is best for them and submit medical records accordingly.

  1. Direct Secure Messaging. Direct Secure Messaging can be performed through many electronic medical record systems (EMR) systems. To clarify, Direct Secure Messaging is NOT email.  Please contact your organization’s IT department or EMR vendor to determine if your facility can securely transmit medical records from your EMR to Livanta upon request.

Providers should follow the directions on the specific medical record request they receive from Livanta.  The individual medical record request will provide the correct Direct Secure Messaging address to submit each record.

Medical records may be transmitted to Livanta through Direct Secure Messaging at the following addresses:

For discharge appeals and service termination appeals:

For quality of care complaints:

  1. Livanta File Transfer portal. Providers can access a portal application via and by clicking on the e-LIFT portal button, can directly upload medical records as a .PDF file.  To ensure secure transmission provider must enter the CASE CONTROL ID and the unique EMR KEY supplied on medical record request before uploading the medical documentation.

Providers MUST obtain a wavier from the Livanta BFCC-QIO to continue faxing medical records.  Waivers may be applied for directly through Livanta’s webpage by clicking here.

Livanta will continue to accept medical records from all sources while providers’ transition.  However, after October 1, 2020 payments for faxed and hard copy medical records will not be processed for providers that do not already have an approved waiver.

For additional information including frequently asked questions, you may visit the website by clicking here.

Provider Helpline phone numbers are listed below for your convenience.  Please do not call Livanta to check on your case until two days after you have sent the medical record.

The region provider helpline phone number for Ohio is 888-9599-6575.

New CMS Emergency Preparedness Worksheet

In light of the Public Health Emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) has clarified in the QSO-20-41-All memo the testing exercise requirements to ensure that surveyors, as well as providers and suppliers, are aware of the exemption available based on activation of their emergency plans. The memo includes the surveyor worksheet that speaks to the requirements for surveying for testing exercises standards.

The emergency preparedness regulations allow an exemption for providers or suppliers that experience a natural or man-made event requiring activation of their emergency plan. On Friday, March 13, 2020, the President declared a national emergency due to COVID-19 and subsequently many providers and suppliers have activated their emergency plans in order to address surge and coordinate response activities. Facilities that activate their emergency plans are exempt from the next required full-scale community-based or individual, facility-based functional exercise. Facilities must be able to demonstrate, through written documentation, that they activated their program due to the emergency.

Facilities may need to conduct an exercise of choice following the current PHE if they were required to conduct such an exercise this year and did not already do so. Facilities may choose to conduct a table-top exercise (TTX) which could assess the facility’s response to COVID-19. This may include but is not limited to, discussions surrounding availability of personal protective equipment (PPE); isolation and quarantine areas for screening patients; or any other activities implemented during the activation of the emergency plan. The emergency preparedness provisions require that facilities assess and update their emergency program as needed. Therefore, lessons learned and challenges identified in the TTX may allow a facility to adjust its plans accordingly.

BD releases guide for batch testing option

For LeadingAge Ohio members with the BD Veritor testing machines, BD has just released this batching guide for use with the BD Veritor Plus System Analyzer machine.

Affordable Senior Housing included in Continuing Resolution

The U.S. House passed a Continuing Resolution (CR) which includes language to extend United States Department of Housing and Urban Development's (HUD) 40-site IWISH demonstration until December 11. It also gives HUD the authority to spend funds at the rate necessary to keep up with Section 202 Project Rental Assistance Contract renewal needs from October 1 – December 11, similar to language that had to be included in last year’s CRs. LeadingAge supports both of these adjustments to the CR, which would otherwise provide FY20 funding level for the duration of the CR without these two changes. The Senate is expected to pass, and the President is expected to sign, the CR before the new fiscal year starts tomorrow, October 1.

Housing Happenings call shares some myths and facts around COVID-19 transmission and prevention

In this morning’s weekly Housing Happenings call, special guest Dr. Kenneth Feder, Epidemic Intelligence Service Officer with the CDC in Maryland, discussed some of the myths and facts around COVID-19 transmission and prevention. “It is much of what we have learned throughout these last several months with the virus that has led to the control measures put in place to mitigate the spread,” shared Dr. Feder. Dr. Feder shared what is now known about COVID-19 transmission and relayed what are believed to be the three key Ws on how to mitigate the spread: watch your distance, wear a mask and wash your hands. He also engaged in a Q&A with participants. A summary of Dr. Feder’s comments and the Q&A can be accessed here .

Housing Happenings is a free member benefit co-hosted by LeadingAge Maryland and LeadingAge Ohio each Wednesday morning from 9:00 AM-10:00 AM. To join next week’s call, register on the LeadingAge Ohio website.

COVID-19 member pulse survey closes today, your input needed

In a special bulletin last Monday, a request was sent to provider members to complete a brief 'pulse' survey to gain member feedback needed to stay nimble in advocacy efforts and stay on target with resource development. Seeking ways to enhance the services and resources LeadingAge Ohio provides members throughout this pandemic and beyond remains a key priority.  If you have not had a chance to complete the survey, today, September 30,  is the deadline.  Please take a moment to complete the COVID-19 Member Pulse Survey. The survey is estimated to take less than 10 minutes.

Nominations open for the LeadingAge Ohio awards program

The need to honor and recognize has never been greater. As we continue to navigate challenges posed by the pandemic, LeadingAge Ohio knows there are some amazing stories and examples of caring, compassion and service like we’ve never known. The LeadingAge Ohio annual awards program has been revamped with fewer categories and a shorter application to save time and help us celebrate the individuals and organizations we are so proud to serve. Visit the LeadingAge Ohio website for all the details.  Deadline to submit nominations is Friday, October 23. Questions regarding the annual awards program can be directed to Jennifer Taylor, Director of Member Experience, at or call 614-545-9028.

LeadingAge Need to Know: COVID-19 – September 30, 2020

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

Check out the full report here.

                Linkage                         Buerger


Please send all questions to 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.