10/14/2020

Today's COVID-19 Report

Thursday, October 15, 2020

Here are the latest need-to-know updates for Thursday, October 15 regarding the COVID-19 pandemic. 

Correction: repayment terms for accelerated or advance payment loans

An article that appeared in the October 12 edition of the LeadingAge Ohio COVID-19 Report entitled, “CMS announces new repayment terms for Medicare accelerated or advance payment loans made to providers during COVID-19,” recounted the announcement by the Centers for Medicare & Medicaid Services (CMS) that indicated that HHS provider relief funds could be used towards repayment of Medicare accelerated or advance payment loans. However, the article omitted the next-day retraction by CMS, which removed the line referencing loan repayment as a permissible use of relief funds. Furthermore, in a later update to the FAQ document, CMS included the following Q&A:

Can providers use Provider Relief Fund distributions to repay payments made under the CMS Accelerated and Advance Payment (AAP) Program? (Added 10/9/2020)

No, this is not a permissible use of Provider Relief Fund payments.

LeadingAge Ohio apologizes for any confusion the omission may have caused, and is grateful to LeadingAge Ohio Partner HW&Co., who pointed out the omission. Questions related to this topic may be directed to Susan Wallace at swallace@leadingageohio.org.

Lab capacity dashboard now available

In response to a suggestion made by LeadingAge Ohio, Governor DeWine announced on Tuesday the creation of a new Lab Capacity Dashboard to help nursing homes and others administering COVID-19 tests find a lab to run their samples. This new resource will help connect groups that are testing with available labs in order to ease turnaround times.

The new dashboard provides self-reported information about labs that can run tests, including hours of operation, types of tests they accept, estimated turn-around time, and locations. Labs with available capacity can sign up on the website to be included in this dashboard.

Updates for long-term care visitation portal

The Ohio Department of Health (ODH) provided updated information related to the instructions for long-term care providers to enter visitation information:

1. You must have an OHID account (7XXXXX). If you do not, follow the directions listed on page 2 of the attached document.
2. If you have an OHID or after you obtain one, you are now ready to register your facility which is step 1 on page 1. Please note that a single user with an OHID account can manage the time entries for multiple facilities, but each facility needs to be registered separately. Each facility doesn’t need an OHID account.
3. Complete all the fields, including identifying your facility type and the county of your facility.
4. ODH will then be able to approve your facility and add the application to your OHID account.
5. Once approved you will then receive an email with the link to enter your visitation information.
6. You must first create your facility with the facility information.
7. After you create the facility, if your information needs changed, you will utilize the update portion

If you have questions please email Rebecca.Sandholdt@odh.ohio.gov and CC Ricky.Hoover@odh.ohio.gov and Jill.Shonk@odh.ohio.gov. Do not email CCURT or the LICCERT account and do not call the Coronavirus call center. These options will delay assistance being provided.

CMS issues technical guidance for hospice carve-in

The Centers for Medicare & Medicaid Services have recently issued technical guidance for providers participating in the “Value-based Insurance Design” Medicare Advantage demonstration, widely known as the hospice “carve-in.” The guidance offers information technical and operational aspects of the implementation of the Hospice Benefit Component for both Model-participating MAOs and hospice providers located in their service areas.

Notably, the guidance includes significant billing and claims processing guidance, to ensure timely payment for the Medicare Advantage plans and hospices alike, including prompt-payment standards.

Of the nine Medicare Advantage plans that have opted into the VBID, only one serves Ohio counties. Humana in northeast Ohio (Cuyahoga, Lake, Lorain, Medina and Summit counties), is part of the demonstration, and so hospices in that region are encouraged to review the technical guidance closely.

RCF, Adult Day and Senior Center testing reporting

All Residential Care Facilities (RCF), Adult Day and Senior Centers should have received a notice this morning regarding the testing reporting tool. Reporting is required regardless of whether a facility/center chooses to utilize state-supported testing (i.e. MAKO) or chooses to use another laboratory. All questions in the reporting tool must be fully and accurately reported within each reporting period. The reporting tool will be accessible from 12:00am on the first reporting date until 11:59pm on the last date of each reporting period.

There is a week between the end of the testing cycle and when the reporting period begins. The purpose of this additional week is to ensure a facility/center receives all tests results back from the lab, particularly if they have opted out and are utilizing a private lab as their turnaround times may vary. If a facility/center utilizes the state-supported testing, results are returned by MAKO via their results portal to the facility/center no longer than 48 hours upon receipt of the specimen to MAKO’s lab.

Please report any questions and/or difficulties you may have with the tool to Kathryn Brod at kbrod@leadingageohio.org.

Some states begin NHSN reporting on point-of-care testing

Beginning tomorrow, Friday, October 16, providers in some states (not yet Ohio) will have the opportunity to report COVID-19 point-of-care testing through NHSN. This will require the enhanced security of upgrade to Level 3 (SAMS grid card) in the NHSN system. CDC is hosting two webinars next week to share more information: Thursday, October 22 at 11:00am ET and Friday, October 23 at 2:00pm ET. Registration information is not yet available for these webinars but will be posted here.

Providers may want to participate in the webinars to learn about this reporting capability should Ohio move to allow this approach for state reporting; LeadingAge Ohio continues to advocate for Ohio to adopt NHSN as the reporting platform, given the significant burden that test reporting places on providers. It is important to note that this capability does not replace required reporting according to CLIA requirements.

ODH provides Nursing Home testing clarification to DPS/EMS Channels

In the LeadingAge Ohio COVID-19 Report for October 6, LeadingAge Ohio reported that personnel providing services under arrangement (e.g. non-urgent medical transportation) should be tested by the facility or provide documentation that required testing was completed during the timeframe that corresponds to the facility’s testing frequency. As promised, the Ohio Department of Health (ODH) has now provided the additional clarification to DPS/EMS channels. 

Examples of non-urgent medical transportation are ambulettes and non-emergent emergency medical services (EMS) transports. Individuals providing emergency services, such as EMS workers or law enforcement, are not required to show proof of testing and should not be delayed in responding to emergency situations.

Members who have experienced challenges with transportation providers and testing are encouraged to share ODH’s documentation with those providers directly.

New hospice rule includes telehealth, pseudopatients

The Ohio Department of Medicaid (ODM) recently issued rule updates to its hospice rules, to align them with the new telehealth rule. Specificially, the changes include:

• 5160-56-01 – Added the definition of Telehealth;
• 5160-56-04 – Added the use of a pseudo patient for hospice aide competency testing;
• 5160-56-05 – Added that Core and Non-Core services could be preformed via contracted services or telehealth or a combination of both; and
• 5160-56-06 – Added the allowing of telehealth services in hospice and added the GT modifier to the claims for telehealth services.

LeadingAge Ohio has voiced is support of the changes to ODM. Questions related to the rule changes can be directed to Anne Shelley at ashelley@leadingageohio.org.

Use of contracted staff under “extraordinary circumstances”

On October 5, the Centers for Medicare & Medicaid Services (CMS) issued memorandum QSO-21-01-Hospice – “Nursing Shortage as an ‘Extraordinary Circumstance’ per 42 CFR 418.64 CORE SERVICES” to State Survey Agency Directors.

CMS has issued memoranda authorizing use of contracted staff under extraordinary or other non-routine circumstances as authorized under the “extraordinary circumstances” core services provisions at 42 CFR 418.64 on a regular basis over recent years based on the ongoing nursing shortage. The most recent memo, issued in 2018, was applicable through September 30, 2020. The October 5, 2020 memo varies from the 2018 memo in two ways:

1. It does not contain an expiration date and
2. It does not explicitly limit authority to contract for core services to nursing

CMS staff have confirmed that there is not an expiration date on the provision, and also clarified that the provisions may be used to contract for social work and counseling as well as nursing. However, they also underscored the temporary nature of the authority in that the provision is applicable to extraordinary and non-routine circumstances only. Additional details will be provided when they become available.

LeadingAge Ohio's Fall Education Fest... You can still attend!

Reminder – it’s not too late to register for the LeadingAge Ohio Fall Education Fest!

The LeadingAge Ohio Fall Education Fest is underway and members are reporting great value for this virtual education series. Whatever your individual role, there is a specific education track to fit your needs. Four unique educational tracks have been planned for leadership, clinicians, administrators, nurses and front line staff. Special group pricing provides great value and offers something for everyone in joining this one-of-a-kind virtual event. Sessions are underway, but there are still many opportunities for learning and professional development to come, and late registrants can catch up on recordings of any missed sessions.

For complete details and to register, please click here.

Don’t miss out! Nomination deadline for the LeadingAge Ohio awards program is Friday, October 23

We continue to navigate challenges posed by the pandemic, and LeadingAge Ohio has heard amazing stories and examples of caring, compassion and service. The LeadingAge Ohio annual awards program was 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.

The deadline to submit nominations is next Friday, October 23. Visit the LeadingAge Ohio website for all the details.  Questions regarding the annual awards program can be directed to Jennifer Taylor, Director of Member Experience, at jtaylor@leadingageohio.org or call 614-545-9028.

LeadingAge Need to Know: COVID-19 – October 15, 2020

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured an update on a new virtual program that dives into the realities facing our field--from the global COVID-19 pandemic to the nationwide social justice movements.

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.  

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.