10/21/2020

Today's COVID-19 Report: Wednesday, October 21, 2020

Wednesday, October 21, 2020

Here are the latest need-to-know updates for Wednesday, October 21 regarding the COVID-19 pandemic. 

In Today's Report

• You Asked... We Answered
• Updated guidelines for resident and staff testing in all nursing homes
• Ohio Department of Aging encourages service providers to take advantage of available coronavirus relief funding with October 30 deadline
  
• ODH clarifies visitation in red counties, questions remain
• CDC reporting concern
• Medicare Part A Cost Report: New bulk e-filing feature webcast
• Housing Happenings call reviews assistance animals and updated HUD FAQs

You Asked... We Answered

You Asked:

If our assisted living has a new admission, must we quarantine that resident for 14 days?  And, if we have an assisted living resident who leaves the facility to visit a low-risk setting, should they be quarantined upon their return? 

We Answered:

ODH indicated yesterday that, as long as the probability of COVID exposure is low, the facility is not required to place an incoming/returning resident into a 14-day quarantine. The resident should be required to continue use of a mask when not within their room.  A facility may have a policy to test a resident upon their entry/return to a facility, but this is not mandated.

LeadingAge Ohio recommends facilities continue educating residents using the following CDC guidance:

• Provide information about COVID-19 (including information about signs and symptoms) and strategies for managing stress and anxiety.
• Describe actions the facility is taking to protect residents and personnel.
• Describe actions residents and personnel can take to protect themselves in the facility, emphasizing the importance of social (physical) distancing, hand hygiene, respiratory hygiene and cough etiquette, and source control.
• Encourage residents, personnel, and visitors to monitor for symptoms and immediately report fever or other symptoms consistent with COVID-19.

You Asked:

When is eye protection needed within assisted living?

We Answered:

ODH has indicated that, based on the CDC’s Considerations for Preventing Spread of COVID-19 in Assisted Living Facilities, if there is a COVID positive case within a building, then eye protection and an N95 (or higher) mask should be worn where the symptomatic or asymptomatic residents reside or move, e.g. in resident rooms, corridors, resident lounge areas. This is irrespective of the county ‘color’. In addition, if the county is ‘red’ but there are no positives within the facility, then eye protection is not required.

Updated guidelines for residents and staff testing in all nursing homes

Updates to the Ohio Department of Health (ODH) guidelines for the testing of the residents and staff of all nursing homes will become effective October 26, and minimally include weekly testing for all nursing homes. In addition to new guidelines, ODH processes have changed in an effort to increase compliance, decrease risks, and promote data uniformity.

The state-supported testing will:

• Implement a weekly testing program for all nursing homes for routine and outbreak testing
• Support compliance with CMS testing requirements
• Expand testing to include rapid antigen tests and PCR tests
• Align testing for nursing homes that share campuses with other facilities (e.g., assisted living)
• Optimize scheduling for predictability and consistency
• Streamline reporting requirements
• Centralize state support for long-term care testing

An informational video of the state's updated testing guidelines for nursing homes and new state-supported testing options has been created and will be available at www.coronavirus.ohio.gov. Please reserve time to familiarize yourself with this new information before October 26. This video will equip you with new information regarding scheduling, supplies, reporting, and much more. At the completion, you will be asked to indicate the level of state-supported testing needed for your facility.

Ohio Department of Aging encourages service providers to take advantage of available coronavirus relief funding with October 30 deadline

In July, the Ohio Office of Budget and Management (OBM) announced the availability of more than $470 million for facility-based and Medicaid waiver providers. In October, an additional $15.2 million was made available for adult day services providers and senior centers as those providers began restarting certain services that have been closed for most of the pandemic. The Coronavirus Relief Funds were awarded to the State of Ohio as Federal Financial Assistance.

Interested providers must apply by October 30, 2020. LeadingAge Ohio has been working with data provided by OBM and ODM staff to identify and contact those members who still have unclaimed relief funds. Provider relief payments will be made by OBM to eligible providers upon completion of their registration and certification online through OBM's Ohio Grants Partnership website. Funds are being distributed based on data-driven calculations for each provider type as assessed by several state agencies.

Questions specific to Ohio’s relief funds may be directed to Susan Wallace at swallace@leadingageohio.org. Providers can find additional information and resources to support their COVID-19 response by visiting the Ohio Department of Aging’s online coronavirus resource center at www.aging.ohio.gov/coronavirus.

ODH clarifies visitation in red counties, questions remain

In conversation with the Ohio Department of Health (ODH) this week, ODH noted the competing criteria in each the Fifth Amended Director’s Order and the CMS QSO-20-39-NH, in terms of whether visitation in high-prevalence counties should prohibit visitation. The CMS memo states “For example, if a facility has had no COVID-19 cases in the last 14 days and its county positivity rate is low or medium, a nursing home must facilitate in-person visitation consistent with the regulations, which can be done by applying the guidance stated above.” Another portion of the memo indicates that “High (>10%) = visitation should only occur for compassionate care situations according to the core principles of COVID-19 infection prevention and facility policies.” 

ODH has agreed to inquire as to whether visitation must be closed when the county or community prevalence reaches a high level, or whether there is room for the nursing facility to assess risk. LeadingAge Ohio will share their response once it is released. The Administration also continues to work on a frequently asked questions (FAQs) document which will address the areas where the Director’s Order is ambiguous and require clarification.

CDC reporting concern

CMS’ Chicago Division (Region V) reached out to LeadingAge Ohio to report that they are seeing a rise in the numbers of providers that are not reporting their COVID testing data to the CDC as required.  CMS reports that several weeks ago as few as 0.8% of providers were not reporting testing data, but that last week over 4% of providers were not reporting.  In the CMS Region V area, they report that “this is 139 providers that will be receiving an easily avoidable CMP.”  Providers are encouraged to check their letters in CASPER and report every week.

LeadingAge Ohio is working to identify and contact those members who appear to have lapsed in NHSN data entry. Questions may be directed to Kathryn Brod at kbrod@leadingageohio.org.

Medicare Part A Cost Report: New bulk e-filing feature webcast on October 29

Medicare Part A providers now have the opportunity to learn how to e-file multiple cost reports in the Medicare Cost Report e-Filing (MCReF) system at the same time. While all provider organizations can benefit from this optional feature, organizations that need to file cost reports for multiple facilities may find it most helpful. 

An upcoming webcast will address:

• Overview of new bulk e-filing, including functionality and layout
• Review of accessing the system and transmitting and tracking your cost report
• Frequently asked questions

Providers will be able to use MCReF to:

• Submit cost reports (individually or in bulk) with fiscal years ending on or after December 31, 2017
• Track the status of cost reports with fiscal years ending after December 31, 2009

You have the option to electronically transmit your cost report through MCReF or mail or hand deliver it to your MAC. You must use MCReF if you choose to submit electronically.

This webcast will take place Thursday, October 29 from 1:00 - 2:30PM ET. Registration for the webcast is now available.

A question and answer session will follow the presentation. To send questions in advance, send to OFMDPAOQuestions@cms.hhs.gov with “Medicare Cost Report e-Filing System Webcast” in the subject line. Questions can be asked during the webcast. For more information, see the MCReF MLN Matters Article, and MCReF webpage.

Housing Happenings call reviews assistance animals and updated HUD FAQs

On this week’s Housing Happenings call, Cory Kalheim, LeadingAge’s Vice President of Legal Affairs and Social Accountability, provided January 2020 HUD guidance on assistance animals for residents and the stipulation that an assistance animal not be considered a pet of the resident.  With COVID and social isolation concerns for residents remaining a concern, an increase in resident requests for assistance animals could be on the horizon. Kalheim also reviewed a few employment cases that were before the Supreme Court this summer regarding sexual orientation and discrimination issues. He also explained how these decisions could play out in both the employment side as well as what changes it may bring to the Fair Housing Act for providers to include gender identity and sexual orientation/discrimination language . Members can reach out to Cory to talk through concerns and seek guidance on either of these issues at ckallheim@leadingage.org.

Juliana Bilowich, LeadingAge’s Director of Housing Operations and Policy, shared with providers that on October 14, HUD issued updated COVID-19 FAQs for Multifamily Housing providers, including HUD Section 202 and Section 8 providers that updated guidance on: CDC’s order to halt evictions, offering COVID-19 tests and flu shots on premises, REAC inspections and MORs.  LeadingAge has created a summary of highlights from the new FAQs.

Finally, a reminder that the weekly update calls have transitioned to Zoom. Please join Housing Happenings each Wednesday at 9:00am for updates and discussions.  The new Zoom access information can be found on the LeadingAge Ohio website.

LeadingAge Need to Know: COVID-19 – October 21, 2020

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured a message from LeadingAge Board Chair, Carol Silver Elliott.

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.