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06/04/2020

Today's COVID-19 Report: Thursday, June 4, 2020

Thursday, June 4, 2020

Here are the latest need-to-know updates for Thursday, June 4 regarding the COVID-19 pandemic.

CMS to Release Survey, NHSN Data on Nursing Home Compare

Today, the Centers for Medicare & Medicaid Services (CMS) announced the release of updated survey and NHSN data on Nursing Home Compare.

The NHSN data show that 88% of nursing homes have reported data into the system. There have been 95,000 confirmed COVID-19 cases and almost 32,000 deaths reported in NHSN. CMS will update this information again in two weeks, then weekly thereafter. CMS will post the survey results monthly on an ongoing basis.

Detailed information and the memos can be found here:

ODH Gives Providers Chance to Volunteer for Testing

As has been widely reported, the state plans to test the staff of all nursing homes in Ohio for COVID-19 with support from the Ohio National Guard.

The Ohio Department of Health (ODH) shared with LeadingAge Ohio that facilities identified by the state team for testing will be given a week's notice before testing begins for each two-week “sprint” - or phase of testing. ODH is now planning for the first sprint, but until that occurs, ODH will send the Ohio National Guard to facilities that volunteer to have their staff tested.

ODH has asked LeadingAge Ohio to share that if any of providers would like to volunteer for testing between June 5 and June 12 to expedite the process, the organization can send an email to CCURT@odh.ohio.gov to indicate interest. 

Appropriations in Place for Telecommunication-focused CMP Funds

As reported in an earlier report (see “CMP Dollars Available to Support IT, Remove Support”), the Centers for Medicare & Medicaid Services (CMS) now allows for the use of civil monetary penalty (CMP) funds to be used for telecommunication devices such as tablets and ipads to facilitate resident-family communication. These devices are intended to help residents in nursing facilities stay in touch with loved ones while they cannot receive visitors. The Ohio Department of Medicaid's (ODM) Bureau of Long-Term Services and Supports has been working to implement this policy since it was announced by CMS late last month.

With appropriations now in place from the Ohio Controlling Board, the Ohio Department of Medicaid (ODM) can now begin processing the requests. 

ODM has received applications from 490 providers—roughly half of Ohio’s nursing homes—thus far and will be working diligently over the next 2-3 weeks to try and process all of these requests. ODM noted in earlier discussions that Ohio’s CMP fund has sufficient reserves to make grants to all of Ohio’s over-900 nursing homes.

As applications are approved, ODM will notify each nursing facility and request receipts individually, with the intent of communicating with all applicants as soon as possible. Although ODM intends to begin sending feedback on applications later this week, it is not certain how long it will take to process all requests given the volume received. ODM has also confirmed that it is not too late to submit a request.

ODM Reiterates Need for Provider Emails

As reported last month (see “ODM Needs Provider Contacts”), the Ohio Department of Medicaid (ODM) is continuing efforts to collect as many current email addresses of long-term care providers as possible prior to emailing the FYs 2017 & 2018 overpayment reports. ODM has asked nursing homes to send two valid email addresses to LTCAudits@medicaid.ohio.gov. This should include the Ohio Medicaid seven-digit number in the subject line, or in the body of the email for organizations representing multiple sites. 

Having current email addresses for facilities will facilitate a speedier and more streamlined process in working toward finalizing these two audit periods. ODM has asked LeadingAge Ohio to let members know that there is still time to send in this information. 

Free Call Series: Tackling High-Priority COVID-19 Challenges for Nursing Homes

Ohio House Aging & Long-Term Care Committee Chairman Tim Ginter shared the following resource from the Ohio Council for Cognitive Health (OCFCH) with LeadingAge Ohio this week:

The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI) have partnered to bring those who care for elders free daily 20-minute online huddles to provide real-time, pragmatic solutions that can be implemented in elder care settings today to solve many of the key problems brought about or exacerbated by COVID-19.

Call topics will reflect the most pressing issues identified by those providing care for nursing home residents, including access to personal protective equipment (PPE), lack of testing, hospital to nursing home transfers, staff illness and absence, and staff attrition.

Benefits of participation include:

  • Immediate access to specific, pragmatic guidance on clinical and operational issues confronting the nursing home community today. Guidance will be focused and ready to implement.

  • Ability to speak with collective voice to federal and state policy makers, regulators, health care systems, and others to help remove policy and regulatory barriers to mission-critical operational challenges.

  • Access to tools and materials to help explain the work of nursing homes and promote participation in the COVID-19 Rapid Response Network for Nursing Homes. These tools will help nursing homes communicate with local media outlets about efforts to serve and protect residents and staff.

The huddles will be held every weekday at 12:00 p.m. Register here for unlimited access. 

Hospice Medical Director Certification Board Survey Coming This Month

Every 5 to 6 years, the Hospice Medical Director Certification Board (HMDCB) conducts a practice analysis to ensure certification and exam content remains relevant to what the role of a hospice physician is today. After a committee of certificants came together in January to identify today’s key roles, HMDCB is ready to gather input from other hospice physicians about whether the committee’s work was on target. The outcomes of this work will likely alter some of the Content Blueprint areas, thus shifting some of the areas tested on the certification exam.  

HMDCB will be putting a survey into the field in June and hopes to have as wide a response as possible to confirm or tweak the committee’s work. 

HMDCB President Brian Murphy shared a letter regarding the survey, as well as a link to participate.

HHS Shares Guidance on COVID Expenses

This week, the U.S. Department of Health & Human Services (HHS) came out with some important guidance on the scope of COVID-19 related expenses that can support the receipt and retention of monies from the Provider Relief Fund.

The guidance offers the following:

The term “health care related expenses attributable to coronavirus” is a broad term that may cover a range of items and services purchased to prevent, prepare for, and respond to coronavirus, including:

  • Supplies used to provide healthcare services for possible or actual COVID-19 patients;
  • equipment used to provide healthcare services for possible or actual COVID-19 patients;
  • Workforce training;
  • Developing and staffing emergency operation centers;
  • Reporting COVID-19 test results to federal, state, or local governments;
  • Building or constructing temporary structures to expand capacity for COVID-19 patient care or to provide healthcare services to non-COVID-19 patients in a separate area from where COVID-19 patients are being treated; and
  • Acquiring additional resources, including facilities, equipment, supplies, healthcare practices, staffing, and technology to expand or preserve care delivery.

Providers may have incurred eligible health care related expenses attributable to coronavirus prior to the date on which they received their payment.  Providers can use their Provider Relief Fund payment for such expenses incurred on any date, so long as those expenses were attributable to coronavirus and were used to prevent, prepare for, and respond to coronavirus.  HHS expects that it would be highly unusual for providers to have incurred eligible expenses prior to January 1, 2020.

The term “lost revenues that are attributable to coronavirus” means any revenue that you as a healthcare provider lost due to coronavirus.  This may include revenue losses associated with fewer outpatient visits, canceled elective procedures or services, or increased uncompensated care.  Providers can use Provider Relief Fund payments to cover any cost that the lost revenue otherwise would have covered, so long as that cost prevents, prepares for, or responds to coronavirus.  Thus, these costs do not need to be specific to providing care for possible or actual coronavirus patients, but the lost revenue that the Provider Relief Fund payment covers must have been lost due to coronavirus. 

HHS encourages the use of funds to cover lost revenue so that providers can respond to the coronavirus public health emergency by maintaining healthcare delivery capacity, such as using Provider Relief Fund payments to cover:

  • Employee or contractor payroll
  • Employee health insurance
  • Rent or mortgage payments
  • Equipment lease payments
  • Electronic health record licensing fees

All providers receiving Provider Relief Fund payments will be required to comply with the reporting requirements described in the Terms and Conditions and specified in future directions issued by the Secretary.  HHS will provide guidance in the future about the type of documentation we expect recipients to submit on the CARES Act Provider Relief page.

HHS also shared a Terms and Conditions FAQ. 

HUD Announces CARES Act Allocation for Project-Based communities

Yesterday, the U.S. Department of Housing and Urban Development (HUD) published a memo with a CARES Act funding allocation update for Section 8 Project-Based Rental Assistance. There has been no update yet on CARES Act funds for Section 202 or Service Coordinators – LeadingAge is urging HUD to move quickly to get the remaining funds out. 

LeadingAge has posted the full summary online. Here are the highlights:

On June 1, HUD published a funding allocation update on COVID-19 relief from the March 27 CARES Act. Of the $1 billion approved for Project-Based Rental Assistance (PBRA), HUD will complete $800 million in funding allocations during the week of June 1 to help communities prevent, prepare for, and respond to the coronavirus through regular operations.

The funding allocations will bring additional subsidy to an estimated 16,500 properties with Section 8 PBRA contracts, including for the 45% households that are senior-led. However, the HUD Notice does not reference the $50 million in CARES Act funds approved more than two months ago for HUD Section 202 Supportive Housing for the Elderly, including up to $10 million for Service Coordinators.

According to the HUD memo, the supplemental resources announced this week will support communities in maintaining normal operations, including by offsetting decreased tenant rent payments. Importantly, the funds will also accommodate increased vacancy payment claims resulting from extended unit turn-over and delayed move-ins.

Owners will receive automated notifications about funds obligated on HAP contracts, and a small number of properties receiving more than the $150,000 threshold may receive additional guidance on reporting requirements.

Infection Control Survey Tip of the Week: Resident Interviews

The Ohio Department of Health (ODH) has confirmed that all nursing homes in Ohio will have an infection control survey. ODH anticipates completion of all surveys by the end of June. The Infection Control survey includes interviewing residents about infection control practices. The COVID-19 Focused Survey Pathway Tool is a tool that could be used by facilities to do their own auditing for compliance. This pathway can be found within the Survey Resources zip file under the downloads section of the CMS Nursing Home webpage.

Below is an example of how to utilize the pathway to interview residents on the following key items:

  • Cleaning: Ask residents if their room is clean and if it gets cleaned often.
  • Hand Hygiene: Ask your residents if they see staff washing their hands often.
  • PPE: Ask residents if they see staff wearing their face masks and eye protection.
  • Precautions: Ask residents if they are being informed about changes and, if they were moved to a different room, why they were moved. Ask if they are restricted to their room and, if they leave, do they wear a face covering. 
  • Resident Care: Ask about activities and dining to see if they can speak to the discontinuing of these communal activities.

The pathway could also be used as a guide to explain to residents why some changes have occurred and as a reminder to keep informing residents of the current situation with the facility.

If you have a question about the Infection Control Survey, email Stephanie DeWees Quality & Regulatory Specialist - Long Term Care at sdewees@leadingageohio.org.

You Asked.. We Answered

You Asked: Are move-outs allowed to happen in RCFs after death since RCFs are still under these pandemic restrictions?

We Answered: Yes, the Ohio Department of Health (ODH) has confirmed that move-outs and move-ins are still allowed to occur. It is recommended to perform all screening consistent with what is being done with current staff. Ensure face coverings are worn by those helping with moving at all times. Minimize as much movement as possible. Ask residents to stay in their apartments as the move is occurring to prevent potential physical distancing issues. Consider having maintenance staff assist in these moves to further mitigate risk.

PPE Opportunities for Members: Masks, Gowns, Sanitizer, and More

With the significant increase in demand for personal protective equipment (PPE) resulting from the COVID-19 pandemic, LeadingAge Ohio members continue to experience shortages of certain products. To meet this demand, several LeadingAge Ohio associate members and partners have increased production of PPE. 

LeadingAge Ohio Partner Medline has increased production of PPE, retrofitted manufacturing facilities to produce hand sanitizer, and utilized air freight to accelerate PPE transit. Medline has also sourced and procured several new products through “spot buys” in order to mitigate the shortages on some of its traditional products. Members interested in participating should reach out to Annette Hutchins with Link-age at AHutchins@linkageconnect.com. For more information on this opportunity, please visit the LeadingAge Ohio Partner and Associate Firm Guidance and Updates page on our COVID-19 Hub.

LeadingAgeOhioShop.com, powered by LeadingAge Ohio Associate Member Consolidus, has reported a number of PPE items available for fast shipping. Contact Adam Biats, Program Manager, at adam.b@consolidus.com for PPE needs such as masks, hand sanitizers, and more.

Gear Medical Supplies, based in Grove City, Pennsylvania has a disposable mask promotion taking place during the month of June. Gear Medical Supplies also has hand sanitizer, along with some KN-95 masks, isolation gowns, and shoe covers currently in stock. This group was brought to our attention by LeadingAge Ohio member McGregor, who has been purchasing from them with great success amid the COVID-19 pandemic. For additional information and current pricing, please contact Chad Henderson, General Manager with Gear Designs, Inc, at chad.henderson@gearracewear.com or 724-458-6336.

NAHC Surveys Worker Safety

Recent events such as the COVID-19 pandemic have given rise to concerns for healthcare workers. For home care workers, safety has always been a concern due to the nature of working in the patient’s home.

The National Association for Home Care (NAHC) is interested in learning how home health, hospice, and home care agencies are addressing the various issues that impact safety for staff. NAHC has released a survey to assist in understanding how agencies are working towards keeping their staff safe during these unprecedented times. 

The survey will remain open until Wednesday, June 17. 

LeadingAge Need to Know: COVID-19 – June 4, 2020

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update includes statements from LeadingAge President/CEO Katie Smith Sloan and LeadingAge Ohio-member Kendal which speak out against injustice,. 

Check out the full report here. 

Links

McKnights - Provider COVID-19 relief funds now to be based on 2018 patient revenue

 

 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 at here.  

 

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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.