03/29/2021

Today's COVID-19 Report: Tuesday, March 30

Tuesday, March 30, 2021

Here are the latest need-to-know updates for Tuesday, March 30 regarding the COVID-19 pandemic and other topics of importance.

A REMINDER TO ALL MEMBERS

Last week’s LeadingAge Ohio all-member call resulted in 50+ questions that have been answered in the Q&A posted here. Additional questions that arrived following the completion of this document are presented as a You Asked... We Answered at the bottom of today's Report.

In Today's Report

• ODM pausing cost report validation work
• Administration sweeps LeadingAge Ohio members into accusation of lack of vaccine planning
• New vaccine announcements from White House
• CDC guidance update: Long-term care implications for resident day trips
• Biennial survey of long-term care facilities launched
• New LeadingAge resources for visitation
• LeadingAge Ohio member survey headed to inboxes next week
• LeadingAge Need to Know: "When 1135 Waivers End" webinar and flu vaccine discounts
  
• You asked... We Answered - Five questions LeadingAge Ohio has addressed this week
  

ODM pausing cost report validation work

The Ohio Department of Medicaid (ODM) has determined that pausing cost report validation work for two months is in the best interest of the nursing facilities.  In a memo to the associations on Friday, ODM noted that the decision was “due to NFs’ other pressing responsibilities (e.g., other audits, cost report prep, Covid-related duties, etc).”

ODM will provide advance notice when this work is to resume.

Administration sweeps LeadingAge Ohio members into accusation of lack of vaccine planning

During a press conference last Thursday, Governor DeWine shared that he was “at the end of his rope” with Ohio nursing homes and assisted living providers who had not yet signed up or opted out of Ohio’s vaccine maintenance program. Citing the need for transparency, DeWine shared that the Administration would be posting a list of over 200 providers who had yet to sign up.

After reviewing the list, LeadingAge Ohio staff noted that a surprising number were organizations that had both assisted living and nursing homes located on the same site. LeadingAge Ohio reached out to each of its members that appeared on the list which represented over 25 sites statewide. With only one exception, all had signed up for the vaccine maintenance program and several had already held their first maintenance clinics. Upon further investigation, LeadingAge Ohio learned that many of the sites had completed the registration as instructed, completing a submission for each level of care and indicating at the appropriate place in the registration form that they had other levels of care on site. Still others noted that problems in the rollout of the Federal Pharmacy program with the pharmacies confused by multiple licensed facilities on a single campus caused them to err on the side of a single submission. Many noted that they found the enrollment instructions confusing for life plan communities.   

Administration officials have assured LeadingAge Ohio that the experience of its members was not the norm, and that many providers that were on the list had, in fact, been lagging in registering for the vaccine maintenance program. Furthermore, they indicated that the list would be updated daily by 6:00PM; as of Sunday evening at 6:00PM it had already shrank from over-200 to 90. LeadingAge Ohio anticipates the last of its members will drop off in the coming days, and is working with the Administration to ensure such a preventable oversight does not happen again.

New vaccine announcements from White House

On Monday, President Biden unveiled new actions to get more people vaccinated quickly and announced that by April 19, 90% of adults in the U.S. will be eligible for vaccination and 90% will have a vaccination site within 5 miles of where they live. The President announced that the Administration is increasing the number of pharmacies in the federal pharmacy vaccination program from 17,000 to nearly 40,000 across the country and will stand up a dozen more mass vaccination sites by April 19. 

President Biden also announced a new effort funded by the Centers for Disease Control and Prevention (CDC) and administered by the Administration for Community Living (ACL) to fund community organizations to provide transportation and assistance for the nation’s most at-risk seniors and people with disabilities to access vaccines. This includes navigation for accessing homebound vaccinations and other issues that LeadingAge has raised with the CDC and ACL.

CDC guidance update: Long-term care implications for resident day trips

The Centers for Disease Control and Prevention (CDC) gave a major make-over to long-term care guidance today. The guidance “Preparing for COVID-19 in Nursing Homes,” has been renamed “Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes” and includes two prior documents, “Responding to COVID-19 in Nursing Homes” and “Performing Facility-wide SARS-CoV-2 Testing in Nursing Homes” which were merged with this guidance.

The recommendations in this document were updated and organized to clarify infection prevention and control practices and stress those that should remain in place whether or not nursing homes are experiencing outbreaks. Additional guidance was included to address circumstances when quarantine is recommended for new admissions and for residents who leave the facility, as well as a section addressing quarantine and work exclusion considerations for asymptomatic residents and healthcare providers who are within 90 days of resolved infection. Finally, this guidance is intended to apply regardless of vaccination status. For modifications to recommended infection prevention and control practices following vaccination please refer to CDC’s "Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination" located here.

Resident departures with family members are explicitly addressed in the guidance, noting that “in most circumstances, quarantine is not recommended for residents who leave the facility for less than 24 hours (e.g., for medical appointments, community outings with family or friends) and do not have close contact with someone with SARS-CoV-2 infection.” Both the residents and their family members and or friends should be reminded of infection prevention and control practices.

Biennial survey of long-term care facilities launched

Scripps Gerontology Center at Miami University is once again conducting the Biennial Survey of Long-Term Care Facilities. Scripps has collected and used these data to track changes in the field of long-term care, and this year is especially important given the profound effects of the COVID-19 pandemic.

Scripps will utilize and communicate the data through conferences and events, to new administrators through the Core of Knowledge curriculum, and to state policymakers. LeadingAge Ohio also makes frequent use of the data in its advocacy work. This year’s study includes questions regarding the impact of COVID19. LeadingAge Ohio encourages all members to participate.

New LeadingAge resources for visitation

As the Centers for Medicare & Medicaid Services (CMS) updated visitation guidance for nursing homes, LeadingAge collaborated with Pathway Health on a Visitation during Covid-19 Toolkit for members. The ten segment toolkit helps an organization navigate visitation guidance through a leader’s guide, implementation checklists, competency tools for managers and all staff, and a pre and post test for all staff. The toolkit can be modified or edited to member's specific needs. The elements of the toolkit also may be used by various providers and service lines in the continuum of care.

LeadingAge Ohio member survey headed to inboxes next week

On April 8, the biennial LeadingAge Ohio member survey will be emailed to all LeadingAge Ohio members. LeadingAge Ohio conducts this survey in partnership with Association Metrics to assess members’ perspectives of LeadingAge Ohio’s strengths and weaknesses. Results feed into planning processes that help LeadingAge Ohio make critical decisions about programming development and resource allocation. Last completed in 2018 with record participation, the member survey's 2-year cycle was interrupted by COVID in 2020. All who receive and/or participate in LeadingAge Ohio newsletter, bulletins, education, and other programs are encouraged to participate. The survey is estimated to take 15 minutes.

Individuals who complete the survey will be entered into a drawing that includes the following prizes:

• Full registration to the LeadingAge Ohio annual conference (2 available); 
• $50 Amazon gift card (2 available);
• $50 Starbucks gift card (2 available).

Any questions regarding the membership survey may be directed to Jennifer Taylor, Director Member Experience, at jtaylor@leadingageohio.org.

LeadingAge Need to Know: "When 1135 Waivers End" webinar and flu vaccine discounts

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's Need to Know featured information on the "When 1135 Waivers End" webinar and flu vaccine discounts for members.

Check out the full report here.

You asked... We Answered - Five questions LeadingAge Ohio has addressed this week

You asked:

Do we have to quarantine a resident that goes out with their family for a few hours, but we do not know the vaccination status of the family?

We answered:

No, the resident does not need to quarantine based on the March 29 Centers for Disease Control and Prevention (CDC) Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes guidance. The CDC explains that in most circumstances, quarantine is not recommended for residents who leave the facility for less than 24 hours (e.g., for medical appointments, community outings with family or friends) and do not have close contact with someone with SARS-CoV-2 infection. The CDC goes on to say facilities might consider quarantining residents who leave the facility if, based on an assessment of risk, uncertainty exists about their adherence or the adherence of those around them to recommended IPC measures. 

You asked:

Is post-mortem visitation permitted?

We answered:

Yes, allowing families to have a compassionate care visit at the time of death would be allowed and language in the CMS QSO-20-39-NH memo or Ohio Orders would not preclude a facility from allowing a post-mortem visit. This would also be in line with a person-centered approach which is referenced in both the Ohio Order and CMS memo

You asked:

Is a facility permitted to have staff self-screen?

We answered:

The CMS QSO-20-39-NH memo nor Ohio Visitation Order specifically state whether screening must be active screening or if it can be self-screening. However, the QSO 20-39-NH memo states there is to be “observations” of signs of symptoms. The memo specifically states screening of all who enter the facility for signs and symptoms of COVID-19 (e.g., temperature checks, questions about and observations of signs or symptoms), and denial of entry of those with signs or symptoms or those who have had close contact with someone with COVID-19 infection in the prior 14 days (regardless of the visitor’s vaccination status).

In addition, the Ohio Order states all individuals and personnel must be screened for COVID-19 each time they enter the facility. Screening guidance is available from the U.S. Centers for Disease Control and Prevention (CDC) and Centers for Medicare and Medicaid Services (CMS) as well as from ODH. Per the CDC, screening should include questions about exposure to COVID-19 and assessing the visitors and personnel for cough, shortness of breath, and body temperature of 100.0 degrees Fahrenheit or higher.

You asked:

Are facilities permitted to conduct interviews in-person?

We answered:

Yes, a facility can choose to conduct in-person interviews following all recommended infection control and prevention practices. The CMS memo nor Ohio Orders specifically preclude this from occurring. CDC still recommends telehealth strategies to reduce the risk of SARS-CoV-2 transmission in healthcare settings as outlined in the Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic.

You asked:

Does a fully vaccinated healthcare worker have to quarantine for 14 days following travel?

We answered:

Yes, the CDC still notes in the March 10, 2021 updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination, that healthcare personnel who have traveled should continue to follow CDC travel recommendations and requirements, including restriction from work, when recommended for any traveler. The CDC today, on a LeadingAge call, stated that travel restrictions are being worked on by the CDC, but quarantine is still recommended at this time.

Questions

Please send all questions to COVID19@leadingageohio.org. Additionally, members are encouraged to visit the LeadingAge Ohio COVID-19 Working Group facebook gro up 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.