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04/20/2020

Today's COVID-19 Report: Monday, April 20, 2020

Monday, April 20, 2020

Here are the latest need-to-know updates for Monday, April 20 regarding the COVID-19 pandemic.

Nursing Homes and Hospitals Must Collaborate, Define Hospital Partners

On webinars with Ohio hospitals on April 17 and earlier today, the Administration announced requirements that all congregate living communities, including nursing homes, have a hospital partner among the Ohio Hospital Association's (OHA) acute care membership. Both congregate living communities and hospitals must designate a clinical leader contact who will be responsible for working with local partners within the health system to plan for an eventual outbreak at their site. 

The new expectations reflect the pivot that Ohio has taken in recent days, from capacity-building efforts focused on a hospital surge to collaboration-based efforts built on the presumption that the pandemic will play out in outbreaks in congregate settings, which include nursing homes and assisted living. Other congregate settings included were prisons, juvenile detention facilities, homeless shelters, and other settings where many individuals are gathered.

In comments directed at hospitals, Medicaid Director Maureen Corcoran asked hospitals to “own” this work in their communities, and examples were shared of hospital systems that had successfully supported nursing homes through outbreaks, including lending PPE and even staff. The Administration described hospital staff that had visited long-term care to assist in their planning for cohorting and quarantine. The hope is that this order fosters increased cooperation and resource-sharing between nursing homes and hospitals, who are both on the frontlines of the COVID-19 pandemic. 

Any members that are experiencing challenges in getting response from their hospital partners is encouraged to contact Susan Wallace at swallace@leadingageohio.org.  

CMS Orders Nursing Homes to Report All COVID-19 Cases to CDC

The Centers for Medicare & Medicaid Services (CMS) has released a memorandum which announces new orders related to nursing home reporting of COVID-19 cases.The CDC noted that they will provide a new reporting tool to nursing home operators; CMS will then make the data available to the public. 

  • Communicable Disease Reporting Requirements. CMS is reinforcing an existing requirement that nursing homes must report communicable diseases, healthcare-associated infections, and potential outbreaks to state and local health departments. In rule-making that will follow, CMS is requiring facilities to report this data to the Centers for Disease Control and Prevention (CDC) in a standardized format and frequency defined by CMS and CDC. Failure to report cases of residents or staff who have confirmed COVID -19 and Persons under Investigation (PUI) could result in an enforcement action. 
  • Transparency. CMS will also be previewing a new requirement for facilities to notify residents’ and their representatives to keep them up to date on the conditions inside the facility, such as when new cases of COVID-19 occur.

These announcements from CMS come on the heels of Ohio announcing last week that all nursing homes must report confirmed and probable cases of COVID-19 to all residents and families within 24 hours of a diagnosis. CMS is saying that reporting must occur within 12 hours of a diagnosis. 

CMS Clarifies PBJ Suspension: Data Due in August

On Monday, the Centers for Medicare & Medicaid Services (CMS) clarified how payroll-based journaling requirements, which were suspended during the COVID-19 pandemic, would resume following the state of emergency.

In an email to LeadingAge Ohio associate member Squared Business Solutions, the CMS nursing home staffing mailbox replied:

… facilities will be required to report Quarter 1 PBJ data.  We are still waiving the May 15th submission deadline and at this time, the instruction to facilities is that they should submit Quarter 1 and Quarter 2 PBJ data (Jan 1st – June 30th) by the August 14th deadline.  If this changes, we will notify providers.  We apologize for the misinformation communicated originally. 

Healthcare Isolation Center Plan

The Ohio Department of Health (ODH) has shared the final version of the Health Care Isolation Center (HCIC) Plan. HCICs will provide additional surge capacity to health systems in the event of an outbreak, and may care for either individuals under quarantine or those that are confirmed positive but do not need a hospital level of care. Additionally, a separate HCIC application packet was shared. There have been updates to the requirements, as well as certain fiscal considerations that facilities will need to review prior to applying.

Please review each plan section prior to applying as there are many requirements to become an HCIC. Additionally, obtaining a letter verifying that a facility is working with the regional hospital zone documenting the need for the HCIC is a requirement. In a bulletin sent directly to providers, ODH shared the following contacts for each zone:

ZONE 1:

ZONE 2:

ZONE 3:

CDC Strategies for Long-Term Care Facilities

The Centers for Disease Control and Prevention (CDC) released new guidance on Key Strategies to Prepare for COVID-19 in Long-Term Care Facilities. 

Strategies include keeping COVID-19 from entering your facility, identifying infections early, preventing spread of COVID-19, assessing supplies of PPE and initiating measures to optimize supply, and identifying and managing severe illness.

The Coronavirus in America: The Year Ahead (NYT)

The New York Times (NYT) recently profiled what the year ahead could look like under the continued presence of COVID-19.

A few insightful sections from the article:

"While this is encouraging news (lower projected death toll), it masks some significant concerns. The institute’s projection runs through Aug. 4, describing only the first wave of this epidemic. Without a vaccine, the virus is expected to circulate for years, and the death tally will rise over time."

"No one knows exactly what percentage of Americans have been infected so far — estimates have ranged from 3 percent to 10 percent — but it is likely a safe bet that at least 300 million of us are still vulnerable."

"Reopening requires declining cases for 14 days, the tracing of 90 percent of contacts, an end to health care worker infections, recuperation places for mild cases and many other hard-to-reach goals."

"Even though limited human trials of three candidates — two here and one in China — have already begun, Dr. Fauci has repeatedly said that any effort to make a vaccine will take at least a year to 18 months."

Read on for this full, engaging story.

SNF Regional Meetings Rescheduled: Register Today

The LeadingAge Ohio SNF Regional Meetings have been rescheduled and will now be held virtually to adhere to social distancing requirements. Join Stephanie DeWees, LeadingAge Ohio’s Quality & Regulatory Specialist for Long-term Care, as she provides information on and discusses how Ohio nursing homes are dealing with the COVID-19 pandemic.

Topics discussed will include infection control-focused surveys being conducted by CMS and ODH, implementation of the pre-surge planning tool kit, review of PPE guidance, and strategies to optimize PPE and more.  The new dates are May 1 (Cleveland region); May 6 (Cincinnati region); May 8 (Columbus region) and May 13 (Toledo region).  Registration is required and continuing education is available. 

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.

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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.