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10/22/2020

Today's COVID-19 Report: Friday, October 23, 2020

Friday, October 23, 2020

Here are the latest need-to-know updates for Friday, October 23 regarding the COVID-19 pandemic. 

In Today's Report

  • State-supported testing program for nursing homes guidelines/training released
  • Federal COVID-19 Vaccination "Pharmacy Partnership for Long-Term Care Program"
  • ECHO Webinars October 23 and October 29
  • CMS offers education to hospice providers on VBID model
  • PRF reporting requirements update regarding lost revenues
  • EVV auto-verification of visits webinars scheduled
  • DRO, CMS weigh in on resident voting rights
  • LeadingAge Need to Know

State-supported testing program for nursing homes guidelines/testing released

The Ohio Department of Health (ODH) today released the updated guidelines for the testing of the residents and staff of all nursing homes effective October 26.  Routine testing of staff will now be weekly for all nursing homes and twice a week for counties that are ‘red’ based on the Centers for Medicare & Medicaid (CMS) county positivity rates.  Resident testing is to occur if they become symptomatic or upon an outbreak, and then continue weekly thereafter until 14 days pass without a new case. Routine testing of residents is not recommended unless the resident leaves the facility routinely.

Ohio Department of Aging (ODA) released a new mandatory opt-in/opt-out survey that must be completed by November 6. Next week, all nursing homes will receive a four-week transitional testing supply of both Abbott BinaxNOW rapid antigen tests and PCR tests – regardless of prior opt in/out status. As indicated in the memo issued October 20, 2020, state-supported testing will include rapid antigen tests. The four-week test schedule is in alignment with the updated guidelines and reflects both rapid antigen tests and PCR tests that will be shipped to nursing homes.

The opt-in/opt-out survey provides the following four different options of state-supported testing for facilities to choose from:

  1. Alternating weeks of PCR and rapid antigen test • Four (4) week state-supported supply of PCR and antigen tests per month.
  2. Rapid antigen test only • Two (2) week state-supported supply of antigen tests per month (this means that the other two weeks of testing would be through the facility’s own means/processes).
  3. PCR test only • Two (2) week state-supported supply of PCR tests per month (as above, this means that the other two weeks of testing would be through the facility’s own means/processes).
  4. Opt-out of state-supported testing • Facility fully responsible for supplying testing (e.g., partnership with a private laboratory, usage of point of care machines) for the mandated weekly cadence, utbreak testing, symptomatic residents and staff, and confirmatory PCR tests in accordance with CDC guidelines.

Additional information can be found on the Ohio Department of Aging Nursing Home COVID-19 Testing Program website. ODA has released training on the new testing strategy.

The final weekly schedule has been released and is in alignment with the updated guidelines and reflects both rapid antigen tests and PCR tests that will be shipped to nursing homes. Effective Monday, October 26, facilities reporting NHSN data will no longer complete the ODH “Verification Nursing Home Compliance with Requirement for Employee Retesting” survey.

ODA encourages providers to email any questions to COVIDTesting@age.ohio.gov.

Federal COVID-19 Vaccination "Pharmacy Partnership for Long-Term Care Program"

The U.S. Department of Health and Human Services (HHS) and Department of Defense (DOD) have announced agreements with CVS and Walgreens to provide and administer COVID-19 vaccines to residents of long-term care facilities (LTCF) nationwide with no out-of-pocket costs. LTCF residents may be part of the prioritized groups for initial COVID-19 vaccination efforts until there are enough doses available for every American who wishes to be vaccinated.

The "Pharmacy Partnership for Long-Term Care Program" provides complete management of the COVID-19 vaccination process. This means LTCF residents will be able to safely and efficiently get vaccinated once vaccines are available and recommended for them. LTCF staff who have not been previously vaccinated will also be able to get vaccinated. It will also minimize the burden on LTCF sites and jurisdictional health departments of vaccine handling, administration, and fulfilling reporting requirements.

Beginning October 19, LTCFs are being asked to enroll in the program or opt out and indicate an alternate plan for vaccinating residents. Nursing homes and skilled nursing facilities will be able to sign up via the National Healthcare Safety Network (NHSN) and all other facilities via an online sign up form. Sign up will remain open for 2 weeks.

The program is:

  • Free of charge to facilities.
  • Available for residents in all long-term care settings, including skilled nursing facilities (SNF), nursing homes, assisted living facilities, residential care homes, and adult family homes.
  • Available to all remaining LTCF staff members who have not been previously vaccinated for COVID-19 (e.g., through satellite, temporary, or off-site clinics).
  • Available in most rural areas that may not have an easily accessible pharmacy.
  • HHS is using multiple authorities to ensure appropriate reimbursement for these services and that no American being vaccinated for COVID-19 will have to pay out-of-pocket.

CVS and Walgreens will schedule and coordinate on-site clinic date(s) directly with each facility. It is anticipated that three total visits over approximately two months are likely to be needed to administer both doses of vaccine (if indicated) to residents and staff. 

The pharmacies will also:

  • Receive and manage vaccines and associated supplies (e.g., syringes, needles, and personal protective equipment).
  • Ensure cold chain management for vaccine.
  • Provide on-site administration of vaccine.
  • Report required vaccination data (including who was vaccinated, with what vaccine, and where) to the state, local, or territorial, and federal public health authorities within 72 hours of administering each dose.
  • Adhere to all applicable Centers for Medicare & Medicaid Services (CMS) requirements for COVID-19 testing for LTCF staff.

More information about the Pharmacy Partnership for Long-Term Care Program is attached. If you have any questions, please contact eocevent494@cdc.gov.

ECHO Webinars October 23 and October 29

Thousands of nursing homes have already signed up for Project ECHO and many are beginning the work this week. Don’t miss out on this opportunity! The National Nursing Home COVID-19 Action Network (or the Network) is a partnership between the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI) and Project ECHO to create a virtual community of practice to support nursing homes around the country to promote health and well-bring of residents and staff from COVID-19. To support this effort ECHO is offering a series of pre-launch webinars to explore some of the key themes, goals, and requirements for the full 16-week program. These webinars will also feature national experts exploring key topics in COVID-19 care in nursing homes and offer significant time for discussion. Register here for the next two upcoming webinars. They will be held October 23 at 3:00 PM and October 29 at 12:30 PM ET.

CMS offers education to hospice providers on VBID model

The Centers for Medicare and Medicaid Services (CMS) is offering a series of educational opportunities for hospice providers who may be interested in participating in the new Value-Based Insurance Design (VBID) model. Both a webinar and CMS office hours during November, December and January will be dedicated to this topic. Hospice providers who might be interested in participating in the VBID model or those wanting a better understanding of this new model are encouraged to participate in these educational offerings. For more information regarding the VBID model or the CMS education, please contact Anne Shelley at ashelley@leadingageohio.org.

PRF reporting requirements updates regarding lost revenues

In September, HHS published final reporting guidance to set expectations for PRF payment recipients. In providing this guidance, HHS also updated its Frequently Asked Questions (FAQs) to clarify that for purposes of relief payments for lost revenues attributable to COVID-19, recipients must submit information showing a negative change in year-over-year net patient care operating income. Per HHS, this definition sought to balance fairness and establish guardrails to restrict some providers from receiving distributions that would make them more profitable than they were before the pandemic.

As providers, provider organizations, and members of Congress familiarized themselves with the reporting requirements, HHS received feedback from many voicing concerns regarding this approach to permissible uses of PRF money. In response to concerns raised, HHS is amending the reporting instructions to increase flexibility around how providers can apply PRF money toward lost revenues attributable to coronavirus. After reimbursing healthcare related expenses attributable to coronavirus that were unreimbursed by other sources, providers may use remaining PRF funds to cover any lost revenue, measured as a negative change in year-over-year actual revenue from patient care related sources.

A policy memorandum on the reporting requirement decision is now available, as is the amended reporting requirements guidance.

EVV auto-verification of visits webinars scheduled

Auto-verification of visits occurs when no provider action is necessary after the visit is recorded at the time of service. All required information is captured and no exceptions are posted.  Join the Ohio Department of Medicaid (ODM) at one of the following webinars to learn more about auto-verification, why exceptions post to your visits, and how to achieve auto-verification of your visits. Click on the date you would like to participate and you will be taken to the registration page.

              Webinar                                          Date/Time                                                 

Streamlining EVV Workflow          Tuesday, October 27, 3:30 - 4:30PM
Streamlining EVV Workflow          Tuesday, November 3, 2:30 - 3:30PM
Streamlining EVV Workflow          Friday, November 6, 10:00 - 11:00PM

DRO, CMS weigh in on resident voting rights

As the 2020 General Election approaches, many long-term care facilities are working to ensure their residents have access to voting. On its monthly Advocacy in Action call this week, LeadingAge Ohio staff chatted with Brian Malachowsky, Deputy Elections Advisor for the Ohio Secretary of State, who shared guidance previously released to Ohio county Boards of Election on voting rights of residents of long-term care. One recommendation on the call was that nursing home staff could be trained and deputized by their county boards of election to assist residents in their community.

Disability Rights Ohio (DRO), Ohio’s federally mandated protection and advocacy system, has shared a flyer that includes their contact information for any facilities needing support in this process.

Contact DRO for assistance at 614-466-7264 or 800-282-9181. Note: due to the ongoing pandemic, DRO advocates are primarily working remotely so voicemail is encouraged.

The Centers for Medicare and Medicaid Services (CMS) also recently released a letter to residents on voting. Please share this letter with all residents.

LeadingAge Need to Know: COVID-19 – October 23, 2020

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured a Call to All Members and nominations are now open for the RWJF Award for Health Equity award.

Check out the full report here.

 

                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 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. 

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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.