Elevating the Post-Acute and
Long Term Care Profession

July 15, 2021
Final COVID-19 Update

Last COVID-19 UpdateWith this edition, we are discontinuing our COVID-19 Updates, which debuted March 9, 2020. While the pandemic is not over, especially with the advent of the delta variant, the volume of COVID-19-related news has declined significantly, especially news that members need to know urgently (e.g., changes in Centers for Disease Control and Prevention guidelines). Instead, to keep members informed, we will emphasize our weekly News Bites for our different membership segments, together with bulletins during the week whenever there is timely information that we feel you need or would want to know immediately - COVID-19 or non-COVID-19. The bulletins will go out to the same mailing list that we used for the COVID-19 Updates, except we will target them to the affected member group(s).

Hint on Scripps Surveys. As we enter the home stretch for submitting the survey on financial and workforce issues in SNFs and residential care facilities that the Scripps Gerontology Center is managing for OHCA and other provider associations, Scripps provided a last hint for ensuring you receive the email containing the survey link. They suggest adding the survey email address, scrippsminisurvey@miamioh.edu, to your address book. Scripps reports many completed surveys are flowing in, and we urge members who have not submitted yet to do so by the close of business tomorrow to give us the largest possible sample size. We very much appreciate your help!

PASRR Hybrid Assessment Model. The Department of Mental Health and Addiction Sevices (OMHAS) is changing their Preadmission Screening and Resident Review (PASRR) Level II assessment process beginning today. They used virtual assessments during the pandemic but are changing to a hybrid model that includes an option for in-person assessments. According to OMHAS, "[d]ecisions on assessment format, either in-person or telephonic, will be determined by the preference of each facility on a case by case basis ...." They will schedule in-person assessments in advance. You may direct questions about the new process to OMHAS's contractor, Ascend, at Ascend-OHPASRR@maximus.com or 833-917-2777.

AHCA/NCAL: Let My Money Go! OHCA member providers across the spectrum of services are frusutrated with continued delay in releasing the remainder of the federal Provider Relief Fund (PRF). Reportedly, the fund contains $24.5 billion in general appropriations plus $8.5 billion targeted to rural providers. Congress specified through legislation how this funding is to be distributed, but the Department of Health and Human Services (HHS) has not allocated it or even announced a date or process for doing so. The latest PRF distributions to long-term services and supports providers date back to early this year, but pandemic-related costs (including costs of attempting to respond to the acute staffing shortage) and lost revenues continue to pile up. This week, AHCA/NCAL issued a press release publicly pressuring HHS to release the money. Focusing primarily on SNFs and assisted living communities, AHCA/NCAL:

A recent survey conducted by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) found that 92 percent of nursing homes and 62 percent of assisted living communities said the PRF has been helpful during the COVID-19 pandemic. The same survey found facilities continue to face significant ongoing economic challenges. Only one-quarter of long term care providers were confident they will make it through to next year. Without additional government support, facilities may be forced to close. In fact, a recent AHCA/NCAL analysis found that nearly 2,000 nursing homes could shut their doors for good over the course of the pandemic.

State Submits Plan for ARPA HCBS Funding. As required by the Centers for Medicare and Medicaid Services (CMS), Ohio submitted a plan for how they propose to spend federal funding generated by the 10% Federal Medical Assistance Percentage (FMAP) increase for home and community-based services (HCBS) under the American Rescue Plan Act (ARPA). This funding must be devoted to enhancing HCBS in the state. CMS mandated that all states submit plans, which CMS must approve, before they can start to receive the money. Unfortunately, this process delays the state's receipt and eventual disbursement of the federal funds. OHCA some time ago submitted a request to the state to direct a portion of the funding to providers in the HCBS systems run by the Departments of Developmental Disabilities, Aging, and Medicaid. Ohio's plan is quite vague and lists a number of options the state may pursue. One of them is described as follows:

The COVID-19 pandemic and ongoing public health emergency have created unique challenges for providers of home and community based services. ODM, ODA, DODD, OhioMHAS and ODE, in conjunction with stakeholders, will explore opportunities to provide targeted, time-limited immediate relief with a portion of the ARPA funding.

In recent remarks to OHCA and other associations interested in the state's Medicaid budget, Medicaid Director Maureen Corcoran said the DeWine Administration intends to hold conversations with stakeholders to develop a more detailed spending plan. While OHCA appreciates the opportunity to help shape the state's proposal, we also are mindful of the need to move as quickly as possible to provide much-needed, "immediate relief" to members.

COVID-19 Cases in Long-Term Care Tick Up Slightly, Still Low. This week's Health Department dashboard on COVID-19 cases in long-term care facilities (ICFs/IID, assisted living communities, and SNFs) shows a slight increase to 117 cases. Last week the total number of current cases between staff and residents was 106. This increase was fueled by a rise in staff cases from 55 to 71, but is still very low for a week's period in more than 2,000 facilities. Overall daily cases reported today throughout Ohio were 547, with 37 hospitalizations and 11 intensive care unit placements, a trend that is sparking concerns among state officials about a potential spike of delta variant infections among unvaccinated Ohioans. A number of rural counties have very low vaccination rates, with Holmes County at the bottom with only 15%. Lawrence County, which consistently has had high positivity rates in the CMS tables, is at 28%. By contrast, most urban counties have vaccination rates above or close to 50%.