Elevating the Post-Acute and
Long Term Care Profession

June 21, 2021

Visitation Orders Formally Rescinded. Last Thursday, when Governor Mike DeWine announced that Health Director Stephanie McCloud would rescind the two health orders relating to visitation in SNFs and assisted living communities, the rescission had not yet occurred. Then the state postponed its webinars originally set for last Friday because of the Juneteenth holiday, raising questions about what was happening with rescinding the orders. Later Friday afternoon, we got word that the two orders were rescinded through another order. To repeat what we reported last week, the testing orders for both assisted living and SNFs are still in place.

Also, remember that the state's webinars covering the order changes and other matters are set for tomorrow and Wednesday. If you wish to participate tomorrow and have not signed up yet, please use the Tuesday link in this flyer for assisted living (8:00 a.m.) or this one for skilled nursing (2:00 p.m.).

Ohio Down to Two Yellow Counties. Today's Centers for Medicare and Medicaid Services (CMS) county positivity table for Ohio shows 86 green counties and only two yellow counties. Holmes and Lawrence Counties remain yellow, and Holmes is just over the line at 5.0% positivity. Lawrence County unfortunately still has positivity of 14.1%, albeit in only 431 tests. Carroll, Harrison, Mercer, and Monroe Counties flipped from yellow to green. The two-week waiting period for counties that move downward in positivity still applies under CMS testing guidance but does not apply for the Centers for Disease Control and Prevention eye protection guidelines.

OSHA ETS Published in Federal Register. The new Occupational Safety and Health Administration (OSHA) Emergency Temporary Standard (ETS) for COVID-19 in health care settings specifies that most of its provisions take effect 14 days after the ETS is published in the Federal Register. A few items, such as requirements relating to training, physical barriers, and ventilation, take effect 30 days after publication. Those clocks now have begun to run, as the ETS was published officially today. The bulk of the standard takes effect July 5. You can use this link (members only) to view the archived recording of AHCA/NCAL's webinar on the ETS and to donwload the handouts.

Full-Scale Exercise Flexibility Extended. Today CMS published a revised version of QSO-20-41-ALL, which provides emergency preparedness guidance in view of COVID-19. One of the pre-existing provisions of the QSO allowed providers to skip the full-scale or individual facility-based exercise (but not the provider's exercise of choice) because they were dealing with the Public Health Emergency. This flexibility applies to inpatient hospices, ICFs/IID, SNFs, and home health agencies. In the revised QSO, CMS exempts providers from the full-scale exercise requirement for 2021 as well as 2020, subject to one very important caveat. That caveat is at the time the exercise would be required, the provider's emergency plan remains activated. CMS wrote:

The updated guidance only applies if a facility is still currently operating under its activated emergency plan. Facilities which have resumed normal operating status (not under their activated emergency plans) and were exempted from a full-scale exercise for its 2020 cycle, must conduct a full-scale exercise or an individual facility-based exercise for its next cycle.

ODM Reveals Security Breach. The Department of Medicaid (ODM) announced today that last month, there was a breach of security in an application that its contractor, Maximus, uses for exchanging provider credentialing information with the department and Medicaid managed care plans. According to Maximus, the breach applies to identifying information submitted by providers for credentialing before October 2020. It does not affect any beneficiary information or any other systems. While ODM and Maximus are unaware of any illicit use of the compromised information, the contractor is offering 24 months of credit monitoring and other services from Experian. Please see this memo for more information about the situation.