Elevating the Post-Acute and
Long Term Care Profession

May 18, 2021

State Masking/Distancing Order and DD Services. In last night’s COVID-19 Update, we shared the amended Health Department order for the general public on facial coverings, social distancing, and non-congregating. While the order specifically states that it does not apply to SNFs, assisted living communities, or adult day services centers for elderly adults, it was silent on the applicability to services for people with developmental disabilities. The order, however, cites last week's Centers for Disease Control and Prevention (CDC) guidance on this same topic. The CDC guidance specifically excludes all health care settings and links to their "Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination" guidelines. At this time, the CDC guidance recommends that even fully vaccinated health care personnel continue wearing source control (masks) while at work. ICF providers are required to have infection control policies based on clinical guidance, so ICF staff should continue following facility policies. Additionally, the second amended order for ID/DD adult day services, which is still in effect, requires employees to wear facial coverings at all times while delivering services. OHCA will continue to communicate with the Department of Developmental Disabilities to see if they will be issuing any additional guidance around these preventive measures in lieu of ODH orders. In the meantime, we suggest following CDC guidance and continuing to require staff to wear masks regardless of their vaccination status.

Ohio SNF Occupancy Hits 70%. The latest SNF data published by the National Healthcare Safety Network (NHSN), which dates from May 2, shows average occupancy was 70.0% at that time. This is a 0.7% increase from 69.3% the week of April 25. The data are taken from the total beds and occupied beds reported by facilities to NHSN each week. 914 of a total of 954 SNFs reported both data elements and were included in the analysis. Census bottomed out below 68% in January.

Volunteers and Entertainers. We receive many questions about whether volunteers and entertainers (volunteer or paid) are allowed to enter SNFs and assisted living communities. The short answer is yes, these individuals can be viewed as necessary or essential to the operation of the business and to residents' quality of life. We suggest treating them like staff or ancillary health care personnel for infection control purposes. This means testing them if necessary (if they are not fully vaccinated), screening them, and requiring them to use source control and to maintain distancing if possible. There is no exception to source control requirements for entertainers, although obviously wearing a mask can detract from the value of a performance. Fully vaccinated entertainers, scheduling events outside, and extra distancing can help enhance safety.

Recording of AHCA/NCAL Vaccination Webinar. If you were unable to attend today's AHCA/NCAL webinar on the new Centers for Medicare and Medicaid Services vaccination requirements, you are in luck. A recording of the webinar, which is primarily of interest to SNFs but may have some applicability to ICFs, is available for on-demand viewing. Here are the instructions:

1. Go to https://educate.ahcancal.org/products/interim-final-rule-requiring-snfs-to-offer-covid-19-vaccine-and-report-to-nhsn?force_login=1 and log in using your username and password.

2. Once the page opens, click on the “View Archived Recording" button on the right hand side of the page. The presentation will open in a new window for you to view and hear the program.

3. Click on the Handout tab to download your copy of the handouts and other available materials.

For questions or support, please email educate@ahca.org