Meeting the needs of Ohio’s
Long-term Care Professionals since 1946

Find a Care Provider
|  Follow OHCA on Facebook Follow OHCA on Twitter Follow OHCA on Instagram Follow OHCA on Linkedin


November 12, 2020

7,000 Cases, 68 Red Counties. The latest Ohio COVID-19 data continue the alarming trend of skyrocketing infections, as the state reported 7,101 new cases, the highest yet. There were 268 new hospitalizations and 35 deaths. All of the state's 88 counties now are considered high incidence, with 68 of them labeled as red in the Ohio Public Health Advisory System (OPHAS). Two counties - Franklin and Tuscarawas - are on the verge of being the first to turn purple. Only Noble County is still yellow. The state this evening refreshed its dashboard for long-term care facilities. It now shows a total of 4,090 new cases in the past week among residents and staff - 1,074 more than the previous week - and 90 more deaths.

Current HCIC List. With the growing number of COVID-19 cases in facilities and expanding demand for moving COVID-19 patients out of hospitals, there is renewed interest in Ohio's Health Care Isolation Centers (HCICs), SNFs that are state-designated to care for COVID-19. There now are 27 HCICs with 360 quarantine beds and 448 isolation beds. Eleven are located in Zone 1, 3 in Zone 2, and 13 in Zone 3. Here is a table showing the currently-approved HCICs.

NHSN Reporting of POC Test Results. AHCA provided a list of Ohio SNFs that have not achieved Secure Access Management System (SAMS) Level 3 access to report point-of-care (POC) antigen test results to the National Healthcare Safety Network (NHSN). There are 334 centers on the list, many of which are OHCA members. The Centers for Medicare and Medicaid Services (CMS) mandates that SNFs report POC test results to NHSN. While CMS currently is not enforcing this requirement, that enforcement discretion is slated to end November 20. If you have not applied for SAMS Level 3, you should do it immediately. See this page for instructions. The process takes several weeks.

NHSN continues to offer training on the POC test reporting process, as listed on this page (scroll down to "Upcoming Webinars").

Benefit Period Waiver Clarifications. Through a Medicare Learning Network Matters update, CMS clarified two billing issues for the benefit period waiver for Part A SNF stays that allows an additional 100 days. The clarifications (see pages 15-16) address gaps in the additional 100-day period (permitted within the same spell of illness) and use of the "benefits exhaust" comment (only when the full extra 100 days have been used). As is the case with the 3-day stay waiver, the benefit period waiver remains in effect through January 21 under the Public Health Emergency.

SNF and AL Leaders Call with Administrator Verma. CMS Administrator Seema Verma held a call this afternoon with the AHCA, NCAL, and LeadingAge boards, along with state association boards and executives. She made a number of points in her brief address:

  • COVID-19 spread into facilities tracks very closely with community spread, but some providers are able to mitigate spread within the building and others are not.
  • SNFs and assisted living communities (ALs) should get priority for vaccines, although an independent group will set the final priority. CMS is providing billing flexibility for vaccines.
  • CMS views the new Eli Lilly therapeutic as being like a vaccine. Facilities can administer the infusion if they are comfortable doing so, or they can partner with home health agencies or others for that purpose. Administration of the drug is billable.
  • The therapeutic will be allocated to each state, so providers should work with their state to obtain access. The drug is most effective when the patient has mild symptoms and does not work for those whose illness is severe enough to require hospitalization. It is good for elderly people with comorbidities.
  • CMS and the Centers for Disease Control and Prevention have begun calling SNFs that report shortages of supplies or staff via NHSN and experience outbreaks. The purpose of the calls is to learn about the facilities' issues and to connect them with support.
  • CMS will publish the names of SNFs that participate in the agency's national training (the Quality, Safety, and Education Portal (QSEP) training, not Project ECHO). Administrator Verma said CMS is finding that SNFs with large outbreaks did not use the training.
  • CMS developed a SNF resource center that gathers COVID-19 information for SNFs in one place.
  • About half of all SNFs are reporting POC test results on NHSN. At some point, CMS will begin enforcement.
  • "Advocates" feel strongly that CMS must continue to do surveys in the "normal course."
  • CMS is working on guidance for the holidays. The Administrator expressed great concern about Thanksgiving. She said under the law, facilities can't stop people from leaving, but they should discourage it, including by pointing out that a vaccine is "around the corner." Staff members too should avoid holiday gatherings with people outside their household.