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November 3, 2020

Ohio Daily Case Count Tops 4,000. Today the state announced that the number of COVID-19 cases exceeded 4,000 for the first time, reaching 4,229, nearly 400 more than the previous record set on Friday. There were 213 new hospitalizations, 33 deaths, and 25 intensive care unit admissions.

OSHA Issues New Long-Term Care Respiratory Protection Guidance. Late last week, the Occupational Safety and Health Administration (OSHA) released a new document entitled, "Respiratory Protection Guidance for the Employers of Those Working in Nursing Homes, Assisted Living, and Other Long-Term Care Facilities During the COVID-19 Pandemic." In the guidance, OSHA provides a hierarchy of items that can be used to cover an employee's mouth and nose, starting at the bottom with cloth face coverings and moving on to facemasks. OSHA characterizes both of these as beneficial for source control, but not as personal protective equipment. Surprisingly, OSHA equates KN95s with facemasks: "An example of this type of product would be a KN95 respirator with ear loops instead of head straps and that has not undergone rigorous fit testing to demonstrate a proper fit/effective seal to the wearer’s face." Next in the hierarchy are true surgical masks, which protect against splashes and sprays but do not provide respiratory protection, and at the top, N95 or higher filtering facepiece respirators (FFRs).

After the hierarchy, OSHA discusses in some detail the required respiratory protection program. Here are a couple of noteworthy provisions:

  • "During times like the present pandemic, when there are increased demands on the supply chain for N95 FFRs, consider alternatives to N95 FFRs, including other FFRs (e.g., P100s, N99s), reusable elastomeric (rubber) respirators, and powered air purifying respirators (PAPRs)." OSHA goes on to say that while initially more expensive, the latter two types of respirators may save providers money because they are reusable.
  • "Note that while N95 FFRs are meant to be discarded after each use, CDC has developed contingency and crisis strategies, including reuse and decontamination of N95 FFRs, to help healthcare facilities conserve their supplies in the face of shortages." This section of the guidance specifically links to one of the Centers for Disease Control and Prevention (CDC) guidelines that in crisis capacity for N95s allows use of respirators "that are similar to NIOSH-approved respirators but are not NIOSH approved and are approved according to standards used in other countries. The performance of some internationally approved respirators was evaluated by NIOSH and the results can be found here." The referenced list includes a number of KN95s.

This provision, which seems to condone the practice of substituting KN95s for N95s when a facility is in crisis capacity, appears to conflict with the earlier provision equating KN95s with simple facemasks for source control only. OHCA will continue to investigate how this guidance affects the practice of wearing KN95s when N95s are not available. We will provide more information as we learn it, but want members to be aware that the new OSHA guidance is out.

State Provides Holiday Flexibility for Assisted Living, Adult Day Testing. The Department of Aging (ODA) announced today that it will allow residential care facilities, adult day care, and senior centers to move their testing days up by one day to avoid the holidays listed below. ODA notes that similar adjustments already were made for SNFs.

In an effort to provide flexibility in your facility’s scheduled testing date in the upcoming holiday season, residential care facilities, adult day centers, and senior centers (nursing homes are currently excluded) currently scheduled on the following holidays will be permitted, though not required, to conduct testing one day prior to the scheduled testing date:

  • Thanksgiving Day (11/26/20) – test 11/25 if facility chooses in lieu of 11/26
  • Christmas Day (12/25/20) – test 12/24 if facility chooses in lieu of 12/25
  • New Year’s Day (1/1/21) – test 12/31 if facility chooses in lieu of 1/1

Facilities electing to utilize this flexibility will resume their previously communicated testing schedule in the subsequent testing period. Facilities do not need to notify of their decision. It is critical facilities confirm shipping arrangements with carriers (FedEx Express) in advance of the holiday to ensure specimens are received at the lab for processing within the required timeframe.

A special thank you to MAKO Medical for providing this flexibility to our facilities.

Questions regarding COVID Testing may be directed to

Please visit ODA’s website often for up-to-date testing resources regarding residential care facilities and adult day and senior centers.

New Training Dates for NHSN POC Test Reporting Tool. Members reported that they were closed out of the National Healthcare Safety Network (NHSN) training programs on its new point-of-care test result reporting tool that were held late last week and yesterday. NHSN scheduled two more training sessions as listed below. Both are re-broadcasts of a previously-recorded program.

  • Thursday, Nov 5, 2020, 12:30-1:30 p.m. Register at this link.
  • Friday, Nov 6, 2020, 11:30 a.m-12:30 p.m. Register at this link.

Please sign up for only one session, as they are identical.

Aggregate POC Test Result Reporting Still Required. Based on questions from members, we thought it good to remind you that if you are conducting point-of-care (POC) antigen testing at a SNF or assisted living community, you still need to report aggregate results from POC tests only to the Department of Health (ODH) even though you also report line-level results to the National Healthcare Safety Network (NHSN). The aggregate reporting must be done by 11:00 a.m. each day. ODH is maintaining this requirement to verify that providers report similar results to NHSN. At some time in the future, the aggregate reporting requirement will go away. 

Bridge Team Available for Staffing Crises. We recently heard several very positive reports about assistance the National Guard provided to SNFs and assisted living communities that suffered COVID-19-related staffing crises. The National Guard's help, which is available as a last resort to avoid having to evacuate residents, is coordinated by the state's Bridge Team. See the Bridge Team guidance for more information about the process. Here are the Bridge Team contacts:

Primary Bridge Team Coordinator (BTC)

Rick Hoover, ODH,, 614-562-2580

Back Up Bridge Team Coordinators (If Rick is unavailable)

Dave Holston, ODH,, 614-301-8750

Julie Davis, ODM,, 614-204-6549

Jayson Rogers, ODH,, 614-752-9156

General CCURT Questions Inbox,

Ohio Health Care Association
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Lewis Center, OH 43035