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November 5, 2020


Important Deadlines Tomorrow. There are three key deadlines coming up tomorrow, as follows.

  • Pharmacy Partnership for Long-Term Care. The opportunity to register for COVID-19 vaccinations for facility residents ends at 11:59 p.m. tomorrow. We strongly urge facility members to sign up for this free, no-obligation program to ensure their residents are not left behind when a vaccine becomes available. SNFs should register by logging into their National Healthcare Safety Network (NHSN) account. All others should register at this link.
  • Provider Relief Fund (PRF) Phase 3 General Distribution. Also before 11:59 p.m. tomorrow, applications for Phase 3 must be submitted to the Department of Health and Human Services (HHS). A broad range of health care providers are eligible for this phase, which is intended to fill any gaps between previous PRF distributions and lost revenue/increased cost incurred in the first two quarters of 2020. According to HHS officials on a call this afternoon, an applicant must submit their Tax Identification Number (TIN) for validation by tomorrow, and they will have until November 27 to complete the application. A provider who still has an application pending for Phase 2 may apply for revalidation of their TIN for Phase 3.
  • State Testing Support Opt In/Opt Out. Tomorrow is the deadline for the opt-in/opt-out survey for state support of testing in SNFs. As explained in the survey and the testing guidelines, there are four options for providers to choose. According to Director of Aging Ursel McElroy on Tuesday, 80.6% of the first 531 SNFs to complete the form opted in. Of those centers, 75% requested the full 4-week cycle, 10% chose 2 weeks of antigen testing only, and 15% chose 2 weeks of polymerase chain reaction (PCR) testing only.
Daily Cases in Ohio Near 5,000 Mark. The number of positive COVID-19 test results ballooned to 4,961 today, 732 (17%) more than the previous daily record. A record number of 2,075 people are currently hospitalized with the disease, with 541 in intensive care, also an all-time high. We are beginning to hear of hospitals reaching capacity. On the newly-released Ohio Public Health Advisory System map, 56 counties are at the red level, 13 more than last week. Most of the counties remaining orange and yellow are sparsely-populated rural counties.

McCloud Becomes Director of Health. At his press conference today, Governor Mike DeWine announced that he appointed Stephanie McCloud, previously Administrator of the Bureau of Workers' Compensation, as Director of Health. The Governor also made other personnel moves in the department. From the official release by the Governor's Office's: 

Chief Medical Officer Dr. Bruce Vanderhoff: Dr. Vanderhoff previously served for more than a decade as a Senior Vice President and as the Chief Medical Officer at OhioHealth. He has years of experience leading large teams in successfully dealing with important healthcare issues in Ohio and prepared OhioHealth to deal with the threat of Ebola and the H1N1 flu pandemic.  

Director Stephanie McCloud: Director McCloud previously served as Governor DeWine's administrator of the Ohio Bureau of Workers' Compensation, managing an agency of 1,800 colleagues and over $28 billion in assets. She has considerable experience in the area of mental health and addiction treatment which is a priority in Ohio's health improvement plan. 

Senior Deputy Lance Himes: Himes had previously served as the interim director of ODH where he has played an integral role in running and managing many aspects of the pandemic response operation. He will lead the coordination of the state’s vaccine distribution plan and will continue to work directly with Ohio’s local health commissioners.

Chief of Staff Kathleen Madden: Madden had previously served as Assistant Director at the Ohio Office of Budget and Management and will now play a key role in keeping ODH's pandemic and non-pandemic programs and operations on track. She will work to prioritize and resolve critical issues, provide oversight and guidance to ODH staff, and ensure that ODH funds are spent responsibly and strategically.

McKesson Taking Orders for BD POC Machines. McKesson informed OHCA that they are taking orders for BD Veritor point-of-care (POC) COVID-19 testing machines along with test kits. This opportunity may be particularly beneficial to home care, hospice, and ID/DD providers who previously did not have access to this rapid testing technology.

Only organizations with a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver are permitted to run rapid COVID-19 diagnostic tests through a POC machine. The Department of Health’s CLIA Laboratory Certification webpage provides information on how to obtain a CLIA Certificate of Waiver. Please note that according to McKesson, BD is drop-shipping their Veritor machines directly. Once ordered through McKesson, fulfillment is running approximately 4-6 weeks, although some orders have shipped faster. To learn more, please contact Jeff Mazer at Jeff.Mazer@McKesson.com.

FDA Issues Letter on Antigen Testing. The Food and Drug Administration (FDA) released a letter to laboratories and health care providers with interesting information about false positive results from antigen COVID-19 tests, for example point-of-care testing machines and BinaxNOW cards. The FDA explains that false positive results can arise from improper testing techniques and conditions. Any member using antigen tests should review these reasons for false positives to ensure that their testing process affords the best opportunity for accurate results. The FDA letter also explains the statistical probabilities of false positives in surveillance testing, which vary inversely with the prevalence of COVID-19 in the general population. For instance, if prevalence is low at 0.1%, 96% of positive antigen test results are likely to be false. According to the Centers for Disease Control and Prevention, positive antigen test results in a surveillance testing regimen should be confirmed with a PCR test.

Swabbing Certificate Not Required. We heard from a member today that a surveyor asked for a "CCURT certificate" evidencing that the personnel who swab for COVID-19 testing had received video training. There is no requirement for such a certificate, and when OHCA conveyed that information to the member, the surveyor backed off. Ohio does not have any professional qualifications or training requirements for swabbers, but obviously it is important for the accuracy of the test that the specimen is collected properly. Please see Ohio's recommended clinical checklist for specimen collection, which includes a link to a training video. Again, neither the checklist nor the video is required, and there is no certificate for watching the video training.