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October 13, 2020


Visitation Portal Open. The state's portal for SNFs and assisted living communities to enter information about their visitation policies, as mandated by the Director of Health order, is now available. Members report various challenges with the portal. One issue is that you must complete all of the sections, even if they are not applicable to you, before you can submit the information. Another member said when they registered a number of facilities, the registrations later disappeared. There also are questions about language in the order and the portal that appears to suggest facilities periodically have to report the number of actual visits. We believe the intent was to show the number of concurrent visits the facility can accommodate, but we will communicate with the Department of Aging about these issues and others members identify. The portal utlimately will feed a consumer dashboard that is scheduled to go live October 19.

Training on NHSN Antigen Testing Pathway. We reported previously that the National Healthcare Safety Network (NHSN) will offer a new pathway for facilities that use NHSN to report COVID-19 data and upgrade their Secure Access Management Service (SAMS) access to Level 3 to report line-level antigen testing data. This pathway is an option for providers to report these data, under the Clinical Laboratory Improvement Amendments (CLIA) requirements, instead of reporting directly to the Department of Health (ODH). CLIA waived laboratories should have received an email today about training on the pathway. NHSN will offer two identical webinars:

1. October 22, 2020, 11:00 a.m-12:00 noon

Join ZoomGov Meeting: https://cdc.zoomgov.com/j/1613111399?pwd=NjNCR0svMFk3N1JtUWhZVUxOT3YxUT09

Meeting ID: 161 311 1399; Passcode: 6x+*.8bx

One tap mobile: +16692545252,,1613111399#,,,,,,0#,,73848065# US (San Jose); +16468287666,,1613111399#,,,,,,0#,,73848065# US (New York)

2. October 23, 2020, 2:00-3:00 p.m.

Register in advance for this meeting: https://cdc.zoomgov.com/meeting/register/vJIsd-2orzooHuSyPRJ5icjmzTkwOlSrC1k  

After registering, you will receive a confirmation email containing information about joining the meeting.

Communication on Testing Transportation Personnel. Following our report last week that ODH supplied an interpretation from the Centers for Medicare and Medicaid Services (CMS) that transport workers providing routine trips for SNF patients must be tested under Quality, Safety, and Oversight letter 20-38-NH, members told us that ambulance companies did not believe this information. We informed ODH of this situation, and the Emergency Medical Services Board sent a message to all medical transportation providers from ODH's James Hodge that reads:

As part of ongoing efforts to minimize the transmission of COVID-19 among Ohio’s vulnerable nursing home residents, personnel providing non-urgent medical transportation to this population should be tested for the virus. Examples of non-urgent medical transportation are ambulettes and non-emergent emergency medical services (EMS) transports.

Personnel providing such services should be tested by the nursing facility or provide documentation that required testing was completed during the timeframe that corresponds to the facility’s testing frequency. 

This is in accordance with a Centers for Medicare & Medicaid Services (CMS) Interim Final Rule (CMS-3401-IFC), included in QSO-20-38-NH, dated Aug. 26, 2020, which provides that personnel providing services under arrangement to nursing home residents are to be tested.

Affected personnel should work with appropriate facilities and local health departments to determine specific testing requirements to comply with this CMS directive.

Individuals providing emergency services, such as EMS workers or law enforcement officers, are not required to undergo testing or show proof of testing, and they should not be delayed in responding to emergency situations.

Additional questions concerning COVID-19 testing requirements should be referred to the Ohio Department of Health Bureau of Regulatory Operations at (614) 644-6220.

In the wake of this communication, we heard some concerns about ambulance companies refusing SNF transports. Please let us know if you experience access problems. 

New CMS Positivity Rates. CMS published new positivity rates again this week. We added to the CMS table the Ohio Public Health Advisory System (OPHAS) designations released last Thursday and listed the mismatch counties that require weekly testing. Please note the OPHAS ratings will change this Thursday, and we will release a new table reflecting those changes.

Governor DeWine Discusses BinaxNOW Distribution. In his press conference today, Governor Mike DeWine spoke about plans for distributing BinaxNOW cards the state is receiving from the federal government. We have been talking with the Governor, Director of Aging Ursel McElroy, and other Administration officials about this for the past week. According to the Governor's release following the press conference:

Governor DeWine today discussed plans for Abbott BinaxNOW COVID-19 antigen screening tests that the federal government is providing to Ohio.

This week, Ohio is deploying thousands of these screening tests to colleges and universities to help them implement proactive screening plans. Next week, Ohio will begin sending tens of thousands of screening tests to nursing homes for both routine and outbreak testing requirements. 

Governor DeWine emphasized that lab-based PCR tests are still considered the “gold standard” test that provides the most accurate results, and antigen tests can have false positives and false negatives.

Director McElroy is conducting a small study of possible methods of distributing the cards this week and next at a few Ohio SNFs.

What to Do if You Did Not Receive Antigen Tests. In recent times, the Department of Health and Human Services sent point-of-care antigen testing machines to SNFs and BinaxNOW cards to assisted living communities and to SNFs located in CMS-designated red and yellow counties. In all cases, the tests were shipped only to facilities with CLIA waivers. If you feel you should have received one or the other of these shipments and did not, please use the following email addresses to report the situation:

POC machines: LabExcellence@cms.hhs.gov

BinaxNow cards: HHSBINAX@hhs.gov