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September 2, 2020


NCAL Webinar Tomorrow on HHS Assisted Living Funding, Testing. At 3:30 p.m. tomorrow, September 3, NCAL will provide an overview of the new Department of Health and Human Services (HHS) funding opportunity for private-pay assisted living communities. Eligible providers must act quickly to take advantage of this funding, as the deadline for applying is September 13. In addition, the webinar will address the possibility that assisted living communities will receive free COVID-19 tests (the new Abbott Laboratories testing cards that just received emergency use authorization by the Food and Drug Administration (FDA)). You may join the webinar by using the log-in to the Webex or by calling 415-655-0003, passcode: 1724262445.

SNF Testing Rule Published, Took Effect Today. The Centers for Medicare and Medicaid Services (CMS) rule on SNF testing and other topics (including civil money penalties) was published today in the Federal Register. The published version of rule is available at this link. Because it is an interim final rule with comment period, like the earlier rule on reporting COVID-19 cases and deaths, it takes effect immediately instead of after the 60-day waiting period for normal rules. As a result, all of the testing requirements are effective today, and the time periods for routine testing also start today.

Who Pays for CMS-Mandated Testing in SNFs? A number of OHCA members have asked this question over the past few days. The answer is that the testing required of SNFs under various circumstances by CMS is separate from the state-mandated testing, so the same funding considerations do not apply (e.g., the state's commitment to cover the cost for self-insured providers). Likewise, the state's laboratory arrangements do not not carry over to the CMS-mandated testing. Instead, providers have two options. One is using the antigen point-of-care (POC) testing units supplied by HHS. These machines are free and come with a limited number of test kits. Providers have to purchase more kits from McKesson or Medline, although only Quidel test kits are available at this time. There is some ability to bill third-party payers for tests using the POC machines - OHCA continues to gather information on this. The second option is entering into an arrangement with a laboratory for tests. Part of the arrangement between the facility and the lab would relate to billing. The lab may insist on "client billing" the SNF or may be willing to bill third-party payers. Recognizing the likelihood that at least some part of the cost of CMS-mandated testing will fall on the center, HHS provided funding to SNFs last Thursday for the express purpose of paying for testing and potentially for other infection control costs. The funding amounted to $10,000 per SNF plus an additional $1,450 per bed, or $155,000 for a 100-bed center.

Further Guidance from ODH on COVID-19 Reporting Under CLIA. As a follow-up to the article "CLIA Laboratory Reporting Requirements Related to COVID-19" in the August 28 SNF News Bites, we wish to share some additional information we learned from the ODH Clinical Laboratory Improvement Amendments (CLIA) laboratory unit. As pointed out in the article, once you obtain your COVID-19 POC unit and complete the requirement to register your lab, you are required to report daily, 7 days a week, by 11:00 a.m., the aggregate daily totals of all tests performed by completing the State of Ohio COVID-19 Laboratory Testing Report.

You will notice two tabs on this report: one that allows you to report totals of “Diagnostic (PCR) COVID-19 Aggregate Test Results” and one that allows you to report “Non-Diagnostic (Antigen and Antibody) COVID-19 Aggregate Test Results.” While the FDA and the Centers for Disease Control and Prevention (CDC) both recognize antigen tests as diagnostic, the ODH reporting portal still lists them under the non-diagnostic category. Accordingly, until further notice, all tests performed using your POC unit must be reported under the Non-Diagnostic tab. Also, both tabs must be completed before you submit the report. Enter “0” in all required fields for which data is not available.

Questions have arisen about where to send the ODH SFTP Request Form that allows facilities to begin the process to establish a secure file transfer connection with ODH to report more specific, line-level data on all POC tests. While that process is still in development, SNFs wishing to begin by initiating the SFTP Request Form should send it to ELR@odh.ohio.gov. Please contact Diane Dietz if you have any questions about the CLIA requirements for POC units.

OHCA COVID-19 Testing Guide for Hospice Agencies. On August 26, 2020, CMS released new survey guidance in Quality, Safety, and Oversight letter 20-38-NH that mandates testing of SNF staff and expressly includes contractors such as hospice personnel along with employees. As a result of this requirement, many hospice providers now are experiencing COVID-19 testing access and funding issues at a much higher frequency. OHCA created a quick reference guide to aid hospice providers in navigating the new testing requirements, understanding staff and patient copays, and learning about COVID-19 testing options. For questions regarding this resource, or if you experience issues in obtaining COVID-19 testing for your hospice staff, please contact Erin Begin.

DODD Shares Updated Plan for DDPs. OHCA received the following update from the Department of Developmental Disabilities' (DODD's) Sara Lawson describing how the department plans to restart the process of performing Developmental Disabilities Profile (DDP) assessments every three years:

I wanted to give you an update on the DDPs. We have been completing the initial DDPs remotely via Teams, FaceTime, etc. The feedback from providers has been very positive. Our plan is to now do a trial of 3 year DDPs. This will be thoughtfully planned to work with providers schedules, spread out the facilities so that providers don’t have multiple CRCs asking to complete DDPs in the same time frame, and will not require documents being scanned and sent unless absolutely necessary. We plan to do around 12 facilities in the next few weeks and gather feedback to ensure the process is working.

Liability Bill Passes Senate. Yesterday, we reported that a conference committee between the House of Representatives and the Senate reached agreement on a conference report on House Bill 606, establishing COVID-19 liability protection for health care providers and other businesses, and the House adopted the report. Today, the Senate followed suit, again by a party-line vote, and forwarded the bill to Governor Mike DeWine for signature.

NHSN Webinar Tomorrow on SNF Reporting Changes. As reported in yesterday's COVID-19 Update, the National Healthcare Safety Network (NHSN) made some changes to the required reporting for SNFs. For more details on this and other reporting issues, please view the webinar, "NHSN Updates for LTC COVID-19 Module and Responses to Common Module Questions," that the agency will offer tomorrow, Thursday, September 3, at 1:00 p.m. You may register for the program here.  

Adult Day Care Guidance. To accompany the Health Department (ODH) order establishing criteria for re-opening day care centers for older adults on September 21, ODH and the Department of Aging (ODA) published guidelines. ODA plans to offer a webinar in the near future to assist providers in re-opening. Please note that the order and guidelines do not apply to adult day services and supports for people with intellectual and developmental disabilities.