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June 16, 2020

More from ODH testing guidance. As we reported yesterday, the Department of Health (ODH) issued 7 guidance documents yesterday, as follows:

Today we will touch upon a few additional points in the guidance, augmented by discussion today with ODH and the Department of Medicaid (ODM) officials.

Members reported yesterday that they were instructed on a state webinar to test any employees newly hired after the National Guard testing day. While this is not in the guidance, Medicaid Director Maureen Corcoran said that because the ODH order requires all employees to be tested, those who are hired after the National Guard testing also should be tested.

The state also stood by its positions that facility medical directors should (and are required to) issue standing orders for testing, without liability to discipline by the Medicald Board, and that laboratories should bill employee health insurance plans for tests even if they are self-funded.

The FAQ does not mandate testing contractors (non-employees): "[a]s part of its infection control activities, the facility may encourage or require these types of individuals who are not employees to participate in the facility’s testing plan or verify their testing status."As for employees who refuse to be tested, a common question, ODH's Heather Coglianese said the order requires testing all employees, but the state will not dictate a specific course of action on the part of the employer if an employee refuses.

ODM's Julie Evers said the department is working on the infection control incentive payment program, but did not have any further details to share.

Other key points from ODH. The following notes are a potpourri of items from today's video conference with ODH and ODM.

  • Heather Coglianese of ODH said she hopes to send out a solution to the beautician issue this week.
  • ODH expects to complete Focused Infection Control surveys of the remaining 138 SNFs next week, but more will be done in certain centers that develop new COVID-19 cases, per Centers for Medicare and Medicaid Services (CMS) Quality, Safety, and Oversight letter 20-31-All. ODH also plans to begin doing late annuals at SNFs and residential care facilities shortly.
  • ODH is not concerned about surveyors going from a building with COVID-19 to one without because they do not engage in close, prolonged contact with patients and they are provided appropriate personal protective equipment.
  • The Bureau of Infectious Disease does not support allowing roommates to dine together in a dining room without distancing. We disagree with this interpretation.
  • The mass gathering order does not apply to health care facilities, so more than ten people can be in, for instance, a dining room.
  • The guidance on cooks in restaurants does not apply to health care - cooks should wear masks.
  • ODH still does not have a position on home care accrediting agencies beginning surveys.
  • ODH has not received any complaints about misuse of residents' stimulus checks, but ombudsmen have. Some of these relate to Medicaid restrictions on use of the money.

DODD ICF update. The Department of Developmental Disabilities (DODD) shared that it will resume pre-admission counseling starting July 1, 2020. In addition to being required for new admissions to ICFs-IID with 9 beds or more, pre-admission counseling will expand to include 8-bed ICFs per the Disability Rights Ohio lawsuit settlement agreement approved by the court in April. Options counseling also will expand to 8-bed ICFs beginning July 1, 2020. DODD stated that both pre-admission and options counseling initially will be done virtually.

DODD officials said the ICF quality measures rule is still pending approval by the Common Sense Initiative Office. DODD anticipates the rule will not be effective until mid-September, but they still expect ICF providers to have written policies by December 31, 2020, to participate in the ICF quality measures program for State Fiscal Year 2022.

Key employment guidance from EEOC on COVID-19. The Equal Employment Opportunity Commission (EEOC) provided guidance to employers on their rights and obligations and how they might have changed during the COVID-19 Public Health Emergency (PHE). The guidance addresses questions relating to medical exams required for healthcare workers, reasonable accommodations for employees with higher risk, return to work criteria, and many other employment issues. Please see the full guidance for more details.

CMS Chicago COVID-19 guidance to reopening. Providers can join the CMS Chicago Local Engagement and Administration (LEA) for their weekly series, “Real Time with CMS Chicago," on Wednesdays at 10:00 a.m. Eastern time. During tomorrow’s session, CMS will review their COVID-19 Guide to Reopening and offer time for questions and answers. Interested providers can join here and enter the password wpWXwJm42e7. 

CMS hosting SNF webinar for managing COVID-19-positive residents. As part of CMS's five-part plan and its continuing effort to provide guidance to SNFs during the PHE, the agency is hosting a National Nursing Home Training Series, a weekly program focused on infection prevention in SNFs. This week’s topic, which will be presented Thursday, June 18, from 4:00-5:00 p.m., will cover clinical management of COVID-positive and presumed COVID-positive residents that aligns with each resident's goals and preferences. The session will feature speakers from the Quality Improvement Organizations (QIOs). Interested providers must register in advance on the CMS event registration portal.