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June 24, 2020

CMS relaxes SNF visitation. The Centers for Medicare and Medicaid Services (CMS) today published a frequently-asked questions (FAQ) document on visitation in SNFs. The guidelines suggest re-opening could be considered when the SNF is at Phase 3, which the guidance describes similarly to Quality, Safety, and Oversight letter 20-30-NH, except the new guidelines call for adequate access to testing instead of weekly testing. Many Ohio SNFs would meet the revised Phase 3 criteria. CMS expands the concept of visits in compassionate care situations to include more than the end of life and prescribes safeguards for these visits. CMS also reinterprets the visitation restrictions to allow outdoor visits and other creative options, even for centers not at Phase 3. Other parts of the guidelines confirm previously announced relaxation of the prohibitions on communal dining and activities, list factors for facilities to consider relative to re-opening, affirm that COVID-19-positive patients should not have visitors, and stress that ombudsmen still have access. While the CMS guidance is certainly influential, we will need to discuss with the Health Department (ODH) its impact on the ODH visitation order.

More SNF testing notes. In today's Department of Medicaid testing webinar, which took the place of the sprint-specific webinars the state previously conducted, a few more tidbits of relevant information emerged.

  • The National Guard will be glad to test staff from an assisted living or independent living that is in the same building or on the same campus as a SNF that is being tested. Simply notify the state of the total number of tests needed on their Survey Monkey or email the mailbox.
  • Providers are welcome to have their staff tested at free pop-up sites, local health departments, or other locations in lieu of the National Guard testing. The center must maintain records of who was tested and of the results and must send a verification letter to ODH. Here is a current map of testing sites.
  • Federal law prohibits insurance companies from charging co-pays or deductibles for COVID-19 testing. Tests for some uninsured individuals will be billed to the federal government, others to the state.
  • As of June 29, Quest Diagnostics will handle all testing in Zones 1 and 2. They have their own portal for submitting the lab requisitions. Zone 3's testing sites will remain the same.
  • SNFs with staff who test positive can utilize the options on the second page of the state's return-to-work guidelines or can contact the Bridge Team to try to stay at a contingency level.

The slides and recording of yesterday's all-provider webinar are available on the SNF testing page.

PPE survey. We mentioned last night that the state is conducting another three-day personal protective equipment survey. Today ODH published the following notice on the Enhanced Information Dissemination and Collection (EIDC) system. Please note that it is a revised survey with a new link.

The joint survey created by The Ohio Department of Health and The Ohio Department of Medicaid has undergone some updates, we have changed or removed several questions.

Please fill out a survey for each ODH ID. If a single facility has a Residential Care section and a Skilled Nursing section please provide each ODH ID with the data recorded for separate entity.

The link to the new survey is below, the previous link is no longer active.  

We are making the survey mandatory for  three days, your responses are due by 10pm on June 24, June 25, and June 26.

This survey does not replace the CMS mandatory survey each nursing home should be filling out per QSO 20-29-NH.

Please note that per ODH's Shannon Richey, the survey is not mandatory for home health agencies.

Another hearing on liability legislation. Today, the Senate Judiciary Committee held a hearing on House Bill (HB) 606, the lower chamber's version of COVID-19 liability protection legislation for health care and businesses in general. HB 606 passed the House earlier this month, and the Senate passed its own version, Senate Bill (SB) 308. The two bills' language on health care is very similar, except House Bill 606 places it into temporary law that expires December 31, 2020, while SB 308 has it in permanent law. OHCA was the lead-off witness on HB 606, but there were numerous others. It is unclear at this time what will become of the bill going forward. You may view OHCA's written testimony here.

Medicare COVID-19 data; NHSN reporting. CMS published an extensive set of data derived from Medicare claims through May 16, 2020. The data focus on COVID-19 cases and hospitalizations. They are separate from the SNF data submitted through the National Healthcare Safety Network (NHSN). Relative to NHSN reporting, CMS's Evan Shulman said today they are taking a very flexible approach to removing civil money penalties (CMPs) if a provider submits documentation showing they were unable to register. This would include serial CMPs imposed before CMS renders a decision on the provider's dispute resolution request, which could take a few weeks or a month. 

Palmetto GBA eServices COVID-19 Transition Tool. In light of the COVID-19 pandemic and transition of employees back into the office, Palmetto GBA provided a quick reference guide to assist with common issues you may face if you have not logged into your eServices account in the last 30-60 days. The COVID-19 Transition Tool includes instructions on how to unlock or reset the administrator account access, to register for eServices if your account has been suspended, and to troubleshoot the Google authenticator. 

BWC hosting OSHA record-keeping webinar June 30; focus on COVID-19. The Ohio Bureau of Workers’ Compensation (BWC) will host a webinar entitled "Precision OSHA Recordkeeping" on Tuesday, June 30, from 11:00 a.m.–12:00 noon. The webinar will examine Occupational Safety and Health Administration (OSHA) record-keeping forms, general recording criteria, and specific situations that must be recorded on OSHA injury and illness record-keeping documents. The primary focus of the presentation will be to determine the recordability of an event to ensure accurate records are maintained. The session also will cover reporting requirements, electronic submission of records, and record-keeping considerations for COVID-19 events. To register for this complimentary webinar, please click here.