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June 4, 2020


CMS releases facility-specific COVID-19 data. Today, the Centers for Medicare and Medicaid Services (CMS) announced that they published data on COVID-19 cases and deaths that SNFs reported to the Centers for Disease Control and Prevention (CDC) and data on the results of focused infection control surveys. The CDC data are shown in summary charts, which find Ohio in the middle of the pack in cases and deaths per 1,000 population. The page also has a link to facility-specific data on 13,600 SNFs that reported as of May 31. The CMS news alert includes a link allowing users to download files with the 2567s from 5,743 focused infection control surveys and a summary spreadsheet. Interestingly, this is considerably fewer than the 8,332 surveys that CMS listed on a table released earlier. For Ohio, the spreadsheet includes only 121 surveys, not the 293 on the table.

Reappropriations bill clears House. The House of Representatives passed Senate Bill (SB) 310 by a bipartisan 87-8 tally, with an emergency clause. The House added several floor amendments to the massive changes the Finance Committee adopted yesterday. SB 310 originated as a measure to distribute Coronavirus Aid, Relief, and Economic Security funds to local governments, but picked up multiple amendments in the House, including the entire Senate reappropriations bill and an OHCA-requested amendment to implement SNF reimbursement changes for July 1. While it is perhaps likely that the Senate will disagree with something in the amended legislation and send it to a conference committee, Senate Finance Committee Chair Matt Dolan (R-Chagrin Falls) was quoted as saying he supports the SNF amendment.

Survey expansion and accrediting organizations. CMS re-prioritized and suspended certain federal and state surveys and delayed revisits beginning March 20, 2020, for all certified provider and supplier types. In Quality, Safety, and Oversight letter 20-31-All, posted June 1, 2020, CMS updated its survey priorities. While the memo focuses mainly on SNF surveys, it also authorizes states to expand surveys beyond the current priorities and allows accrediting organizations (AOs) to resume normal survey activities in conjunction with the state. Some AOs, such as Community Health Accreditation Partner (CHAP), already have confirmed their intention to resume site visits for re-certification. OHCA reached out to ODH for guidance, but they stated they still are working with CMS on specific details of how the new survey guidance will be implemented in our state.

ODH news/clarifications. On a call with provider associations today, Health Department (ODH) and Medicaid Department (ODM) staff gave several updates:

  • The CMS outreach call mentioned in yesterday's COVID-19 Update is about entering data into the National Healthcare Safety Network.
  • ODH's goal is to complete focused infection control surveys of all 959 SNFs by the end of this month. Infection control surveys done previously will count for purposes of the Department of Medicaid's incentive program.
  • Rebecca Sandholdt confirmed that the incentive program will use the infection control self-assessment checklist attached to Quality, Safety, and Oversight letter 20-20-All, which doubles as the focused infection control survey form. Please note that this incentive program is not available yet.
  • ODH and ODM personnel asked that SNFs fill out the lab requisition forms for COVID-19 testing completely and electronically, including the employee's home address, and provide two copies on testing day. The form should not be pre-populated until the testing date is known, or the bar code will be incorrect. The form either should include the employee's insurance information or a statement that they have none.
  • Ms. Sandholdt said the facility should have physician's orders, typically from the medical director. When we pushed back that medical directors will be unwilling to order tests for employees without being absolved of responsibility for after-care, ODM's Marisa Weisel said the Revised Code makes medical directors responsible for infectious disease surveillance (we have not been able to locate this provision, but there is a rule on supervising employee health).
  • There is no change in ODH's position relative to beauticians: they are not considered essential personnel and cannot enter a SNF or residential care facility, even if they are designated as direct care staff.
  • State Ombudsman Bev Laubert said her office is developing a plan to resume ombudsman visits to facilities on a very limited basis as well as a postcard for providers to distribute to residents telling them the ombudsman is still available.
Study of factors related to COVID-19 status. An academic study of factors that predict whether a SNF is more likely to have COVID-19 cases was accepted for publication. The study of 9,395 SNFs concluded, "2,949 (31.4%) had a documented COVID-19 case. Larger facility size, urban location, greater percentage of African American residents, non-chain status, and state were significantly (p<0.05) related to increased probability of having a COVID-19 case. Five-star rating, prior infection violation, Medicaid dependency, and ownership were not significantly related." These research findings refute CMS's recent comments suggesting SNFs are to some degree responsible for COVID-19 cases.

NAHC staff safety survey. The recent events over the past months, such as the COVID-19 pandemic and civil unrest across the nation, have given rise to safety concerns for healthcare workers. For home care workers, safety has always been a concern because of the nature of working in the patient’s home. NAHC is interested in learning how home health, hospice, and home care agencies are addressing the various  issues that impact safety for staff. The national association asks providers to complete a survey that will assist them in understanding how agencies are working towards keeping their staff safe during these unprecedented times. Thank you in advance for your assistance. The survey will remain open until Wednesday, June 17, 2020.

Employee appreciation webinar recording available. We heard great comments about the free webinar, "The Do’s and Don’ts of Employee Appreciation During Tough Times," that Drive provided for OHCA members on June 2. If you missed it, you may view the recording here.