Reporting CRF Issues to State. We apologize for giving different advice to members day-to-day about how to report issues they are experiencing with the state's Coronavirus Relief Fund payments. This morning we received a message from Patrick Beatty at the Department of Medicaid (ODM) asking that members not email him, as we suggested in our Saturday COVID-19 Update, and instead email only CRFprovider@obm.ohio.gov to make tracking the issues easier. Mr. Beatty further stated that a meeting would be set to update the provider associations on the process. Unfortunately we have not received any more data on where the applications stand and have not heard members have had their questions resolved.
Assisted Living Testing - False Positives. Some OHCA assisted living members reported an inordinate number of false positives on saliva testing they conducted under the voluntary Department of Aging (ODA) testing program, before the state order took effect that mandates testing. False positives require quarantining residents or staff until the local health department clears them through additional, nasal-swab testing. It could be that the false positives occurred because of mishandling of the tests. We will discuss the situation with Director of Aging Ursel McElroy, but members may want to hold off on administering any more of the saliva tests until we have greater clarity. Only assisted living staff are subject to mass testing under the order. Providers will need to balance the fact that the saliva testing is free and nasal-swab testing is not against the drawbacks of saliva testing once they are confirmed. We will keep members posted on developments.
Project ECHO Trainings Scheduled. Today, the federal Agency for Healthcare Quality and Research (AHRQ) announced three training webinars for SNFs. On its registration page for the Zoom programs, AHRQ offered this description:
In partnership with the Agency for Healthcare Research and Quality (AHRQ), Project ECHO is mobilizing our national network of ECHO partners to rapidly deploy COVID-19 ECHO programs to train mentor, and support nursing home staff on infection prevention and control. With support from the Agency for Healthcare Research and Quality (AHRQ), the ECHO Institute will provide training, mentorship, and support to nursing home staff on infection prevention and control to an estimated 15,000 nursing homes across the country.
The three sessions scheduled so far are "Optimizing Clinical Care in the Time of COVID in Skilled Nursing Home Facilities" (August 25, 2020), "The Latest News on Testing, Cohorting, and Critical Infection Prevention Strategies" (August, 26, 2020), and "Telehealth in the Time of COVID/Recent Study on Infection at Skilled Nursing Facilities" (September 2, 2020). SNF personnel can register for all three sessions at this link.
Filling Out Quest Lab Requisition Forms for Self-Insured SNFs and Uninsured Staff. OHCA clarified with Quest Laboratories the correct way to fill out their online lab requisition forms for the mandatory, every-two-week SNF staff testing program. If you are a self-insured SNF, please choose the insurance option and click on “COM,” which stands for commercial third-party coverage. This choice allows you to enter the name and address of the third-party administrator (TPA) that processes your self-insured claims and may have negotiated fee screens for laboratory services. OHCA still is seeking clarification from the state about the process by which they will pick up the tab for repeat testing for self-insured SNFs, as they have agreed to do. Self-insured centers are responsible for the cost of the initial baseline testing conducted by the National Guard. If you have an employee who is truly uninsured, you should complete their lab requisition as a “patient bill.” Quest assured OHCA that they will bill the Health Resources and Services Administration (HRSA) uninsured program for these employees.
McKesson Offers Training Webinar on BD Veritor POC Unit. On Wednesday, August 26, beginning at 3:00 p.m., OHCA Platinum Champion Partner McKesson will hold a webinar for SNFs on the BD Veritor™ system for rapid detection of SARS-CoV-2, one of the two point-of-care (POC) testing units the Department of Health and Human Services (HHS) is sending to all centers in the county. This presentation will help explain the HHS program and will provide a BD system overview and a discussion of its functionality. You also will learn where to turn for answers and for the next steps your facility will need to take. We encourage members to register for Wednesday’s webinar.
Hospice Staff Should Be Permitted Without Testing in End-of-Life Situations. OHCA member hospice agencies continue to report that some SNF providers require negative COVID-19 test results to visit patients who are in end-of-life situations. Per the revised Department of Health (ODH) Guidelines for Testing of Nursing Home Residents and Staff, “individuals participating in end-of-life situations are permitted in-person visitation and should not be required to be tested first.” ODH also revised the corresponding frequently asked questions document to reflect this direction under question 11, stating that “[h]ospice providers and family members are permitted in a facility in end of life situations without a COVID-19 test.” As a reminder, per the fourth amended Director’s order on visitation and facility entry, “end of life situations are defined as a substantial change of condition indicating end of life is approaching. Providers shall notify family several days and up to one week in advance and shall not wait until active dying.”State Guidance on Home Visitation Screening. Various state departments, including ODA, ODM, ODH, and the Department of Developmental Disabilities (DODD), developed a “Home Visiting Screening Guide” to assist providers with pre-screening individuals for home visit eligibility under COVID-19. The two-page document also provides information on how to prepare for visits and to sanitize between them. Even if a patient does not appear to show symptoms or report exposure, the agencies recommend home care providers wear a mask during in-person visits. Providers also may consult the Centers for Disease Control and Prevention (CDC) guidance for caring for patients at home. While DODD is listed as participating in development of the screening guide, we still are waiting for a response from the department on its applicability to in-home services for people with intellectual and developmental disabilities.