ODH makes PPE survey mandatory. According to an announcement this evening on the Enhanced Information Dissemination and Collection (EIDC) system, the Department of Health (ODH) is making the personal protective equipment (PPE) and staffing sections of their daily survey mandatory for Wednesday, Thursday, and Friday. ODH explains, "[p]lease review and verify the facility's PPE stockpile before beginning the survey, so you have this info collected before you begin the survey. Information gathered over this three day period is intended to provide accurate data regarding statewide PPE needs to help inform state procurement efforts [in other words, target allocations of PPE]. Therefore, your completion of the survey on each of these three days will be extremely valuable." The survey applies to long-term care, non-long-term care (home health and hospice), and hospital providers. ODH reminds providers to use their National Provider Identifier, not their provider number, and to complete the survey daily. See the EIDC notice for more information.
What is a probable COVID-19 case? Both the ODH order requiring facilities to report COVID-19 cases to residents and families and tomorrow's anticipated re-opening of ODH's online list of facilities with cases incldue confirmed and probable positives. This is likewise true of ODH's daily statewide reporting. While confirmed cases are based on two positive tests, the newer official designation of probable is more complicated. According to a statement by the Council of State and Territorial Epidemiologists (CSTE) earlier this month, probable cases are those for which:
- There is both clinical (symptoms) and epidemiologic (exposure) evidence; or
- There is a presumptive positive test and either clinical or epidemiologic evidence.
The CSTE statement explains in more detail which symptoms and what type of exposure are considered clinical and epidemologic evidence, respectively. You may wish to familiarize yourself with these new definitions for purposes of the required reporting.
More on HCICs and zones. During a stakeholder call today, the Department of Medicaid (ODM) emphasized that applicants for ODH designation as Health Care Isolation Centers (HCICs) must supply a letter signed jointly by the applicant and the regional zone commander for their region affirming the need for the HCIC. Even with this approval, ODM reserves the right to deny enhanced Medicaid reimbursement to the HCIC if they perceive it to be unnecessary.
ODM also said that not all hospitals and local health departments in Ohio may be aware of the new regional zone coalitions, particularly small, rural entities. If you contact one of these hospitals or local health departments for assistance under the coalition model, they may not respond. If that occurs, we suggest reaching out to your zone contacts. ODM said they will develop and circulate a list of contact people at each hospital and local health department, but the list is not available now. See our folder of ODM materials on this for more on the zones, including the contacts for each zone.
RHC/FQHC waiver impacts for home health. The Centers for Medicare & Medicaid Services (CMS) issued new waivers for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) that have a direct impact on home health agencies (HHAs). One of the waivers lifts the requirement for the centers to provide visiting nurse services (RN/LPN) to homebound patients only if there is a shortage of HHAs within the center’s area. With the waiver, RHCs and FQHCs may see their patients in the home in areas where there is a sufficient number of HHAs.
RHCs and FQHCs also may provide and may receive reimbursement for telehealth services using real-time, interactive, audio-visual communications with their patients in the home. While RHCs are only in rural areas, the FQHC waiver may further diminish HHA referral sources.
Hospice waiver and payment rule webinar recording. NAHC provided a link to their complimentary informational webinar held last week, which reviews changes under the new hospice payment rule as well as updated information on telecommunications interpretations for hospice care visits.
FDA letter on serological testing. Given the shortage of polymerase chain reaction (swab-based) testing, serological or antibody tests have received a great deal of attention, especially because they generate quick results. Because the Food and Drug Administration (FDA) has not reviewed the manufacturers of these tests, there are questions about the accuracy of some of them. Just as important is understanding what serological tests can and cannot do. In a nutshell, they cannot be used to diagnose COVID-19, but they can show whether a person was exposed at some time in the past. Please see this FDA letter for a detailed discussion.
Red Cross instructor certifications extended. The American Red Cross announced that because of technical issues, all Instructor and Instructor Trainer certifications set to expire between November 1, 2019, and September 29, 2020, are extended and now expire on September 30, 2020. Recertification assessments for everyone whose certification is extended must be completed by that date.
Useful AHCA materials. AHCA continues to develop tools for members to use in different COVID-19-related situations. Two of the latest are a template message (Word download) for front-line staff about social distancing both at work and at home and a list of action steps for staff and residents to prevent the virus from spreading.