New edition of the list. The Department of Health (ODH) posted an updated version of its list of long-term care facilities with confirmed or probable COVID-19 cases. This week, the list includes both current cases and cumulative cases since April 15, again broken down by residents and staff. Unfortunately, OHCA received from members a number of examples of errors in the reported data. We believed ODH put in place a process for local health departments to verify the information before it is posted, but clearly that process broke down. Please email Pete Van Runkle if you identify errors that need to be corrected. In addition, ODH began posting a second list of COVID-19 deaths in long-term care by county. We believe these data also may be incorrect.

Training on COVID-19 reporting to NHSN. The Centers for Medicare and Medicaid Services (CMS) announced 10 days ago that SNFs must report positive COVID-19 cases to the Centers for Disease Control and Prevention (CDC) through its National Health Safety Network (NHSN). Since then, the reporting expanded to include personal protection equipment (PPE), staffing, and ventilators. Last evening, all SNFs should have received an email notifying them of a LTCF COVID-19 Module for submitting the data and a web page on the Module. The web page includes training on registering for NHSN and reporting data, beginning with a webinar to be held tomorrow from 1:30-3:00 p.m. and continuing with a second, different webinar on Friday at the same time. Expand the Training tab on the web page to view the options for participating in the training.

Health care re-opening. Today's state webinar on re-opening the health care services (e.g., elective surgeries) closed in March mainly focused on the regional zone concept, which is not new and not specifically about re-opening. One segment of the webinar, however, did outline three steps to restoring the suspended services starting Friday. The first step, which already is in effect, allows procedures needed because of a threat to the patient’s life if the surgery or procedure is delayed, a threat of permanent dysfunction of an extremity or organ system if delayed, risk of metastasis or progression if staging is delayed, presence of severe symptoms causing an inability to perform activities of daily living (new), or risk of rapidly worsening symptoms if delayed. Step 2 includes procedures that do not require an overnight hospital stay or an inpatient admission and minimize PPE use, as well as routine medical, dental, and veterinary appointments. This phase is structured as it is because of a concern that opening other businesses could result in a surge of hospital utilization for COVID-19. Phase 3 is all other elective procedures and services. A Director of Health order incorporating these steps will be published before Friday.

Technology grants only available to SNFs. In recent COVID-19 Updates, we covered CMS's offer of grants for technology to enable patients and families to communicate during the current period of restricted visitation. These grants are available only to SNFs, as they are funded by money collected from SNFs via civil money penalties (CMPs). According to federal law, CMP money can be used only for projects that benefit SNF patients.

DODD today. The Department of Developmental Disabilities (DODD) issued updated guidance for supportive technology options that relaxes authorization requirements for assistive technology authorized on or after March 12, 2020. In addition, Director Jeff Davis released a new video message reminding everyone to continue the fundamentals for fighting the spread of COVID-19.

NAHC-Recommended Operations Protocols for home care providers. NAHC's Home Care Steering Committee, the Private Duty Home Care Association (PDHCA), and other contributing expert members created Recommended Operations Protocols for home care agencies dealing with COVID-19. The protocols cover management and action steps, communication, screening, training, PPE, coping with pandemic stress, and other topics. As research and experiential learning give new information about this novel disease, the document will be updated and the updates shared with OHCA members.

CDC offers webinar series for staff, updates symptoms of COVID-19. CDC updated its Key Strategies to Prepare for COVID-19 in Long-term Care Facilities (LTCFs) webpage to include a new webinar series for front-line staff. The agency also amended its definition of symptoms indicating COVID-19 to include cough, shortness of breath, difficulty breathing, or at least two of the following: fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell. It still lists these symptoms as appearing within 2-14 days of exposure, although anecdotally we have heard of longer intervals.

EPA guidance on cleaning and disinfecting workplaces and homes. Yesterday, in preparation for relaxation of stay-at-home measures, the Environmental Protection Agency (EPA) released guidance for cleaning and disinfecting public spaces, workplaces, businesses, schools, and homes. For long-term services and supports professionals, this guidance can assist in re-opening administrative offices and also in decontamining a patient’s home. The guidance also includes a listing of EPA-approved disinfectants for COVID-19 and specific disinfecting protocols for each surface type.

Upcoming free webinars for home care and hospice. NAHC is providing three complimentary webinars this week for home care and hospice providers related to the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

• Accounting for CARES Act and Determining Allowable Expenses for Relief Funding, by Simione Healthcare Consultants.  Two sessions will be held on Thursday, April 30, 2020, at 3:00 p.m. and Friday, May 1, 2020, at 12:00 noon.
• CARES Act Emergency Funds: How to Achieve Accountability and Compliance, by NAHC and the Home Health Financial Managers Association (HHFMA). This webinar will be held on Thursday, April 30, 2020, at 2:30 p.m.
• Mechanics of the Paycheck Protection Program, Arbitration Programs, and the Latest Advocacy and Legislative Developments, by NAHC, Home Care Association of America (HCAOA), and Littler Mendelson. This session will be held on Thursday, April 30, 2020, from 12:00 to 2:00 p.m.