New CMS/CDC guidance for SNFs. The Centers for Medicare and Medicaid Services (CMS), in conjunction with the Centers for Disease Control and Prevention (CDC), released new COVID-19 guidelines for skilled nursing centers. They address five topics: compliance with infection control precautions; personal protection equipment (PPE) and testing needs; symptom screening for all; staff use of PPE; and separate staffing, including COVID-specific units and centers.

We recommend careful review of the guidance as a whole, but we would like to point out two items in particular.

In one bullet, the federal agencies write, "[p]atients and residents who enter facilities should be screened for COVID-19 through testing, if available." In other words, testing before admission. This issue is controversial with hospitals, who may not want to wait for test results before discharging patients to SNFs. OHCA recommends following the CMS/CDC guidance that clearly expects testing.

In another bullet, CMS and CDC specify, "[i]f COVID-19 transmission occurs in the facility, healthcare personnel should wear full PPE for the care of all residents irrespective of COVID-19 diagnosis or symptoms." This statement, however, is preceded by a proviso that the guidelines apply "to the extent PPE is available," which makes clear that the full-PPE recommendation is ideal, but isn't possible when PPE isn't available.

Battelle to decontaminate N95s free. During today’s daily state press conference, Lt. Gov. John Husted announced that Battelle and JobsOhio partnered to decontaminate N95 respirators for health care providers and first responders at no cost for the next two weeks. Providers interested in sending their masks can request information using the Batelle Provider Decontamination Contact Form. 

Other press conference highlights. Health Director Dr. Amy Acton extended and revised her stay-at-home order under May 1, effective at 11:59 p.m. on April 6, to enhance restrictions on retail environments and to create a process to resolve disputes over whether a business is considered essential. The state also created a new job posting site to reach people displaced by COVID-19. Employers can post job openings here. OHCA members also should use the Ohio Care for the Aging or DSPOhio job sites, as appliable.

Humana waives authorization requests for COVID-19 patients. Previously, Humana suspended pre-authorization requirements on COVID-related diagnoses, excluding post-discharge, for both participating/in-network and non-participating/out-of-network providers. Humana now is expanding this suspension to cover nearly all pre-authorization requirements for participating/in-network providers. This applies to inpatient acute and post-acute, outpatient, and all referrals for Humana’s individual and Group Medicare Advantage, Commercial Group, and Medicaid plans when the member has a COVID-related diagnosis. 

NAHC recommends Massachusetts admission/discharge guidance. NAHC policy staff recommend home health and hospice agencies use guidance from the Home Care Alliance of Massachusetts on admissions from and discharges to hospitals of COVID-19 patients. The guidance includes:

• Screening and acceptance protocols for patients diagnosed with COVID-19.
• Denial of admission for a home health or hospice patient with known or suspected COVID-19.
• Pre-visit COVID-19 screening and assessment.
• In-home considerations for known or suspected COVID-19 patients.
• Use of personal protective equipment in the home.