AHCA updates cohorting guide. As a growing number of facility-based providers have residents who are COVID-19 positive or persons under investigation, cohorting (often through creating a COVID unit) becomes more important. AHCA updated their cohorting guide to include the latest advice on this evolving but extremely important subject. We recommend all members who operate facilities review and bookmark this document for current or future use.

Ohio 1135 waiver? During yesterday's state press conference, a reporter asked Governor Mike DeWine about an 1135 waiver for Ohio. Neither the Governor nor Lieutenant Governor Jon Husted were familiar. OHCA members frequently ask about 1135 waivers, as nearly all states in the union have secured them from the Centers for Medicare and Medicaid Services (CMS). Under 1135 waivers, CMS sets aside federal Medicare/Medicaid regulatory requirements in emergency situations such as natural disasters or COVID-19. States, individual providers, and associations can apply for the waivers, or CMS can grant them of its own volition. The state of Ohio has not applied, but OHCA (in conjunction with LeadingAge Ohio) and the Ohio Hospital Association both did so. Neither of the requested waiver packages have been granted, but CMS approved blanket 1135 waivers for the entire country this past week that include some of the provider-facing items in the state waivers CMS granted.

Advice from the President. As time goes on, more OHCA members unfortunately encounter COVID-19-positive cases among their employees or the people they serve. Many more providers likely will be touched before the pandemic recedes. OHCA President David Parker, who speaks from experience, offers advice for members, aside from complying with all applicable state and federal guidelines: communication and cooperation. Quick and frequent communication to state and local health authorities, in addition to families, is critical. The state and local health departments need to know in detail about the circumstances of the case and appreciate timeliness and transparency on the part of the provider. Cooperate with these officials and give them whatever access and information they need. In cases involving multiple positives, the state will convene one or more conference calls that include a large number of agency personnel. Participate openly in these calls and with whatever other information-gathering is requested, and the government agencies will regard you as a partner. Multiple experiences have shown this is invaluable when media are involved, as the health authorities are likely to support a cooperative provider publicly instead of casting blame.