Elevating the Post-Acute and
Long Term Care Profession

April 7, 2021

ODH Annual Survey Restart. Last week, we shared correspondence from the Health Department (ODH) announcing that they intend to restart annual surveys for both SNFs and residential care facilities (RCFs) this month, probably later rather than sooner. This week, ODH's Rebecca Sandholdt provided a little more detail. She said ODH will return to previous practice of starting newly hired surveyors on RCF surveys. They plan a slow roll-out of annuals. Ohio is part of a multi-state workgroup looking at the backlog of complaint and annual surveys. The Centers for Medicare and Medicaid Services (CMS) only gave states 45 days to clear the backlog of non-long-term care surveys. For SNF annuals, ODH will prioritize facilities with more than 15.9 months since their last annual, which as of the end of March was 749 centers. Within this group, priority will be determined based on how many deficiencies were cited on the last annual and intervening complaint and Focused Infection Control surveys. Ms. Sandholdt said certain survey tasks have to be done on-site, per QSO-20-31-NH as revised January 4, 2021, but she hopes the rest can be done off-site. She added that ODH is having difficulty getting the proper size N95 respirators for some surveyors, so those surveyors cannot survey buildings with COVID-19.

Frequently-Asked Questions. Here are a few issues that come up frequently from SNF and assisted living members, with our advice on them.

  • Volunteers. Many members are under the impression that facilities cannot use volunteers. That is not the case. Volunteers who perform important functions, for instance escorting visitors to the location of the visit, can be considered "[p]ersonnel who are necessary for the operations" of the facility, in the language of the seventh amended ODH orders on SNF visitation and RCF visitation. State Long-Term Care Ombudsman Bev Laubert observed that volunteers also help make life better for residents.
  • Communal Dining. While the six-foot rule still applies to communal dining (see AHCA/NCAL guidance on this topic), ODH recognizes that in some cases, residents' rights prevail. The example case is two alert and oriented, fully-vaccinated residents who insist that they wish to eat together without six feet of separation. ODH, with the support of Ombudsman Laubert, accepts this kind of arrangement with appropriate documentation that the residents have been educated about the distancing recommendation but chose otherwise. There is no specific frequency for the education, but it must be a person-centered approach, not a blanket policy of setting aside the six-foot distance. 
  • PPE for Visitors. Another common perception is that visitors must wear N95s/full personal protective equipment (PPE) in various circumstances, such as compassionate care visits. For SNFs, revised QSO-20-39-NH refers only to facemasks, even in the compassionate care section. Similarly, only requirement in the ODH visitation orders is for surgical masks. Full PPE may be best practice for protection of visitors when the resident has COVID-19 or is in quarantine, but it is not required. If you choose to provide N95s, there is no requirement for fit testing visitors. 
  • Pets/Therapy Animals. There is no COVID-19-related prohibition on pets or therapy animals entering a facility, as they may be of great benefit to socially isolated residents. The facility's normal pet policy, developed under the pre-existing licensure rules, applies.

In tomorrow's COVID-19 Update, we will address some additional questions from yesterday's SNF member call.

CMS Adds New Speech-Language Pathology and Audiology Services to Medicare Part B Telehealth Codes List (from AHCA/NCAL). CMS recently posted updates to the List of Telehealth Services for Calendar Year 2021.  This update includes several new services that can be furnished by speech-language pathologists (SLPs) and audiologists when furnished via telecommunications technology during the current COVID-19 public health emergency. See this AHCA/NCAL blog post for more detail on these codes.

AHCA/NCAL Offers Follow-Up OSHA Webinar. This program is scheduled for next Tuesday, April 13, at 1:00 p.m. It is a sequel to the well-attended March 30 session on the Occupational Safety and Health Administration's (OSHA's) COVID-19 National Emphasis Program, featuring Brad Hammock, an attorney with Littler. The purpose of next week's webinar will be to answer frequently-asked questions as well as any new questions participants pose. You may register here for the April 13 program, and you may wish to view the recording of the March 30 webinar beforehand if you did not attend at the time.

Senior Adult Day Services Grant Opportunity Deadline April 9. OHCA members who operate adult day services for seniors should take note that the Department of Aging's (ODA's) $10 million "second chance" grant program for adult day centers closes Friday, April 9. Please see ODA's web page for detailed information about the grants. You may apply at the Office of Budget and Management's grants page.