Fire Drills During Pandemic. The Health Department's (ODH's) Rick Hoover clarified the agency's stance on fire drills under the Life Safety Code, which applies to SNFs and ICFs/IID. The once per shift, per quarter requirement is still in place, but the Centers for Medicare and Medicaid Services (CMS) blanket waiver for fire drills (see page 28) discourages drills involving mass gatherings. Instead, CMS expects the drills to focus on orientation and education of residents and staff. Mr. Hoover added the alarm still must be transmitted to the monitoring company to ensure it is functional.
Positive Tests Among Contract Staff. Amanda Smith of the Bureau of Infectious Disease said it depends on the role a contract staff member plays whether their positive COVID-19 test should be included in the case count of the facility where the test occurred. If contractor is stationed at the facility, the answer is yes. If they serve multiple facilities, the answer is no. On the other hand, Mr. Hoover said the testing facility must report the positive case per existing requirements.
Testing in ICFs. We reminded ODH this morning that ICF/IID members with symptomatic or known exposed staff and residents are having difficulty securing testing and that no one has provided a consistent solution. Other congregate care settings may experience this issue too. ODH's James Hodge acknowledged that this is a "blind spot," and they will work to find an answer that we can share with members.
Reporting Data on SNF Testing. Mr. Hodge said ODH will issue a Survey Monkey for SNFs to report the results of their repeat testing. He said the survey, which should be available by the end of this week, will be simple and will include facility identifying information and the summary results (number positive, number negative). SNFs are to complete the survey anew for each round of testing. Marisa Weisel reported that Quest Diagnostics, since July 21, is averaging a 3 to 5-day turn-around time, as is Dayton Children's Hospital.
OHCA Member Concerns. Mr. Hodge said the National Guard also will pick up swabs for the second repeat SNF testing round, but he acknowledged problems with the Guard's performance so far. He said the state has reinstituted twice-a-week calls with the Guard to address issues. We recommend members report any concerns to the Congregate Care Unified Response Team mailbox at CCURT@odh.ohio.gov.
Relative to the letters from ODH to nurses recruiting them to work at Oakwood Village, Mr. Hodge said the only letters ODH sent were to nurses who in March or April signed up to be in the CCURT licensee bank, which is part of the Bridge Team offerings to facilities experiencing a staffing crisis. He suggested the letter may have been circulated more widely via social media.
Twelve-Week Limit on Positive Test Exemption. Ms. Weisel reaffirmed the state's position that SNF staff who previously tested positive must be re-tested as part of the mandatory testing program if twelve weeks have passed since the positive test. She said they will re-examine some of the related issues, but the clinical guidelines support re-testing after 12 weeks.
SNF Testing Schedule May Go to Fourth Week. Ms. Weisel informed us that because of laboratory capacity issues, it is likely not all the remaining SNFs (including those postponed from this week) will be scheduled next week. Some may go over to the following week (week of August 24). The state may introduce another commercial laboratory next week. Ms. Weisel also asked us to remind members that all laboratory requisitions must be filled out online, not on paper. The state still has not finalized a process to retain employee information in their portal.
Choice Between SNF and AL Testing. Ms. Weisel confirmed that a community with both assisted living (AL) and SNF components may choose between the two testing programs. SNF testing is mandatory and uses nasal swabs, while AL testing is voluntary and tests saliva. Nonetheless, a combined community always could have had their AL staff tested as part of the SNF program. Now, it can choose to have the SNF staff tested in the AL program and still meet the mandate. The state asks that the provider notify both the CCURT@odh.ohio.gov and the ALCOVIDTesting@age.ohio.gov mailbox of their decision. As a reminder from the Department of Aging webinar, the portal to sign up for AL testing is https://nova.dxresults.com/Signup.aspx.
DODD Provider Review Tools Updated. The Department of Developmental Disabilities (DODD) Office of System Supports and Standards updated their provider review tools. The changes will take effect September 1, 2020. The notification from DODD states, “[y]ou will be pleased to know that there were no questions added. In fact, you will find that there were a few questions removed, and several questions combined.” Below are links to the revised review tools:
DODD also provided a Summary of Changes to 004 Agency Provider Review Tool 9/1/2020.
Latest CMS/CDC/QIO Weekly Training Topic of SNFs. This week's program is entitled, "Transparency: Resident and Family Notification, Department of Health and Other Notifications." It will be offered Thursday, August 13, from 4:00-5:00 p.m. According to the notice, the training will cover updated guidance and policies regarding transparency during the COVID-19 Public Health Emergency, best practices to implement a comprehensive and actionable communication plan, insight from a shared experience of a COVID-19 family member, and strategies to provide compassionate care and communication during the COVID-19 pandemic. You can register here for the program, sign up here to receive direct invitations to future sessions, and view recordings, slides, and resources from previous sessions at QIOProgram.org.