OHCA's virtual educational programming to continue. A recent, under-the-radar interpretation of Governor Mike DeWine's business re-opening guidelines would allow associations to resume in-person meetings and educational programs, subject to social distancing and other restrictions. After careful consideration, with particular attention to the recent spike in COVID-19 cases, we decided for the foreseeable future not to alter our course of offering a robust catalogue of high-quality, virtual educational programming. Recognizing that pre-COVID-19, members valued OHCA's in-person offerings, the OHCA Board of Directors nonetheless feels strongly that we are different from other trade associations because our members serve the most vulnerable Ohioans, and we cannot countenance increasing the risk to them, especially when there are other viable options for delivering education to our members.

Progress of National Guard testing. Rebecca Sandholdt of the Department of Health (ODH) reported that as of yesterday, staff at a total of 285 SNFs had been tested by the National Guard and another 129 centers opted out by securing their own testing. The total of 414 is roughly 43% of all SNFs in Ohio. Ms. Sandholdt added that as of last Saturday, 25,518 staff and residents had been tested. Unfortunately, she could not provide the number or percentage of positive tests. As we reported previously, OHCA members tell us they have experienced very low levels of positives.

Ombudsman notes. Beverley Laubert, the State Long-Term Care Ombudsman, said the most frequent complaints ombudsmen receive are about inability of families to visit loved ones in SNFs, restrictions on  visits at the end of life, and the physical appearance of assisted living residents observed during visits.

Although providers cannot do anything now about SNF visits, there is light at the end of the tunnel. Providers at least can give family members and residents a date - July 20, 2020 - for resuming visits. With regard to end-of-life visits, state and federal guidelines have become increasingly lenient, but some members report non-compliance with facility safety guidelines during these visits. Facilities can withdraw visitation privileges from individuals for serious non-compliance. Especially during this period when facility beauty shops remain closed, special attention to grooming and personal care of residents is important.

Communication with residents and families is the number one thing facilities can do to ensure they are meeting the needs of their residents, ensuring a safe environment, and easing the worry that distance can cause. Ms. Laubert offered as a best practice a facility that set up a visiting area and allowed residents to schedule a time to meet with the ombudsman. They provided residents with a paper tool on which they could write down anything they would like to address or issues they were experiencing.

Updated DODD guidance. Today, the Department of Developmental Disabilities (DODD) released several updates to previously issued guidance. The first is to the guidance for COVID-19 Standards of Care for Vulnerable Populations, which addresses hospital care and specifies, among other things, that hospitals must allow a family member or caregiver at the bedside of patients who require special assistance.  Next, the state revised the LTSS Pre-Surge Planning Toolkit to apply to longer-term community supports and made various other changes listed in the overview. Finally, in response to questions posed by OHCA, DODD confirmed that ICF providers no longer need to do anything when a resident goes on hospice, but need to "re-admit" anyone who currently is on hospice and previously was removed from the resident roster so they can be included in the ICF’s ODDP scoring and certification. 

Assisted living tours. ODH advised that assisted living communities should not provide in-person tours, even with social distancing and use of masks. ODH staff interprets tours as violating the prohibition on inside visitng. ODH is considering whether to permit families to assist with move in/move out instead of using movers who are also not part of the facility's staff.

Local health department off-hours reporting. Members inform us that some local health departments (LHDs) are not available for case reporting or for assistance during off hours and on weekends. ODH responded that the LHD's voice mail should provide a 24-hour contact number. This number could change regularly based on the location and who is on call. If providers are unable to reach a LHD during off hours, ODH suggested they contact their regional collaborative or the state agency.