Elevating the Post-Acute and
Long Term Care Profession

March 23, 2021

Director of Health Visitation and Testing Orders Drop. Director of Health Stephanie McCloud issued four revised orders, dated yesterday but circulated today, dealing with visitation and testing. The orders correspond with information shared in Department of Aging webinars last week and Governor Mike DeWine's press conference yesterday. The four orders cover:

  • Visitation in assisted living. This order now is separated from the SNF visitation order, but most of the provisions are the same as the previous order. Some items are carried over from revised Centers for Medicare and Medicaid Services (CMS) Quality, Safety, and Oversight letter (QSO) 20-39-NH, even though the QSO does not apply to assisted living. Examples include the compassionate care language, the provisions on physical touch, and in-room visitation. The new order retains the list of considerations for each assisted living community to use in developing its visitation plan but does not have the SNF provisions on vaccinated and unvaccinated residents.
  • Visitation in SNFs. This order incorporates the changes CMS made in QSO 20-39 specifying when routine indoor visits are required but adds a few key items not prescribed by the QSO. These include duration of visits, the number of visitors, the visitation dashboard, and a specific requirement for in-room visitation for residents in private rooms and for related individuals sharing a room. The order also adds several examples to the federal list for compassionate care. Both visitation orders take effect immediately.
  • Testing in assisted living. This order, like the SNF testing order, incorporates testing frequency requirements. These requirements previously were specified in guidelines. The assisted living cadence for fully vaccinated staff will be weekly and for unvaccinated staff will be twice a week, which is an increase from the previous guidelines. The new order retains strategic testing for residents and does not prescribe outbreak testing.
  • Testing in SNFs. This last order mirrors the testing cadence for assisted living, which is a reduction for fully vaccinated staff, but adds outbreak testing in keeping with federal guidance. Neither the SNF nor the assisted living order addresses state support for testing. Both testing orders take effect April 5, 2021.
Maintenance Vaccinations. In several different member meetings today, we inquired about whether members received encrypted emails from the Department of Aging (ODA) with usernames and passwords for the maintenance vaccination schedule portal for SNFs and assisted living communities. Some members received the emails, others did not. The usernames and passwords come in separate emails (not always encrypted), both sent to the person designated as the contact when the facility completed the survey to register for the program. Other members reported that their long-term care pharmacy notified them about their clinics. Another member said their pharmacy is not in the maintenance program and they do not know what to do. One member who had not received a username or password got assistance by contacting the ODA help desk at ODA_ISD_HelpDesk@age.ohio.gov.

Verifying Vaccination Status. Last week, we advised that if a new admission doesn't have their vaccination card (and perhaps even if they do), a way of verifying vaccination status is to ask your long-term care pharmacy to check the Ohio Impact Statewide Immunization Information System (ImpactSIIS). We learned today that some facility members have had success logging into ImpactSIIS themselves. To do this, you first must enroll as a vaccine provider (affirm that you have cold storage capability even if you don't). Once you are enrolled, go here to sign up for ImpactSIIS access. This information is particularly important for determining if SNF admissions can be exempted from quarantine, but also can help verify whether new hires are vaccinated. Relative to quarantining new admissions, SNFs also will need to document (as best they can) that the person did not have close, prolonged, and unprotected exposure to another person with COVID-19 in the previous 14 days.