Elevating the Post-Acute and
Long Term Care Profession

March 2, 2021

New CMS Positivity Data. The Centers for Medicare and Medicaid Services (CMS) released their latest county-level positivity data. The Ohio table generally shows continued improvement, as Franklin County went green and Cuyahoga County went yellow. On the other hand, two southeastern Ohio counties (Belmont and Washington) moved back to red as their positivity rates crept back above 10%. Other changes this week were Adams, Hocking, Noble, Ross, Union, and Wood Counties becoming green and Gallia, Greene, and Lake Counties going from red to yellow. These changes have an immediate impact on routine indoor visitation in SNFs. Absent a new-onset COVID-19 case within the past 14 days, CMS requires SNFs in green and yellow counties to allow routine visitation, while centers in counties that become red cannot allow visitation other than for compassionate care situations.

OSHA’s ITA Hits Snag from High Traffic. As members hopefully are aware, today, Tuesday, March 2, is the deadline for employers to submit their Injury Tracking Application (ITA) electronically via the OSHA ITA portal. A number of OHCA members reached out to us regarding errors they experienced when trying to submit their data. The error message was: “There was an issue with our [OSHA] service.” According to OSHA, “the ITA is having significant performance issues due to high traffic. We are working to minimize the issue but we do not anticipate its complete resolution until after the March 2nd due date of the collection.” 

OSHA advised that members should attempt to submit the required data because the system is working. If it does not allow you to submit, please make a record of your efforts, including taking a screen shot of the error message, initiating a help request form with OSHA, and calling OSHA directly.  Please check back daily, as the system is working, will be open for data submission after the March 2 deadline, and will function as soon as use decreases.

Remember, electronic submission of Form 300A data is required both for establishments with 250 or more employees currently required to keep OSHA injury and illness records and for establishments with 20-249 employees in specific industries with historically high rates of occupational injuries and illnesses. The latter group includes North American Industry Classification System (NAICS) classes 6231 (skilled nursing facilities), 6232 (ICF/IIDs), and 6239 (licensed residential care facilities/assisted living). For more information on electronic submissions via the ITA portal, please click here.

AHCA/NCAL Provider Relief Fund Use Document. AHCA/NCAL compiled some key material from the Department of Health and Human Services (HHS) guidance on use of Provider Relief Fund (PRF) money. The document pulls together items from HHS's frequently-asked questions to address both permissible expenditures and transfer of PRF money among related entities.

AHCA/NCAL Begins #GetVaccinated Campaign. The national association received a grant from the Centers for Disease Control and Prevention (CDC) to launch a campaign to encourage greater staff uptake of COVID-19 vaccine. Part of this effort is identifying strategies that have proven effective in overcoming vaccine hesitancy through a survey of providers. As Ohio readies its maintenance vaccination program that will give hesitant SNF and assisted living staff members a second chance, you may find the results of AHCA/NCAL's research in this summary helpful.

ODH News. Today we met with staff from the Department of Health (ODH) Survey Bureau and Bureau of Infectious Diseases (BID). Survey chief Rebecca Sandholdt announced that ODH restarted ICF/IID and home health agency surveys, but not hospice. They plan to begin SNF annual surveys sometime in April.

ODH soon will circulate a "how-to guide" for the state's visitation dashboard, following up on Governor Mike DeWine's letter to administrators last week urging facilities to allow visitation to the greatest extent of the CMS guidance. Ms. Sandholdt reported that 220 facilities (SNF and assisted living) have not registered for the dashboard and another 140 have registered but have not entered information. The guide is intended to encourage these buildings to comply with the dashboard requirement.

Marika Mohr of BID said ODH still limits gatherings, including communal dining and activities in facilities, to no more than 10 people. She referred to CDC guidance, but did not indicate which guideline. The most recent ODH order on mass gatherings, issued today, does not address people gathering within a congregate living environment.

Ms. Mohr also said the 6th amended ODH visitation order does not allow assisted living communities to conduct tours for prospective residents, although the order does not speak to tours, which arguably are entry of personnel necessary to the facility's operation. Ms. Mohr said the provisions alowing visitation do not apply to tours because they are not visits to specific residents. ODH will elevate the tour issue to leadership.

The ODH staff also still did not state a position on the CDC vaccination guidance that allows fully vaccinated health care personnel to be freed of work exclusions for COVID-19 exposure. BID's Sarah Mitchell said BID follows CDC guidance, but then deferred to the regulatory staff, who did not provide clear direction.

More Information on Searching Nurse Aide Registry. This afternoon, ODH distributed through the Enhanced Information Dissemination and Collection system (EIDC) a second clarification on use of the new Nurse Aide Registry platform, which includes instructions on how to address common issues. Here is the text of the EIDC notice with a link to the instructions:

We have received several questions about the nurse aide registry as a result of the migration of the registry to the new platform. The attached document is to serve as guidance to help assist with those frequently asked questions we are receiving. Also, please keep in mind that the web links to access the registry have been changed. Below are the new links:

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