Elevating the Post-Acute and
Long Term Care Profession

March 3, 2021

Home Health Agencies Available for mAb Infusions. Many OHCA SNF and assisted living members have expressed a need for home health agency RN staff to administer the monoclonal antibody (mAb) treatment to their residents. Recently, OHCA held an education session with our long-term care pharmacy partners on how home health agencies can assist with mAb infusions in facility settings. Following the webinar, we sent a survey to home health agencies in Ohio and asked that they identify counties in which they are able to provide staffing for mAb administration. We compiled a list of those agencies by county, with contact information for referrals. Please feel free to reach out directly for infusion referrals and coordinate with your long-term care pharmacy for treatment delivery. For questions about coordinating with home health agency staff or about mAb treatments in general, please contact Erin Begin.

MMO SNF Prior Authorization Waiver Extension. Notwithstanding an apparent communication error, Medical Mutual of Ohio confirmed that they indeed extended their SNF prior authorization waiver through April 2, 2021. They have not yet updated their related frequently-asked questions (FAQ) document to reflect this change, so it still shows an expiration date of February 28, 2021. We received verbal confirmation of the extension and that the discrepancy should be corrected soon. Robin Bender is the single point of contact for facility questions regarding this change. We updated our SNF Prior Authorization Grid to reflect the waiver extension.

Leftover Chat from SNF Member Call. We did not get to a few items in the chat box for yesterday's SNF member call within the allotted time. Many of these items were answers to previous questions raised during the call, but a few are worthy of elaboration.

  • Volunteers.

    • What about allowing volunteers back in our campuses who can prove they have been COVID vaccinated? We allow families with no idea if they have been vaccinated or not.

    • We are getting prepared for when we are allowed to open visitation. Our visiting area is in a large room with 3 different stations for residents/guests. I have a few families who want to be monitors to help out, knowing staffing is limited to monitor these visits. Do we think this would be acceptable or not?

The answer to these questions is not entirely clear, although the available guidance would suggest volunteers can enter SNFs to perform necessary functions. Neither Centers for Medicare and Medicaid Services (CMS) Quality, Safety, and Oversight letter (QSO) 20-39 nor the state's sixth amended Director of Health order specifically addresses volunteers, although the QSO does contain a sentence suggesting CMS expects volunteers would be allowed to enter. The sentence reads, "[w]e remind facilities that all staff, including individuals providing services under arrangement as well as volunteers, should adhere to the core principles of COVID-19 infection prevention and must comply with COVID-19 testing requirements." This suggestion is supported further by QSO 20-38, which, along with the governing CMS regulation it quotes, refers multiple times to testing volunteers and even defines them as part of facility staff. While this QSO deals with testing, not entry, there would be no reason to discuss testing volunteers if they could not enter the building.

The Director's order restricts entry to "personnel who are necessary to the operation" and gives non-exclusive examples of these personnel, so depending upon their function, it would be easy to argue that volunteers are necessary to the facility's operation. This is particularly true, as the question above notes, during the present severe staffing shortage.  

  • Vaccine providers. Under the new vaccine pharmacy program, option 2 requires the facility to be a provider. Is there a place to check to see if the facility was accepted as a provider? The state's search tool only shows vaccine providers that have been allocated vaccine. Although today the Department of Health (ODH) reported that 142 long-term care locations are enrolled as vaccine providers, to our knowledge none have been allocated vaccine. All enrolled providers, however, receive notification by email from ODH when their enrollment is approved.
  • Vaccination training. Here are links to Centers for Disease Control and Prevention (CDC) training on the Pfizer/BioNTech and Moderna vaccines.

ODH Vaccine Communications. We thought you might be interested in two recent vaccine-related items from ODH. One is a slide deck with various updates that ODH's Lance Himes would have presented to the Vaccine Provider Workgroup if the meeting had not been canceled. The other is ODH's message to vaccine providers with details about the newly-approved Johnson & Johnson (Janssen) vaccine, which information also is summarized in the slide deck.

BinaxNow Cards. The state published a notice on the Enhanced Information Dissemination and Collection system (EIDC) about Abbott's extension of the expiration date on some of their BinaxNOW cards, many of which are in the possession of Ohio assisted living communities and SNFs. The notice states:

For those facilities who participate in the state-supported testing program using BinaxNOW rapid antigen or who utilize HHS direct allocations of BinaxNOW rapid antigen, Abbott has been working with the FDA to address the issue of short expiration dates. The attached message provides explanation about expiration extension and lists the lot numbers that qualify for extension. Please note: kits manufactured with six (6) month dating can now be extended by three (3) months and kits manufactured with nine (9) month dating do not qualify for the extension.

We hear from members with some regularity that they have a surplus of BinaxNOW cards and wonder if there are other members who need them. If you need more cards, please let us know at OHCA, and we will attempt to connect you.

Message from BELTSS: Pandemic Continuing Education (CE). Deb Veley of the Board of Executives of Long-Term Services and Supports (BELTSS) asked that we share the following note with members.

The Board recently made the following changes to its Pandemic CE program for LNHAs:

  • You now have 30 days post-program attendance to submit for approval, instead of the original five days;
  • If you were previously denied or did not apply due to not meeting the submission deadline, you have until March 31,2021 to submit/resubmit and be considered for credit, and may go back to the beginning of the program (11/1/2020); and
  • The program was scheduled to end on 7-1-21, but that has been changed to stay active for as long as the Governor’s state of emergency declaration remains in effect.

We’ve listened to your suggestions and continue to try and support you whenever possible. New forms reflecting the new time frame will be posted to the website soon, so watch for that on the Continuing Education page under the heading “Pandemic CEs”.

Thanks, and let us know if you have any questions by emailing lhedrick@age.ohio.gov or dveley@age.ohio.gov.

We add that this does not apply to the OHCA, Metro Hospital, or University of Toledo Project ECHO cohorts. OHCA submitted all of the ECHO sessions to BELTSS for approval separate from the pandemic program. As a result, each attendee receives a certificate with a BELTSS approval number that they can upload to their MyBELTSS account as they would credits from any other approved event that they attend.