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March 9, 2020

Three cases in Ohio. Governor Mike DeWine announced this afternoon that three individuals from Cuyahoga County tested positive for COVID-19 and declared an emergency. These three cases are the first confirmed in Ohio, although several others still are in testing. None of the three appear to be in long-term services and supports. The Governor also announced that some 75 polling places for next Tuesday's primary election that are located in SNFs will be moved. Further, we understand that a local health department in northwest Ohio directed a SNF not to hold gatherings on site.

COVID-19 testing: As of last Thursday, Ohio has a test kit for COVID-19, but the kit only allows for testing 300-400 people. Questions have arisen about who should be tested and when. According to Department of Health (ODH) officials at a meeting Friday afternoon, if you feel a person may have COVID-19 because of their symptoms and possible exposure, you immediately should contact your local health department. If you do not know your local health department, here is a listing to help you find them. ODH emphasized that local health departments have experts who can rule out people who should not use up the short supply of tests.

The Centers for Disease Control and Prevention (CDC) issued detailed guidance yesterday on when testing should be performed.

COVID-related Medicare billing. On Friday, the Centers for Medicare and Medicaid Services issued a frequently asked questions document on Medicare billing for services related to COVID-19. The guidance is broken out by different provider types. There are no specific sections for home health agencies, hospices, or SNFs, but some of the questions are relevant.

OHCA convention. With the recent decisions to cancel the AHCA Quality Summit and to restrict the Arnold Sports Festival to contestants only, we started receiving questions about the OHCA convention in late April. As of today, we have not made a decision to cancel or otherwise to limit the convention, but we are monitoring the situation continuously. We will consult with state officials as part of the decision-making process.

Screening people entering a facility. One of the key measures facility-based providers can take to prevent the introduction of COVID-19 or other infectious diseases is screening people who enter. This includes visitors, staff, new admissions and others who may have contact with residents. According to CDC guidelines for long-term care facilities and for persons under investigation for COVID-19, screening is to identify people who have a respiratory infection or who may have been exposed to COVID-19. The guidelines at this time are not more detailed than that. For instance, there is no recommendation to take temperatures of visitors, to post employees at each entrance, or to lock all but one entrance. The guidance does, however, stress communication through signage in the building and in writing to employees and families about not visiting or coming to work if sick.