To test or not to test. This morning, Vice President Mike Pence and White House Coronavirus Task Force Coordinator Dr. Deborah Birx told a group of governors on a video conference that the White House strongly recommends testing all 1 million SNF residents in the US, along with all facility staff, for COVID-19 in the next two weeks. When asked about this recommendation during his press conference this afternoon, Governor Mike DeWine said it is unlikely it will be accomplished in Ohio. He added that many people in the medical profession would argue testing everyone is not the best thing to do.

Governor, Health Director count on regional zone plan. Also in the press conference, both Governor DeWine and Health Director Dr. Amy Acton expressed faith in the regional zone plan that State Medicaid Director Maureen Corcoran developed over a number of weeks to help SNFs and other congregate care settings deal with COVID-19. Director Corcoran is scheduled to discuss the concept at tomorrow's briefing. Governor DeWine said the state is executing a holistic plan that includes involving hospitals, getting personal protective equipment (PPE) to facilities, and testing when a provider believes someone may be infected. Relative to the regional zones, he said the hospitals have provided "tremendous assistance," and that "every nursing home has been adopted by a hospital."

Monthly Rate Calculator, CPR/first aid certification updates. The Department of Developmental Disabilities (DODD) released an update to the Monthly Rate Calculator (MRC) to allow residents in a MRC site to have no services reflected when a person is out of the home for an extended period of time such as during the COVID-19 crisis. Interested providers can read the full memo for additional information. DODD also released a memo notifying providers that both the American Red Cross and the American Heart Association allow extending their certifications for 120 days. Additionally, DODD extended, until further notice, their previous guidance allowing online cardio-pulmonary resuscitation/first aid certification for new hires.

Interpretations and guidance. Two hot questions of the day involve reporting: Payroll-Based Journal (PBJ) and National Healthcare Safety Network (NHSN). Relative to PBJ, SNFs are not required to report while the public health emergency is in effect, per a Centers for Medicare and Medicaid Services (CMS) blanket waiver. Centers eventually will have to report the data (only submission is waived during the emergency, not maintenance of the data), and they may report now if they wish to do so. Relative to NHSN, SNFs are not required to report retroactively from January 1, 2020, but again they may do so if they wish. NHSN encourages retroactive reporting, but the CMS interim final rule only requires it for May 1, 2020, and forward. The first report is due May 31.

AHCA NHSN reporting guidance. Speaking of NHSN, AHCA recommends providers take care when reporting their PPE and staffing levels. They suggest answering that you have sufficient staffing or PPE only if you are not taking extraordinary measures (e.g., PPE conservation, agency staff utilization). Please see AHCA's daily update for examples of how they recommend answering these questions and for why they suggest this strategy.