Latest on CCURT. Tomorrow the pilot of Congregate Care Unified Response Teams (CCURT) - mandatory COVID-19 testing - begins. The Departments of Health and Medicaid held a webinar today for personnel from the 10 SNFs that were selected for the pilot. In the pilot, only staff will be tested. During the webinar and in response to questions from participants, the state shared various updates about the program, which are subject to change:

• Each facility will be assigned to a Contact Administrator, who will coordinate the testing. This person and the National Guard will contact the SNF before the testing day. When resident testing is initiated, a clinical person will work with the facility to identify the residents to be tested.
  
• National Guard teams of 10 people will divide into 5 two-person teams to do the swabbing. It will occur indoors and for residents, the SNF is to assign a staff person to accompany each swab team.
• The National Guard will supply the test kits and their own personal protective equipment (PPE).
• Swabbing at a 100-bed building is estimated to take about 90 minutes, exclusive of set-up and tear-down.
  
• The National Guard or a courier will transport the swabs to a lab designated for the SNF. Turn-around time will vary by lab.
• The state has not determined how to handle staff members who refuse the test. This and other unanswered questions were deferred to a frequently-asked questions document (FAQ) that the state says will be released by Friday.
• The state would like to test staff who are not on duty when the testing occurs, agency personnel used by the center, and contract personnel and encourages providers to ask those individuals to be present for the testing. If they cannot participate, the state may ask the SNF to have them tested elsewhere.
• The State Medical Board has not issued anything in writing that absolves facility medical directors who order test for employees from the responsibility for continuing care. State Medicaid Director Maureen Corcoran said the testing will proceed with or without physician orders.
  
• The Contact Administrator will discuss the test results with the center. Return to work for positive staff has not been fleshed out and will be addressed in the FAQ. Health's James Hodge indicated that if a number of staff must be quarantined, resulting in a shortage, the state's solution is for the provider to call the Bridge Team, which will offer lists of agencies, health care personnel who have volunteered to help, or National Guard staffing, depending on the immediacy and extent of the shortage.
• The state did not address how the laboratory charges will be paid.
• In addition to providing more guidance on key issues, the state personnel on the webinar said the testing program will be adjusted based on learning from the pilot and afterward.
  

Visitation. On Monday, the executives of OHCA, LeadingAge Ohio, the Ohio Assisted Living Assocition, and the Academy of Senior Health Sciences met by video conference with Aging Director Ursel McElroy to discuss the associations' suggestions for re-opening visitation at assisted living communities, SNFs, and ICFs/IID. After detailed review of the proposals and extensive discussion, Director McElroy said she would produce a revised version. The consensus seemed to be that assisted living and ICFs should re-open sooner than SNFs, subject to guidelines establishing minimum standards (e.g., circumstances under which visitation still would not be allowed) and considerations for providers to use in developing their visitation policies and communications with families.

Clarification on PRF compliance. In yesterday's COVID-19 Update, we reported on the Department of Health and Human Services (HHS) press release announcing a 45-day extension of the deadline for accepting the Terms and Conditions for Provider Relief Fund (PRF) payments. This extension, however, seems to be of little value because HHS still has on their website a statement issued two days earlier that sets June 3 as the deadline for providers who received an additional payment from the PRF (that is, a payment from the second tranche) to agree to the Terms and Conditions and to submit the required financial information.

CMS hosting infection prevention program for SNFs tomorrow.  As part of the Centers for Medicare and Medicaid Services' (CMS's) five-part plan and its continuing effort to provide guidance during the public health emergency, CMS is hosting the first webinar in a new National Nursing Home Training Series. This will be a weekly series focused on infection prevention in SNFs. The first topic, which will be presented tomorrow, May 28, from 4:00-5:00 p.m., will cover establishing an infection prevention program and conducting ongoing infection surveillance. The session will feature a speaker from the Health Services Advisory Group. Interested providers must register in advance on the CMS event registration portal.

NAHC hospice COVID-19 impact survey results. Recently, OHCA asked members to participate in a survey conducted by NAHC to ascertain the impact of COVID-19 on hospice providers. There were several common threads relative to the highest impact areas experienced by hospice providers:

• Decreased admissions: most respondents reported a decrease in referrals. Most providers, however, experienced a decrease of less than 15%.
• COVID-positive patients: nearly two-thirds of hospices confirmed COVID-19-positive patients on service.
• Decreased revenues and increased costs: about 60% of respondents anticipated a decrease in annual revenues during 2020, and over 80% expected increased costs. This is primarily attributable to costs of PPE and staffing and reduced fundraising revenues.
• Use of technology: an overwhelming 95% of respondents reported patients refusing visits because of fear of COVID-19 exposure. Additionally, about one quarter of hospices could not substitute visits with virtual technology, and only 4% reported that technology addressed facility access issues. About 84% of hospices reported utilizing telecommunications in some fashion.

For more information on the survey data, please see the NAHC report.