Governor announces more steps to gradual re-opening. Today, Governor Mike DeWine said that on May 15, 2020, Ohio will allow business to re-open for personal care services such as beauty shops and for outside dining. Inside dining, including both restaurants and bars, will be permitted to re-open on May 21, 2020, if they develop floor plans that allow for 6-foot social distancing between customers or they install physical barriers. Open congregate space, such as dance floors, will remain closed or used for additional space for social distancing between tables. These relaxations to do not negate restrictions set by Centers for Medicare and Medicaid Services (CMS) and the Department of Health on SNFs, assisted living communities, and ICFs/IID.

Key points from QSO 20-29-NH. Yesterday, CMS issued Quality, Safety, and Oversight (QSO) letter 20-29-NH, which comprehensively addresses the new COVID-19 reporting and notification requirements for skilled nursing centers. Those requirements are part of an omnibus interim final rule that CMS adopted earlier. Important clarifications in the QSO include:

• The first set of data to be reported to the National Healthcare Safety Network (NHSN) is due May 17, with a two-week initial grace period.
• CMS established two new survey tags, F884 (reporting to NHSN) and F885 (resident and family notification).
• SNFs that do not report data will receive F-level deficiencies under F884 and will be fined for each week after the deadline at $1,000 for the first week, increasing by $500 for each subsequent week.
• CMS will begin posting the reported data by the end of May on a new web site that is not yet live, not on Nursing Home Compare.
• The NHSN reporting does not replace existing state or local reporting.
• States may submit data on behalf of SNFs.
• CMS encourages, but does not require, SNFs to report older data going back to January 1, 2020.
• Deaths of facility patients that occur in another location (e.g., a hospital) must be reported by the facility.
• All residents, representatives, and families must be notified when a notifiable event occurs, not just the affected people. Notifiable events are that a confirmed COVID-19 case occurs or that three or more residents or staff have new onset respiratory symptoms that occur within 72 hours of each other in the facility.
• Facilities must make cumulative updates for each additional notifiable event.
• CMS does not require a particular method of notification. That is, individual phone calls are not required.
• New admissions of positive COVID-19 patients to a COVID unit count as notifiable events.
• Staff are defined as including employees, consultants, contractors, volunteers, and caregivers who provide care and services to residents in the facility.

See AHCA's detailed summary of the QSO for more information.

Update email addresses for ODM audit reports. Mark Graves of the Department of Medicaid asked OHCA to make the following request of members:

In our continuing effort to collect as many current email addresses as possible prior to emailing the FYs 2017 & 2018 overpayment reports, ODM wanted to ask for a favor: would it be possible for you to contact your Ohio LTC members and request of them to send two valid email addresses to LTCAudits@medicaid.ohio.gov.

This should include the Ohio Medicaid seven-digit number in the subject line (if only one email address is possible, that will suffice. However, we’d prefer to be able to cc a second person to ensure the reports are delivered). ODM will add this information to its current list to ensure as many facility’s as possible are able to participate in this streamlined approach. [P]lease remind your providers responsible for multiple locations to include all Ohio Medicaid provides numbers in their correspondence to ODM (if it’s a long list it certainly doesn’t have to be all contained in the subject line).

Provider Relief Fund updates. The Department of Health and Human Services (HHS) extended by 15 days the deadline for providers who received payments under either of the first two Provider Relief Fund tranches to attest to receipt and to their compliance with the terms and conditions. Please note that separate 45-day deadlines apply to payments within each tranche. In addition, HHS published an updated version of its frequently-asked questions (FAQ) document, with the new items marked as "Added 5/6/2020." The key clarifications in the FAQ relate to payments that exceed the 2% of net patient revenue standard. HHS writes that these payments only need to be returned if they also exceed the provider's lost revenue and increased cost because of COVID-19.

Central Ohio hospital transfer criteria. The three central Ohio hospital systems released revised criteria for taking a COVID-19 patient from a congregate care setting to an emergency department.