08/27/2020

Today's COVID-19 Report: Friday, August 28, 2020

Friday, August 28, 2020

Here are the latest need-to-know updates for Friday, August 28 regarding the COVID-19 pandemic.

You asked… we answered

You asked: Would we be permitted to allow a priest to come in to celebrate daily Mass for us? If he went straight to and from the sacristy upon arriving and departing, he would not engage with any residents. When celebrating Mass, he would be socially distanced from the residents, since our chapel is quite large. Our Pastoral Care Director would distribute communion, so the priest would never have to be near any residents.

We answered: LeadingAge Ohio reached out to the Ohio Department of Health (ODH) with this question. ODH inquired of the Centers for Medicare & Medicaid Services (CMS) and received the response below:

“CDC Releases Recommendations for Communities of Faith” (5/23/20) provides recommendations to help guide faith communities while respecting their fundamental right to gather for worship, mass etc. The guidance states, “…in accordance with the First Amendment, no faith community should be asked to adopt any mitigation strategies that are more stringent than the mitigation strategies asked of similarly situated entities or activities. In addition, we note that while many types of gatherings are important for civic and economic well-being, religious worship has particularly profound significance to communities and individuals, including as a right protected by the First Amendment. State and local authorities are reminded to take this vital right into account when establishing their own re-opening plans.” The guidance goes on to provide specific points for scaling up operations, safety action, promoting healthy hygiene practices, taking steps to minimize community sharing of worship materials (such as a common communion cup) and other items.

The setting you described could be considered as a community of faith in that its express mission is to serve retired clergy. The fact that residents are distressed and grieving over the inability to attend mass strongly supports the importance of restoring and ensuring residents ability to worship and receive pastoral care (including mass). The impact of the coronavirus pandemic on worship and other spiritual activities, not just in nursing homes, but all across America, was of such concern that President Trump recently called the CDC to discuss the need to scale back on restrictions so that individuals could receive the spiritual care they needed. The President has told all of the governors that they were to allow places of worship across the country to reopen immediately, arguing that places of worship are essential. Indeed, spiritual health and an individual’s need for spiritual services is critical to the individual’s overall sense of well-being, even more so for residents who are in the last days/years of their lives. This certainly speaks to the high degree of importance placed on spiritual services, mass, visits by clergy etc. and provides support to facilities to find safe ways of accommodating spiritual care for their residents. Many of our nations nursing homes have served as a “place of worship” for residents who are no longer able to go to their church or synagogue in the community.

Ohio is one of 37 states where nursing home visitation restrictions have been relaxed and visitation is allowed in varying measure. For visitation to occur safely, each facility has an obligation to assess its capabilities to put safeguards in place that would allow visitors, such as clergy, to safely come to the facility. Visitation practices (e.g., visitation log, education, screening process in place for visitors, adequate staffing etc.) need to be assessed and will likely vary from facility to facility depending on factors such as the facility’s ability to ensure sufficient staffing levels, PPE, cleaning supplies etc. Facilities that are fully staffed, coronavirus-free and have adequate PPE can be evaluated to determine if they meet CDC requirements for clergy to visit outdoors, have scheduled visitation, or provide services such as mass. Facilities can be creative and are not limited to holding mass indoors and would be responsible for ensuring appropriate social distancing and other CDC recommended safeguards are in place.

HHS again extends provider bailout deadline as applications lag

The Trump administration is again extending a key deadline for health care providers to seek coronavirus relief funding, with applications from safety net providers lagging amid confusion over the rules.

The new deadline is September 13, giving providers over two additional weeks to apply.

The initial two rounds of relief funding were calculated based on providers' Medicare business and annual revenue, which disproportionately benefited providers with greater income or Medicare revenue. The third round of funding ($15 billion) was focused on providers that had not received funding in either of the two previous rounds, but challenges included confusion about who was eligible for the funds as well as communication challenges with reaching many small Medicaid-focused providers.

On a late-July call, Ohio Administration officials reported that less than ten percent of eligible providers had applied for funding. Currently, nationwide, the state with the highest proportion of providers who have applied is nearing only 30 percent.

LeadingAge Ohio strongly encourages members who are eligible to apply, to ensure they don’t leave money on the table. Questions related to any of the relief funding opportunities may be directed to Susan Wallace at swallace@leadingageohio.org.

Ohio Medicaid's (ODM) fiscal years 2017 and/or 2018 overpayment report(s)

The Ohio Department of Medicaid (ODM) has reported that release of Fiscal Years 2017 and 2018 overpayment reports will begin the week of September 14.  ODM  indicated that the goal is to complete this round of overpayment audits even as they know “there will be new or unique circumstances to consider.”  In order to ensure effective communication, they note the following:

• Reports, letters and response forms will be sent via encrypted email from a Medicaid auditor;
• Encrypted emails must be opened within 14 days or the email will expire / no longer be accessible;
• Response forms are due to LTCAudits@medicaid.ohio.gov within 30 days, but supporting/dispute documentation is not required to be submitted with response form.  ODM urges providers to carefully review the updated response forms;
• Organizations receiving reports for both fiscal years will see the year reflected in the language contained in the email and separate emails will be sent on the same day for each fiscal year;
• Organizations receiving a report for one fiscal year only will see the year reflected in the language contained in the email.

A separate effort is being made to send letters to providers who are not receiving FY 2017 or FY 2018 overpayment reports, but ODM indicated this process isn’t finalized.

Questions should be directed to JEFFREY.FUKUDA@medicaid.ohio.gov or Mark.Graves@medicaid.ohio.gov.

Ohio Department of Health (ODH) shares updated testing schedule

Ohio Department of Health (ODH) released an updated nursing home testing schedule for August 31 through September 6. ODH made changes to which labs facilities would use and changed dates to eliminate specimen collection or pick-ups on Labor Day. All facilities with lab changes will continue to use the ODH Lab Portal. Facilities not listed on the schedule for August 31 through September 6 will be on the subsequent updated schedule that will be released by September 2. All facilities that opted out are also listed in the spreadsheet. Facilities that opted out can opt-in at any time by contacting CCURT@odh.ohio.gov and by filling out a new survey.

ODH asks that facilities review the data and to email CCURT@ODH.OHIO.GOV with the correct information and fill out a new survey. To access the updated schedule, please click here.

OBM provides updates on relief funds

On a call with LeadingAge Ohio staff yesterday, DeWine Administration officials, including leadership from the Office of Budget and Management (OBM) and the Ohio Department of Medicaid, provided an update on the coronavirus relief fund (CRF) disbursements. The disbursements, approved at a July 13 meeting of the Controlling Board, are set to channel over $400 million to Ohio providers that were identified as the most-impacted by the COVID-19 pandemic. Eligible provider types include skilled nursing facilities, MyCare waiver providers, Ohio Home Care waiver providers, PASSPORT waiver providers, assisted living facilities (regardless of whether they participate in the assisted living waiver), critical access , rural, distressed hospitals, behavioral health providers and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs).

OBM confirmed that the first round of disbursements were made in mid-August, and that another round is currently underway (August 27-28), and that a third disbursement would be made next week (September 1-2). At that point, roughly one-half of the total amount will have been paid out to providers.

OBM officials noted that they have been building the process and system “from the ground up” and that they have had several hurdles in terms of assembling accurate provider information from various other Administrative agencies.

The process by which applications are processed is by matching application fields to OBM's provider list; when fields do not match, the applications must be reviewed by OBM staff to be reconciled before being processed. Currently, the zip code field is causing most applications to be delayed, and OBM clarified that the zip code entered on the application must match the provider’s Medicaid pay-to address noted in MITS.

They noted that the process is a very manual one, and that they are working through the applications as fast as possible.

Steps providers can take include:

• Wait to send inquiries to the CRF mailbox until after next week’s disbursement. OBM noted that most of the emails received are status inquiries, and many of those payments may be in the queue.
• When providers make an inquiry to the CRF mailbox, they should include the relevant Medicaid ID numbers in the subject field, which helps OBM staff quickly search and manage inquiries.
• If a provider knows that their application included fields that would not match, they should reach out to the CRF provider inbox.

Additionally, the Administration provided LeadingAge Ohio with a list of providers receiving payments, so if providers have questions about whether they qualify or how much the payment will be, they can reach out to Susan Wallace at swallace@leadingageohio.org.

HHS distributes $2.5 billion to nursing homes

The U.S. Department of Health and Human Services (HHS) has announced it has now distributed approximately $2.5 billion of the planned $5 billion funding for nursing homes to support testing, staffing, and personal protective equipment (PPE) needs. This funding allocation was made through the Health Resources and Services Administration (HRSA) as a targeted distribution from the $175 billion Provider Relief program funded through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act. HHS has posted terms and conditions and the funds are restricted to “Infection Control Expenses”:

• Costs associated with administering COVID-19 testing, which means an in vitro diagnostic test defined in section 809.3 of title 21, Code of Federal Regulations (or successor regulations) for the detection of SARS– CoV–2 or the diagnosis of the virus that causes COVID–19, and the administration of such a test, that—
• Is approved, cleared, or authorized under section 510(k), 513, 515, or 564 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360(k), 360c, 360e, 360bbb–3);
• The developer has requested, or intends to request, emergency use authorization under section 564 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb–3), unless and until the emergency use authorization request under such section 564 has been denied or the developer of such test does not submit a request under such section within a reasonable timeframe;
• Is developed in and authorized by a State that has notified the Secretary of Health and Human Services of its intention to review tests intended to diagnose COVID-19; or
• Other test that the Secretary determines appropriate in guidance
• Reporting COVID-19 test results to local, state, or federal governments
• Hiring staff, whether employees or independent contractors, to provide patient care or administrative support
• Expenses incurred to improve infection control, including activities such as implementing infection control “mentorship” programs with subject matter experts or changes made to physical facilities
• Providing additional services to residents, such as technology that permits residents to connect with their families if the families are not able to visit in person.

HHS plans on distributing another $2 billion to nursing homes later this fall based on certain performance indicators that will be shared in the future.

FDA warning on hand sanitizer packaged in food and drink containers

The U.S. Food and Drug Administration (FDA) has released a warning about alcohol-based hand sanitizers that are being packaged in containers that may appear as food or drinks and may put consumers at risk of serious injury or death if ingested. The agency has discovered that some hand sanitizers are being packaged in beer cans, children’s food pouches, water bottles, juice bottles and vodka bottles. Additionally, the FDA has found hand sanitizers that contain food flavors, such as chocolate or raspberry. FDA provides a list of hand sanitizer products that are not approved by the FDA.

For more information, consumers should refer to the FDA’s guidelines on safe use of hand sanitizer as well as a question and answer page.

The FDA encourages health care professionals to report adverse events or quality problems experienced with the use of hand sanitizers to FDA’s MedWatch Adverse Event Reporting program.

LeadingAge Ohio COVID pulse member survey heading to your inbox next week

The LeadingAge Ohio staff and Board of Directors would like to understand the impact of the COVID-19 pandemic on our members and how LeadingAge Ohio can best support members during this challenging and ever changing time. Next week a brief survey will be sent out to members to help us continue our development of tools and resources to best meet members' needs. Please take a few minutes to respond. Contact Jennifer Taylor, Director of Member Experience, with any questions regarding the survey at jtaylor@leadingageohio.org

LeadingAge Need to Know: COVID-19 – August 28, 2020

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured the Scenario Planning Toolbox and information on the upcoming 2020 Collaborative Care & HIT Summit.

Check out the full report here.

Questions

Please send all questions to COVID19@leadingageohio.org. Additionally, members are encouraged to visit the LeadingAge Ohio COVID-19 Working Group facebook group to pose questions to peers and share best practices. LeadingAge is continuing its daily calls for all members.  To participate in these daily online updates, members should register here.  

LeadingAge Ohio is working to ensure that the information in our daily alerts, on our website, and all coronavirus-related communications is as accurate as possible. However, LeadingAge Ohio makes no guarantees about the accuracy of the information.