08/19/2020

Today's COVID-19 Report: Wednesday, August 19, 2020

Wednesday, August 19, 2020

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

Today's 3:30 LeadingAge Update Call - White House Coronavirus Coordinator Visits LeadingAge Member in Oklahoma

White House Coronavirus Coordinator Dr. Deborah Birx visited the Governor of Oklahoma and stopped to spend an hour at LeadingAge member community Baptist Village at Owasso. According to LeadingAge, Dr. Birx used every one of her 75 minutes at Baptist Village of Owasso to listen first hand to the COVID-19 experience of the leaders, staff, and residents of the community.  

Today's LeadingAge Coronavirus Update Call at 3:30 PM features an interview with Baptist Village at Owasso administrator Mitzi Epperson regarding what Dr. Birx asked about and advised on – including PPE, staffing, testing, asymptomatic spread, and other key issues. If you aren’t already registered for LeadingAge Coronavirus Update Calls, sign up here.

State-Supported Nursing Home Staff Testing – Specimen Preparation and Pick-Up Notes

In an EIDC bulletin distributed today by the Ohio Department of Health (ODH), providers were given notes for specimen preparation and pick-up for state-supported nursing home staff testing. 

Providers must complete lab requisition forms electronically. All forms created through the ODH portal must have a unique barcode generated for each patient, each test. ODH asked that providers do not try to edit the form after the barcode has been generated, as a new barcode is needed for each person for each round of testing to make sure the lab has the information it needs to process the specimens.

ODH is working on IT enhancements to alleviate this administrative load and asks that providers stay tuned for updates in the coming weeks. Moving forward, handwritten forms or electronically altered forms will result in specimen denial by the labs and/or lab charges being billed directly to the facility.

Each specimen must be accompanied by a paper lab requisition form. Forms can be placed in the small pocket on the outside of the biohazard bag. If the biohazard bag does not have an external pocket, please double bag the specimen and place the requisition in the outside bag. Staple the bags together with the paper inside. Providers were also asked to be prepared to tell the Ohio National Guard how many specimens you are giving to them when they arrive for pick-up.

CMS Memo on Expanding Survey Activity

The Centers for Medicare & Medicaid Services (CMS) released a memo announcing expansion of survey and enforcements for all CMS-certified providers and suppliers. This builds on the survey activity as announced previously in the reopening guidance and in a memo on June 1.

Expanded activity now includes complaints assessed at non-IJ medium annual recertification, and mandatory revisits for surveys on or after June 1. CMS has also expanded the desk review policy and issued guidance on resolving enforcements that were previously suspended (Denials of Payment for New Admission and CMPs). LeadingAge notes that CMS directed on-site survey activity will resume as soon as resources permit (staff, PPE, etc). There was no mention of testing for surveyors.

In discussions with the Ohio Department of Health, Ohio’s state survey agency, department leaders reminded LeadingAge Ohio that it has submitted its proposal for restarting surveys to the CMS Regional Office, which details what activities surveyors will do on-site and which can be done remotely, to mitigate possible transmission of COVID-19. To date, ODH has not received approval for its plans. They did confirm that survey activities will not resume to pre-pandemic practices, but rather, survey processes will be modified in keeping with the heightened infection control practices adopted since the spring.  

CDC Releases New Guidance on Antigen Testing

The Centers for Disease Control & Prevention (CDC) released new guidance on antigen testing this week. This guidance applies broadly to any provider using rapid antigen testing. LeadingAge expects that guidance specific to nursing homes and long-term care facilities will follow in the coming days.

This new guidance acknowledges that rapid antigen testing is not as accurate as PCR testing, but asserts that the testing is useful and proper interpretation of results is critical. As LeadingAge was informed previously, antigen tests are most helpful when viral load is highest, generally within the first five days of infection. CDC asserts that antigen tests are useful in cases of known exposure or high risk congregate settings when repeat testing can help to quickly identify infections and inform infection control procedures. Related to the question of testing asymptomatic individuals, CDC concedes that there is limited data to guide the use of these tests with asymptomatic individuals for purposes of detecting or excluding infection. Regarding false negatives, clinical presentation and community prevalence of infection will guide interpretation of antigen test results and help to determine the need for follow up with PCR testing.

Only 51 Ohio nursing facilities have been identified in the second shipment of point of care (POC) antigen testing devices. Previously, the DeWine Administration had signaled its hopes that these devices may replace the state-coordinated PCR testing to relieve the pressure on testing labs. LeadingAge Ohio is actively engaged with the Administration on the promise of the delivery and challenges of the POC devices, and will keep members informed of any developments.

N95 Shipment to Nursing Homes

According to LeadingAge contacts with FEMA’s Supply Chain Task Force, N95 masks will be sent to the more than 3,000 nursing homes that report on the NHSN that they have a low supply on-hand. The Task Force believes it can ship them in the next 10-14 days. 

In addition to sending masks directly to nursing homes, the Task Force will also direct several million masks to hot spot areas through commercial distributors. While this is good news, LeadingAge continues to advocate for a comprehensive, national approach to addressing PPE shortages.

Provider Relief Fund Reporting Information Delayed

The U.S. Department of Health & Human Services (HHS) announced that it will not be providing additional details about the reporting process for provider relief funds this week as previously planned. The Health Resources & Services Administration (HRSA) is continuing to refine the required data elements and will provide those additional details at a later date.

HHS assured providers that the reporting instructions and data collection template will be provided “well in advance” of when providers will need to submit their data into the reporting system, which is targeted to be available on October 1.  

CMS-CDC Training Series Transitions to Pre-recorded Format

Starting on August 20, the National CMS/CDC Nursing Home COVID-19 Training Series will transition to a pre-recorded, self-paced format. The new CMS-CDC Fundamentals of COVID-19 Prevention for Nursing Home Management training series will include 13 topics that nursing home partners must know to manage the COVID-19 pandemic. These trainings will be housed on QIOProgram.org for 24/7 access.

New, pre-recorded trainings will be released every Thursday at 4:00 PM through September 2020. CMS and CDC will have subject matter experts available on bi-weekly Q&A sessions through early January 2021 to answer questions you may have about the trainings.

Access to certificates of participation are still available for those who complete fundamentals trainings and those who have participated in the live training series. Providers should watch email for details on how to access these resources in the coming weeks.

To keep your nursing home training momentum going, providers can take a moment to complete the following:

1. Sign up for updates to CMS-CDC Fundamentals of COVID-19 Prevention for Nursing Home Management training, including new training releases, resources and tools.
2. Register for upcoming Q&A sessions.

Please contact the Nursing Home Trainings support team at NursingHomeTrainings@thebizzellgroup.com with any questions.

COVID-19 Supplemental Payment Requests – Authorized Signatures Required

Housing provider reimbursement requests for COVID-19 expenses under the CARES Act were due to Housing & Urban Development (HUD) on August 5. HUD has granted additional time for providers to resubmit their previously submitted request forms, if the original submission was not signed by the owner or owner agent with legal authority to commit the owner to the terms of the CARES Act distributions. This is usually authorized through a board resolution or other means.

For more information or assistance, reach out to Juliana Bilowich, LeadingAge’s Director of Housing Operations and Policy, at jbilowich@leadingage.org

LeadingAge Statement on Expired Eviction Protections

LeadingAge released a statement in response to the President’s recent executive order on evictions, together with several other national affordable housing organizations.

The federal eviction moratorium expired last month, and the President’s executive order from last week does not reinstate it. Because housing stability is especially important during the ongoing crisis, LeadingAge and its coalition partners are calling for meaningful evictions protections for low-income older adults impacted by COVID-19, paired with financial support for housing providers.

HUD NSPIRE staff join LeadingAge Housing Advisory Group Call, Next Monday is on Fair Housing

LeadingAge hosted a special edition of the Housing Advisory Group call on Monday featuring House & Urban Development (HUD) NSPIRE program manager Dan Williams. During the call, HUD staff shared updates from a powerpoint presentation and addressed questions from LeadingAge members. A recording of the call is available here. The agency recently released a new set of standards for its current physical inspection pilot program; the new inspection model will eventually replace the current UPCS standards. HUD told LeadingAge members that the agency is still targeting late 2021 for implementation of the new standards for the rest of the portfolio, and NSPIRE is still accepting properties into the demonstration program. More information is available here.

On Monday, August 24 at 12:30 pm EST, the Housing Advisory Group will hear from a Fair Housing expert about challenges for the new pandemic-era in senior housing. The call is part of LeadingAge's Housing Advisory Group series; during the calls, members have the chance to hear updates and discuss issues or solutions with other members.

To join the Housing Advisory Group, or to submit a question on Fair Housing in advance of Monday’s webinar, reach out to Juliana Bilowich at jbilowich@leadingage.org.

The Housing Effect: What Role Does Shelter Play in Elders’ Lives?

The Summer 2020 edition of Generations, the journal of the American Society on Aging, recognizes the significant impact that housing policy has on all aspects of life for older adults, particularly persons of color.

This issue’s guest editor is Alisha Sanders, director of housing and services policy research at the LeadingAge LTSS Center @UMass Boston. Linda Couch, vice president for housing policy at LeadingAge, also contributed an article to the issue.

Housing Happenings Call Highlights Dementia Inclusive Initiative and HUD Inspection Plan

On today's weekly Housing Happenings call, Laura Lamb, President and CEO of Episcopal Retirement Services in Cincinnati, presented part one of Fostering a Dementia Inclusive Community, sharing the foundation and passion behind this important initiative. With rising numbers of individuals coping with dementia, Lamb focused on what providers can do to educate and inspire communities to do more in support of these individuals and their caregivers/families. She encouraged providers to conduct a memory support journey to discover what might be done differently to support residents and families dealing with dementia, i.e. layout, programs, etc.  Part two of this initiative will be highlighted during the September 16 Housing Happenings call and will focus on structure for training and programs for local businesses “to know better to do better”  and how to get started.  

Juliana Bilowich, LeadingAge’s Director of Housing Operations and Policy, reported that HUD REAC inspections will resume on a risk-based schedule based on COVID-19 rates by state or locality in early October; REAC will begin sending 14-day inspection notifications to owners on September 21. Senior living is still excluded from the beginning of the inspection scheduling. Additional details are available in a LeadingAge summary article.  LeadingAge held a call earlier this week with HUD staff that discussed updates and implementation timelines for NSPIRE, the agency's current physical inspection demonstration program. 

Call participants discussed two approaches to the face masks/coverings in communities: (1) house rules that require masks in all public spaces and (2) educating residents and staff but not changing house rules due to the fluid and ever-changing guidance on addressing COVID. A sample amendment to house rules was provided as an example.  HUD does allow owners/operators to amend the house rules.

Housing Happenings is a free member benefit co-hosted by LeadingAge Maryland and LeadingAge Ohio each Wednesday morning from 9-9:30am. To join next week’s call, register on the LeadingAge Ohio website.

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

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured a stated from LeadingAge president and CEO Katie Smith Sloan and materials and resources to support advance care planning.

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.