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08/20/2020

Today's COVID-19 Report: Friday, August 21, 2020

Friday, August 21, 2020

Here are the latest need-to-know updates for Friday, August 21 regarding the COVID-19 pandemic.

Governor Announces Re-opening of Adult Day Services, Mandatory Residential Care Facility Testing

Governor DeWine announced yesterday that he is issuing an order to re-open adult day centers and senior centers around the state, beginning Monday, September 21. The new order comes after months of discussion with state authorities and pressure from industry advocates like LeadingAge Ohio. Efforts included distributing results of a survey conducted by LeadingAge Ohio; the survey demonstrated the impact of the ongoing closure on adult day providers and families around the state. The governor specified that facilities re-opening must operate at a reduced capacity and follow forthcoming safety standards. 

LeadingAge Ohio responded to the move and noted the extended wait before re-opening, stating:

“Adult day services have been proven to delay nursing home admission for individuals with dementia, and allows caregivers to continue to work and engage in other activities. Today’s announcement that Ohio’s adult day centers will be allowed to reopen is long-anticipated and welcome news, but another month is a long time to wait given the preparation efforts of providers already underway and the needs of the older adults they serve. A July survey of Ohio adult day services providers conducted by LeadingAge Ohio reported that, since the March 21 closure, the care needs of participants served by Ohio’s adult day centers have increased, many participants have had to move to higher and more expensive levels of care, and family caregiver stress and anxiety have increased."

On a call this morning with officials from the Ohio Department of Aging (ODA), Director McElroy noted that adult day providers and senior centers may also receive testing guidance along with the forthcoming order and guidance.  

During yesterday's press conference, Governor DeWine also announced a new mandatory testing initiative for staff and residents of residential care facilities around the state. The Governor announced that the state had designated a vendor who would provide saliva tests, paid for by the state, that can be self-administered with medical supervision. The order will make the assisted living testing program that rolled out last week mandatory rather than voluntary.

LeadingAge Ohio responded to this new testing requirement, stating:

"A baseline test in assisted living is critical to begin to better understand the spread of COVID-19 in these congregate settings, which serve an extremely vulnerable population. It is important to remember that this test is simply a snapshot in time; a more strategic, long-term testing program is still the ultimate goal."

NAHC Survey Seeks Input on Hospice Readiness for New Election Statement & Addendum Requirements

The Centers for Medicare & Medicaid Services (CMS) finalized in the Fiscal Year (FY) 2020 Hospice Wage Index and Payment Rate Update and Quality Reporting Update (final rule) an implementation date of October 1 for the modified election statement and election statement addendum requirements. 

The National Association for Home Care & Hospice (NAHC), as well as other stakeholders, has recommended that CMS delay implementation until at least 2 full months after the end of the COVID-19 Public Health Emergency (PHE).  However, CMS announced, in the FY2021 Hospice Payment Rate Update Final Rule, the intention to impose the requirements, as planned, beginning October 1, 2020.  This is only a little more than 40 days away. 

In comments to the FY2021 Hospice Payment Rate Update Proposed Rule, NAHC submitted questions to CMS about the modified election statement and addendum. CMS responded to most of the questions; however, there are still some outstanding questions and new questions that have arisen.

NAHC is asking hospices to complete a short survey pertaining to the status of preparations for implementation of the modified election statement and election statement addendum.  Please complete the survey by August 28. 

Ohio to Begin Gathering PDPM Data

This morning, the Ohio Department of Medicaid (ODM) announced that beginning on October 1, it will begin to gather the 28 MDS items that are used to calculate payments under the Patient-driven Payment Model (PDPM). The move is intended to allow ODM to compare the new methodology with the previous one (RUGS IV), to inform Ohio’s decisions regarding whether to adopt PDPM as a new basis for calculating case mix scores.

In its memo, ODM notes, “In order to make a comparison between RUGS IV and PDPM, ODM will require nursing facilities to work with their software vendors to ensure the 28 PDPM MDS item set fields are available for entry and transmission on all OBRA assessments. These additional fields are located in Sections GG, I and J.”

ODM will continue to work with its contractor Myers & Stauffer in determining how to best move Ohio forward in light of CMS sunsetting the items relied on for RUGS IV. Any questions related to the transition may be directed to Susan Wallace, Director of Government Relations & Public Affairs at swallace@leadingageohio.org.

ODA Shares Provider Manual, Anticipates Rule Extensions

On its bi-weekly stakeholder call, the Ohio Department of Aging (ODA) shared two important developments for aging services providers:

The first is that on Friday, August 14, ODA published an updated version of the provider guidance manual, including updates to protocols outlined in the manual.

The second is that, though the public health emergency (PHE) is scheduled to end in October, ODA is working to make permanent some of the emergency rules that it has employed during the COVID crisis. ODA staff encouraged providers to sign up to receive rule updates directly by visiting its website.

Other updates included an extensive conversation on Ohio’s efforts to address health disparities both in the context of the COVID pandemic and beyond the scope of the pandemic and encouragement to participate on a Strike Force Cabinet the Administration is creating to develop solutions. Also, Ohio’s annual fall prevention campaign, 10,000 Steps for Falls Prevention, is being redesigned as “10 Big Steps for Falls Prevention.”

Annual Business Meeting / All Member Call Information

The LeadingAge Ohio Annual Business Meeting will be held in conjunction with the All-Member Call taking place Thursday, August 27 at 10:30 am. This call will review the key initiatives of LeadingAge Ohio this past year. LeadingAge Ohio staff, Board and other invited guests will provide an overview of the association’s efforts to shine a light on the commitment of care, service and compassion provided by the membership.  

At the meeting members will be asked to approve last year's Annual Business Meeting minutes and approve the slate of nominees to the LeadingAge Ohio Board of Directors.

The Zoom meeting link for this event is https://easyconnecthd.zoom.us/j/96747083002

Dial in information is 1-301-715-8592 / Meeting ID 967 4708 3002.

LeadingAge Coronavirus Update Call, Monday, August 24 at 3:00PM with Dr. Monica Gandhi

Dr. Gandhi is an infectious disease specialist at the University of California, San Francisco.  She has appeared in numerous mainstream national media outlets and publications in recent months. Her research focuses on asymptomatic COVID and viral load. She has been widely cited for her work on aerosol vs. droplet transmission; she promotes mask wearing to protect both the wearer and others. She will talk about these issues and other COVID-related concerns for aging services providers.

LeadingAge Ohio encourages members to register for the call.

Defense Production Act Used to Prioritize Nursing Homes

The US Department of Health and Human Services announced yesterday that it would use the Defense Production Act (DPA) to expedite shipments of Quidel and BD antigen testing machines to nursing homes.  Through the use of the DPA, the production of antigen testing devices and test kits has significantly ramped up, allowing HHS to make good on its promise to distribute machines and test kits to every CMS-certified nursing home ahead of schedule.  Distribution has now been divided into two waves, with a different methodology for each wave.  Wave 1 was completed August 14. Wave 2 will be completed by September 30. Find more information on the prioritization methodology, including hotspots and nursing home information, by clicking here.

Results of LeadingAge Ohio Compensation Survey Addendum Highlight Impact of COVID-19

LeadingAge Ohio member organizations that participated in the 2020 compensation survey were contacted last month to answer questions on the impact of COVID-19 on compensation.  The survey addendum focused on pay adjustments for staff and modifications, if any, to policies for paid time off and sick leave.  The survey closed on July 31 and results were shared with survey participants in early August.  Twenty organizations participated in this survey addendum and a few highlights are listed below.

  • 73% reflecting they made pay adjustments because of COVID
  • 37% adjusted paid time off policies to address unused paid time off
  • 46% allowing employees to carry over time off or raised the maximum amount of time employees are allowed to carry over
  • 70% will pay employees for unused time off  

As a reminder, non-participating member organizations have the opportunity to purchase the overall compensation survey results for $200. Contact Jennifer Taylor at jtaylor@leadingageohio.org to learn more.

LeadingAge Need to Know: COVID-19 – August 21, 2020

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured a reminder not to miss the virtual 2020 Collaborative Care and HIT Summit, taking place September 15-17 and a reminder on resources available to help with mental well-being.

Check out the full report here.

                Linkage                         Buerger


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. 

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Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.