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COVID-19 Updates

Essential Employee Verification Template

For any provider who has outstanding concerns, please contact us at Inquiry@LeadingAgeOK.org.  Let us know your current challenges, needs, supplies, information regarding operations, child care, staff, etc.  We will be working with ODSH and DHS staff to address your concerns and get back to you.

My LeadingAge Member Community:  The LeadingAge Member Community is a national online discussion forum between LeadingAge members. Join the COVID-19 group to ask questions, access resources, and share best practices for dealing with the coronavirus.

LeadingAge national Main Coronavirus Pagemain coronavirus page
LeadingAge COVID-19 Daily Recordings:  Listen to the most recent recording.

Medical Supply Vendors (LeadingAge Oklahoma Business Associate Members): 

Able Rents & Active Sales www.able-medical.net, Ron Howe ronhowe@activesales.us
ARGENCIS  www.argencis.com, Trey Starr trey@argencis.com  
APN Health Care, Inc.  www.apnhealthcare.com, Bobby Noon rnoon@apnhealthcare.com
Z & D Medical Services, Inc.  www.zdmedicalservices.com, Zach Gray z.gray@zdmedicalservices.com
American Medical Technologies  www.amtwoundcare.com, Amanda Moen, amanda.moen@amtwoundcare.com
Custom Medical Solutions  www.custommedicalsolutions.com, Jason Richardson, jrichardson@custommedicalsolutions.com
Clock Medical Supply www.clockmedical.com, Guy Cunningham Guy@clockmedical.com

April 4, 2020

Heroes Among Us
Each and every administrator, nurse, CNA, housekeeper, and every single member of your team is truly a hero in this day and time. Oklahoma Methodist Manor is sharing, to all who pass by, a reminder of the heroes who are working tirelessly to serve in their community. What a great idea for ALL members to tell the public of the heroes inside your community!  LINK

Public Notice of COVID-19 Cases
OSDH has released to the media a list of the 9 long term care communities with active cases of COVID-19: 8 nursing facilities and 1 assisted living. One nursing home has a total of 36 positive cases, 33 resident cases, and 3 staff cases, in addition to 4 resident deaths. At this time, it is not known how OSDH will share the updated list, but they plan to do this daily once the process is established.

Special Legislative Session
The Governor has called a Special Legislative Session to commence on Monday, April 6, 8:00 a.m. to address approval of the state Declaration of Emergency and the Executive Orders that have followed. Watch for your email notice on Sunday to contact your legislators to support the Governor’s Order.

CNA/CMA Training
LeadingAge OK has shared the emergency rule for the in-house training of CNA/CMAs. This rule has been approved by the Commissioner of Health and is awaiting the signature of the Governor, which will be done. OSDH has shared that providers should proceed with this plan as the final step is assured. Be sure to review the rule and include all steps in your training process: 16 hrs. of required training, skills check list, and a registry check. Emergency Rule    Federal Training Requirements   Employment Screening  Medication Skills Checklist        Nurse Aide Skills Checklist  

Positive COVID-19 Case in Your Community
It is our hope that no provider will have to deal with having a positive COVID-19 case in your community. However, every single member must be prepared to deal with this issue should it arise. First, have a media policy in place and ensure that only one person from the organization is allowed to speak to the media. It is advised to include that under no circumstances should any staff have any communications with the media. Providers should know how to report a positive case: contact your county health department, if you are a licensed provider submit an incident report, Form 283, and contact Acute Disease Services, OSDH, 405-271-4060. All staff should have universal use of face masks (N95), gown, gloves, and eye protection in your community if a positive case exists. Contact your regional emergency response agency to coordinate your needs of PPE. All providers should utilize consistent assignment staffing and have staff stay in separate areas of the community as much as possible.

Resources
Letter to Family- Positive Case LINK
Letter – COVID-19 in the building LINK
Emergency Preparedness Template LINK
Crisis Communication LINK
Internal Communication Positive Case  LINK

LeadingAge New York Guidance
The State Executive for Leading Age New York shared the following:
Rule 1: life is unfair. Rule 2: ignore rule 1, especially now.

LeadingAge New York members are making do as best they can. Their ideas: encourage staff with money and sympathy, fight for PPE (we need our fair share), triage what you have, assume the virus is everywhere and keep people alive. Regardless of what your government does, tell staff, residents, and their families to lock down. Our members are incredibly resourceful and they are leading a way through this mess.

Note: in light of this message, please share with your families and staff: assume everyone you come in contact with is COVID-19 positive and everything you come in contact with has the virus on it. Only then can we really understand the full protections we must practice in order to avoid this virus.  

Hand Sanitizer
LeadingAge OK has been contacted by a company that is producing hand sanitizer. It is CDC and GHO quality, 75% alcohol content. Price: 5 gallon bucket $200 each. SDS sheet available. Email: mary@LeadingAgeOK.org as soon as possible if you are interested. The order will be placed on Monday, April 6.

COIVD-19 Testing
Drive-Thru Testing for COVID-19 by the Oklahoma State Department of Health  LINK

CMS New Guidance
On April 2, CMS issued enhanced guidance for nursing homes related to COVID-19.  CMS Guidance     LINK   CMS Link  CMS Recommendations

This guidance includes a new requirement for all staff to wear a facemask while in the nursing home. The CDC has stated that homemade masks or other non-surgical masks are appropriate for this use given the limited amount of PPE if any other type of mask is not available.

Public Mask Solution
Effective April 3, the CDC has advised that every individual wear some kind of a protective mask when in public. Be reminded, it is important to secure homemade masks or other options as the N95 and surgical masks are critically needed for healthcare workers and are not advised to be used by the general public.

Value First has been researching various suppliers that can fill member needs for critical supplies such as masks, gowns, sanitizer, etc. They have found a viable solution for reusable antimicrobial personal safety masks.  Details

Are You in Compliance?
Much has been shared about the COVID-19 requirements for nursing homes and assisted living communities are implementing some of the same protections. As a reminder, every provider should assess their policies in order to protect their residents.
LeadingAge Oklahoma is strongly encouraging the following for all member communities:

  • Continued screening of all staff and persons coming onto your premises.
  • Strict adherence to a “no visitation” policy unless medically urgent or end-of-life. 
  • Suspension of all facility-sponsored indoor and outdoor activities (exercise, games, etc. – anything promoting any congregation of residents)
  • Suspension of any congregate dining.  Meals should be provided to residents in their residences with monitoring as appropriate. 
  • Providing mechanisms or options for the delivery of essential provisions, medications and other necessary goods.  A single drop-off location is suggested.
  • Enforcement of the Governor’s “stay at home” order for persons aged 65 and older.  If you are allowing residents to leave for “essential errands,” you need to educate them on safe practices (social distancing, hand hygiene, etc.).  If allowing residents to leave for any other purposes, they will need to self-quarantine for 14 days if they are allowed to return. 

All members need to recognize how devastating this virus will be if it enters your campus.  Should someone in your community contract the virus, it is much more defensible to have strong measures in place than to continue to allow unsafe practices. 

Don Blose, President of the Board, LeadingAge Oklahoma
 
HUD Update
HUD has announced that they will replace their calls with pre-recorded sessions. LeadingAge and LeadingAge OK will continue to share essential provider updates. LINK

Housing providers need to be aware of the implications of the Families First Coronavirus Response Act and its impact on your operations. LINK
 
Adult Day Services
Realizing the important role of adult day services, LeadingAge and NADSA have sent a letter to leadership in Congress to protect this service that has been curtailed during this crisis. LINK

Step-Down Facilities
It is projected that Oklahoma will need at least 500 nursing home beds to accommodate hospital discharges of positive COVID-19 cases and additional beds for transfers of positive COVID-19 cases from other settings. A licensed nursing home would be able to “stand-up” a facility dedicated to COVID-19. If you are interested,  please email mary@LeadingAgeOK.org for more detail

April 1-2, 2020

CARES Act Small Business Loans Can Support Aging Services Providers
The Coronavirus Aid, Relief, and Economic Security (CARES) Act signed on March 27 provided $2 trillion in federal dollars in response to the COVID-19 pandemic. About $350 billion of these funds are directed to provide loans to small businesses, with opportunity for loan recipients to receive forgiveness and not have to repay the amount borrowed. On April 3, entities with less than 500 employees, including 501(c)(3) not-for-profit organizations, will be able to access these funds. On March 31, the U.S. Department of Treasury issued guidance for potential borrowers and for lendersClick here to learn more about these opportunities with a detailed summary by LeadingAge.

Treasury guidance on SBA payroll loans.  Late this afternoon the Department of Treasury posted new guidance for borrowers and lenders on the SBA payroll loans described in the article we posted yesterday.  These loans can start on Friday, and the interest rate is very low (.5%) for non-forgiven funds.  LINK

Legislative Special Session
The Governor has just announced that a Special Legislative Session will be held on Monday, April 6. More to follow on the issues they will address.

OSDH Update

New Guidance for LTC
On the Wednesday provider call, OSDH informed providers in counties with an active case of COVID-19, that “healthcare workers that provide patient care in long term care facilities should use a minimum level of PPE for all patient care activities….a face mask for all resident encounters.” OSDH recognizes the short supply of PPE but understands the need to protect workers and the vulnerable populations in long term care settings. Be reminded, staff and residents can be asymptomatic for days before passing the virus from person to person. This was the case in the Washington state nursing facility. LINK

ICF Guidance
OSDH shared that for community activities, no more than 10 total individuals can be in the same setting and only essential activities should take place.  CMS has issued guidance for Infection Control in ICF facilities.  LINK

OSDH Questions
Email your questions to: OSDH, hfs@health.ok.gov or qies@health.ok.gov.

CNA/CMA Training
The Presumptive Training Program Approval Rule has been approved by OSDH General Counsel and we are now waiting for this to be signed off by the Commissioner of Health and Governor, which should be any time. LINK

Once approved:

  • Any facility that wants to train aides and technicians is presumptively approved to do so.
  • Any facility that wants to employ trainees that is presumptively approved as a training program can do so.
  • Document training consistent with the curriculum requirements for the aides/technicians in rule.
  • Once documented that the individual knows the skill they can do it.

Governor Issues 7th Executive Order  
Governor Stitt just issued his 7th Executive Order addressing the COVID19 pandemic in Oklahoma.  It amends all previous exiting orders in multiple ways.  Of greatest importance is that it EXTENDS ALL PROVISIONS of the pre-existing orders to ALL 77 COUNTIES (not just those counties with a COVID19 case).  In addition, it extends the prohibition on non-essential medical and dental procedures to April 30 (from the previous date of April 7) in order to preserve needed PPE and prevent transmission of COVID19.  ALL PROVISIONS of the previous executive orders are now extended to April 30th.
 
The Executive Order as it exists allowing today’s announcement is attached for your review.  LINK   

Adult Day Services
Today’s COVID-19 daily call will featured  a discussion on the new Paycheck Protection Program loans. While these can go to 501(c)(3)s of any provider type in the membership (and for-profits), adult day services providers may find these particularly valuable at this juncture.
 
Below are two articles on the program.  All the daily calls are recorded, so if you missed the call today it should be online tomorrow. 
Article 1 LINK       Article 2 LINK
 
Moment for Motivation and Reflection
Dr. Linda Shell, MA, RN, in collaboration with MedBridge Education, is pleased to announce a multipart series designed for leaders and managers of provider organizations. This includes a leadership insights and tools with a short video. During this unprecedented COVID-19 virus crisis it is essential that leaders and their teams come together, with common purpose, to lead effectively, support one another, the residents they serve, and families represented. Be sure to click on the link provided to view the video. LINK

IRS Guidance on Stimulus Checks and LeadingAge Advocacy! 
There WAS bad news here, but it was just reversed on Wednesday evening and it’s now good news!  The Treasury Department published guidance earlier today that would have required Social Security recipients who do not usually file tax returns would have to file an “easy,” yet to be developed tax form in order to get stimulus checks.  LeadingAge reached out to the Senate staffer who spoke on our 3:30 call on Monday, who had a heavy hand in crafting the language.  He was very clear that it was written to NOT require this.  After many calls to the Hill and IRS, by LeadingAge and others, it looks like Treasury just reversed the decision.  Here’s a Washington Post article explaining what happened.
 
Media
It is our hope that members won’t have to deal with a positive COVID-19 case in your community. But, every member MUST be prepared in the case that it does happen. It can’t be stressed enough that one person and only one person must be designated to speak to the media. Some communities have a policy that if any staff speaks to the media on community issues, they would be terminated immediately. There is no margin for error when addressing the media.

Template Media Statement for a COVID-19 Outbreak in Your Organization (3/12)
Sample Media Talking Points (3/11)
Planning for a COVID-19 Outbreak in Your Community: Tips for working with the media. (3/13/20)

CMS Issues ICD-10 Code for COVID-19
CMS has announced that they posted a revision to the PDPM DLL Package (V1.0004 FINAL) and removed the previous version (V1.0003 FINAL). This new version adds support for the new ICD-10-CM code for Coronavirus, U07.1. Note that this code is ONLY in effect for assessments with target date 04-01-2020 and later.  The package contains updated test files and documentation. Also, the lookup file for the allowable ICD codes in item I0020B has been updated to include U07.1 (Coronavirus). 
 
LeadingAge COVID-19 Workforce Partnerships
LeadingAge is establishing partnerships with major national employers to reach displaced workers from fields such as dining, retail, and hospitality. Through these partnerships—with organizations like Marriott, Hilton, the Peace Corps, and the American Hotel and Lodging Association—we will help you fill available jobs in aging services.

To participate, members should post jobs of all kinds (including temporary positions and those that do not require certification) on the LeadingAge Aging Services Career Center. LeadingAge is making all job postings FREE to members starting this week to make it easier for you to fill staff roles during this unprecedented time of need. Learn more about how to post your jobs now.

Member Ideas and Inspiration
A hallmark characteristic of LeadingAge is collaboration. Our membership has a strong history of sharing ideas and lessons learned freely with one another. There may be no more important time for sharing and learning from one another than during the current national pandemic. 

Click here to find ideas and inspiration from members across the country on a variety of topics critical in today’s environment including: 

CARES Act Small Business Loans Can Support Aging Services Providers
The Coronavirus Aid, Relief, and Economic Security (CARES) Act signed on March 27 provided $2 trillion in federal dollars in response to the COVID-19 pandemic. About $350 billion of these funds are directed to provide loans to small businesses, with opportunity for loan recipients to receive forgiveness and not have to repay the amount borrowed. On April 3, entities with less than 500 employees, including 501(c)(3) not-for-profit organizations, will be able to access these funds. On March 31, the U.S. Department of Treasury issued guidance for potential borrowers and for lendersClick here to learn more about these opportunities with a detailed summary by LeadingAge.

Alzheimer’s Association Offers Resources
Those individuals with Alzheimer’s/Dementia require special attention during this challenging time. LINK

Recap of Recent CMS Waivers
CMS released a package of significant regulatory changes, granting multiple waivers for several provider types. These changes were much needed in supporting our members through this unprecedented time. LeadingAge considers these changes a huge advocacy win for members. CMS has created Fact Sheets regarding these waivers by provider types, which are listed below.

Additionally, CMS announced that it is suspending routine audit activity for PACE organizations.

LeadingAge has created charts for Nursing Home, Home Health, and Hospice waivers. These charts compare the waivers LeadingAge requested, whether the waiver was granted, and highlights from respective rules. Additional information will follow.

Trusted Business Resources: Free COVID-19 Training

  • NextStep, a startup that trains and places workers into high-demand health care roles, created an online course designed to improve the safety of caregivers of all kinds working with COVID-19 patients in all settings. The COVID-Ready Caregiver program uses expert-developed online learning to help develop critical skills for safety during the pandemic.

Staff at LeadingAge members communities can access the course at no cost through April 10. Use code COVIDCERTNOW at check-out.

March 31. 2020

CMS Nursing Home Stakeholder Call set for tomorrow. 
At 7:05 p.m. March 30, CMS announced a National (Nursing Home) Stakeholder Call on COVID-19 for Tuesday, March 31 at 11:00 a.m. CST.  We recommend you join early, CMS is reporting more people calling in than ever before and they run out of lines.   
 
Please see dial-in details below. Conference lines are limited, so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser.
Participant Dial In: 877-251-0301
Conference ID: 7786289
Audio Webcast: https://protect2.fireeye.com/url?k=56ba1b23-0aee3208-56ba2a1c-0cc47a6d17cc-5cccd974ae4ce7ee&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=1754
 
CMS Home Health Stakeholder Call set for tomorrow. 
At 7:44 p.m. CMS announced a COVID-19 all with Home Health providers, set for, Tuesday, March 31 at 2:00 CST.  We recommend you join early, CMS is reporting more people calling in than ever before and they run out of lines. 
 
Conference lines are limited, so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser.
https://protect2.fireeye.com/url?k=ea154c9d-b64155e1-ea157da2-0cc47adc5fa2-fc16b499326a8886&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=1759
 
Participant Dial In: 877-251-0301
Conference ID: 5889768

CMS Issues New Blanket Waivers
CMS put out a package of additional “sweeping regulatory changes to help US Healthcare system address COVID-19 patient surge.” 
CMS    announced   its 221-page Interim Final Rule adjusting a wide range of Medicare and Medicaid regulations to give providers additional flexibility to respond to the COVID-19 pandemic.  The waivers are retroactive to March 1 and will be effective through the duration of this national public health emergency. CMS will host a national stakeholder call, Tuesday, March 31 at 11:00 C.S.T. to review the announcements.  To register to listen to the CMS audio webcast, click here

CMS issued a memo on PACE that says CMS is suspending routine audit activity for PACE organizations.  Audits related to instances of “noncompliance where the health and/or safety of beneficiaries are at serious risk (for example, lack of access to critically needed health services or prescription drugs)” and those related to infection control related complaints.  For those interested, this suspension also extends to Medicare Advantage plans. 

Please see below for highlights of the announced waivers based on member provider type, many of which were requested to LAI and LeadingAge.  You can also expect a summary from LeadingAge as well as additional detail tomorrow and throughout the week.    

Long Term Care/Skilled Nursing Facility (SNF):

  • Training and Certification of Nurse Aides: CMS is waiving the requirements which prohibit a SNF from employing a Nurse Aide for longer than four months unless they met the training and certification requirements under §483.35(d).  To ensure the health and safety of nursing home residents, CMS is not waiving §483.35(d)(1)(i), which requires facilities to not use any individual working as a nurse aide for more than four months, on a full-time basis, unless that individual is competent to provide nursing and nursing related services. Nor is CMS waiving §483.35(c), which requires facilities to ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents’ needs, as identified through resident assessments, and described in the plan of care. [Note: This waiver will assist with the nurse aides who have completed their course but have been unable to complete their exam due to the closure of community colleges.]
  • Physician Visits in SNF (certification and re-certification visits–30/60/90 day): CMS is waiving the requirement for physicians and non-physician practitioners to perform in-person visits for nursing home residents and will allow visits to be conducted, as appropriate, via telehealth options.
  • Payroll Based Journal (PBJ) Submissions: CMS will provide relief to SNFs on the requirements for submitting staffing data through the Payroll-Based Journal system. [Note:  no detail on extensions or adjusted timeline yet.]
  • Physical Environment/Alternate Settings: Transfers of COVID-19 Patients: CMS will allow a SNF to move residents within a facility, or transfer resident(s) to another SNF solely for the purposes of cohorting and separating residents with and without COVID-19.
    • Non-SNF Building Temporary Conversion-Provided that the State has approved the location, CMS will allow for non-SNF buildings to be temporarily certified as and available for use by a SNF in the event there are needs for isolation processes for COVID-19 positive residents which may not be feasible in the existing SNF structure to ensure care and services during treatment for COVID-19 is available while protecting other vulnerable adults.  [Note-This waiver would assist campuses who may want to utilize other resident spaces like assisted living and independent living to provide more space for isolation of residents.]
    • Temporary New SNF –CMS will waive certain conditions of participation and certification requirements for opening a SNF if the state determines there is a need to quickly stand up a temporary COVID-19 isolation and treatment location.
    • Non-Resident Room Space for Surge Capacity-To assist with isolation needs, CMS will temporarily allow rooms in SNF not normally used as a resident’s room like activity rooms or conference rooms to be used to accommodate beds and residents for resident care in emergencies and situations needed to help with surge capacity as long as residents can be kept safe, comfortable, and other applicable requirements for participation are met. This can be done so long as it is not inconsistent with a state’s emergency preparedness or pandemic plan, or as directed by the local or state health department.
  • CMS Facility without Walls (Temporary Expansion Sites):  A SNF can temporarily transfer its COVID-19 positive resident(s) to another facility, such as a COVID-19 isolation and treatment location, with the provision of services “under arrangements.” The rule details how the transfer and billing will work in these situations. 
  • 3- Day Prior Hospitalization: CMS is waiving the requirement for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF) stay. This waiver provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who experience dislocations, or are otherwise affected by this emergency. In addition, for certain beneficiaries who exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period. [Note:  this waiver has been in place since the March 13 announcement.]
  • Reporting Minimum Data Set (MDS): CMS will provide relief to SNFs on the timeframe requirements for Minimum Data Set assessments and transmission.  [Note:  no detail on extensions or adjusted timeline yet.]
  • Waive Pre-Admission Screening and Annual Resident Review (PASRR): CMS is allowing states and nursing homes to suspend these assessments for new residents for 30 days.
  • Resident Groups: CMS is waiving the residents’ right to participate in in-person resident groups.
  • Provider Enrollment: CMS has established toll-free hotlines for all providers to enroll and receive temporary Medicare billing privileges. CMS is also waiving certain screening requirements, postponing all revalidation actions, and expediting all pending and new applications. 

Hospice Programs

  • Hospice Services:  Hospice providers can provide services to a Medicare patient receiving routine home care through telehealth, if it is feasible and appropriate to do so.
  • Face to Face Visits:  Face-to-face encounters for purposes of patient recertification for the Medicare hospice benefit can now be conducted via telehealth.
  • Hospice Volunteers:  CMS is waiving the requirement that hospices are required to use volunteers (including at least 5% of patient care hours).
  • Hospice Aide Supervision: CMS is waiving the requirements for a nurse to conduct an onsite visit every two weeks and the requirement for a nurse or other professional to conduct an onsite visit every two weeks to evaluate if aides are providing care consistent with the care plan. 
  • Comprehensive Assessments: CMS is extending the timeframes for updating the comprehensive assessment from 15 to 21 days.
  • Waive Non-Core Services: CMS is waiving the requirement for hospices to provide certain non-core hospice services during the national emergency including physical therapy, occupational therapy, and speech-language pathology.

Home Health Agencies (HHAs)

  • Telehealth:  HHAs can provide more services to beneficiaries using telehealth within the 30-day episode of care, so long as it is part of the patient’s plan of care and does not replace needed in-person visits as ordered on the plan of care.
  • Homebound Definition:  A beneficiary is considered homebound when their physician advises them not to leave the home because of a confirmed or suspected COVID-19 diagnosis OR if the patient has a condition that makes them more susceptible to contract COVID-19. As a result, if a beneficiary is homebound due to COVID-19 and needs skilled services, an HHA can provide those services under the Medicare Home Health benefit.
  • Plans of Care and Certifying/Recertifying Patient Eligibility: HHS is utilizing enforcement discretion and will not conduct audits to ensure that only physicians provided orders, signed and dated the plans of care, and certified/recertified patient eligibility for claims submitted during this public health emergency which will allow for nurse practitioners and physician assistants to help ensure access to home health.
  • OASIS Timeframes: CMS is extending the 5-day completion requirement for the comprehensive assessment and waiving the 30-day OASIS submission requirement. HHAs are expected to complete the comprehensive assessment within 30 days and delayed submission is permitted.
  • Initial Assessments: HHAs can perform initial assessments and determine patients’ homebound status remotely or by record review.
  • Waived onsite visits for both HHA Aide Supervision: CMS is waiving the requirements for a nurse to conduct an onsite visit every two weeks and for a nurse or other professional to conduct an onsite visit every two weeks to evaluate if aides are providing care consistent with the care plan. This waiver is also temporarily suspending the 2-week aide supervision requirement by a registered nurse for home health agencies, but virtual supervision is encouraged during the period of the waiver.
  • COVID-19 Diagnostic Testing:  If a patient is already receiving Medicare home health services, the home health nurse, during an otherwise covered visit, could obtain the sample to send to the laboratory for COVID-19 diagnostic testing.
  • Ordering Medicaid Home Health Services and Equipment: Medicaid home health regulations now allow non-physician practitioners to order medical equipment, supplies and appliances, home health nursing and aide services, and physical therapy, occupational therapy or speech pathology and audiology services, in accordance with state scope of practice laws.
  • Requests for Anticipated Payments (RAPs): MACs can extend the auto-cancellation date of RAPs during emergencies. RAPs are a pre-payment for home health services.

PACE

  • Reprioritization of Audits:  CMS is reprioritizing its scheduled program audits for PACE organizations until further notice.  CMS will temporarily shift the oversight activities from routine audits to the investigation and resolution of “instances of noncompliance where the health and/or safety of beneficiaries are at serious risk (for example, lack of access to critically needed health services or prescription drugs); and complaints alleging infection control concerns, including COVID-19 or other respiratory illnesses.”

All Provider Types

  • Accelerated/Advance Payments: In order to increase cash flow to providers impacted by COVID-19, CMS has expanded the Accelerated and Advance Payment Program to provide accelerated or advance payments during the period of the public health emergency to any Medicare provider/ supplier who submits a request to the appropriate Medicare Administrative Contractor (MAC) and meets the required qualifications. Providers can get more information on this process here: www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf  [Note: This expansion was announced on March 28, 2020]
  • Medicare Cost Reports:  CMS will delay the filing deadline of FYE 10/31/2019 cost reports and FYE 11/30/2019 cost reports until June 30, 2020.  CMS will also delay the filing deadline of the FYE 12/31/2019 cost reports until July 31, 2020.
  • Medicare Appeals: 
    • CMS is allowing Medicare Administrative Contractors (MACs) and Qualified Independent Contractors (QICs) in the FFS program and MA and Part D plans, as well as the Part C and Part D Independent Review Entities (IREs) to allow extensions to file an appeal and to waive certain requirements for timeliness for requests for additional information to adjudicate appeals. 
    • CMS is allowing MACs, QICs, MA and Part D plans, as well as the Part C and Part D IREs to process an appeal even with incomplete Appointment of Representation forms.  However, any communications will only be sent to the beneficiary.
    • CMS is allowing MACs, QICs, MA and Part D plans, as well as the Part C and Part D IREs to process requests for appeal that don’t meet the required elements using information that is available.
    • CMS is allowing MACs, QICs, MA and Part D plans, as well as the Part C and Part D IREs to utilize all flexibility available in the appeal process as if good cause requirements are satisfied.

CARES Act Expands Federal Small Business Loans, Can Support Aging Services
We gave this a mention in the call today. The CARES Act (3rd stimulus) includes $350 billion for loans to small businesses, with opportunities for loan recipients to receive forgiveness and not have to repay the amount borrowed.  There are two key programs, the Paycheck Protection Program and Economic Injury Disaster loans. We are working on the website tonight but an article will be posted in the morning. It’s attached in case you need the content before early tomorrow morning when we can add to the resources page.   LINK

Home Health Blanket Waivers  LINK

Hospice 1135 Blanket Waivers LINK
 
Nursing Home Blanket Waivers LINK
 
CMS Current Emergencies website has everything they’ve released for the coronavirus emergency; it’s all dated so you can tell what’s new. Link

LeadingAge’s March 29 HUD Regulatory Relief and Streamlining Requests 
It is our hope that we will see the kind of flexibility and responsiveness from HUD that we are seeing from CMS. The asks range from more availability of HUD staff to answer the myriad questions housing providers have to HUD agreeing to allow properties to accept the SBA loans described above to HUD working across government and with others to increase access to cleaning supplies, PPE and other critical supplies. Link
 
Correction:
According to the Governor’s Emergency Order dated March 29, an emergency declaration was issued for all 77 counties, including that people 65 and older and those with compromised immune systems must shelter at home and no gatherings in groups larger than 10 people. However only counties with an active case of COVID-19 are impacted by the order to close all non-essential businesses. 

 

March 29-30, 2020

Department of Labor Exempt Employee Definition
The Department of Labor has issued the following guidance:
 
56. Who is a “health care provider” who may be excluded by their employer from paid sick leave and/or expanded family and medical leave?
For the purposes of employees who may be exempted from paid sick leave or expanded family and medical leave by their employer under the Family First Coronavirus Response Act, FFCRA, a health care provider is anyone employed at any doctor’s office, hospital, health care center, clinic, post-secondary educational institution offering health care instruction, medical school, local health department or agency, nursing facility, retirement facility, nursing home, home health care provider, any facility that performs laboratory or medical testing, pharmacy, or any similar institution, employer, or entity. This includes any permanent or temporary institution, facility, location, or site where medical services are provided that are similar to such institutions. 

This definition includes any individual employed by an entity that contracts with any of the above institutions, employers, or entities institutions to provide services or to maintain the operation of the facility.
This also includes anyone employed by any entity that provides medical services, produces medical products, or is otherwise involved in the making of COVID-19 related medical equipment, tests, drugs, vaccines, diagnostic vehicles, or treatments. This also includes any individual that the highest official of a state or territory, including the District of Columbia, determines is a health care provider necessary for that state’s or territory’s or the District of Columbia’s response to COVID-19.

To minimize the spread of the virus associated with COVID-19, the Department encourages employers to be judicious when using this definition to exempt health care providers from the provisions of the FFCRA.

This update is to clarify the employees who are “exempt” from the FFCRA as there was concern with Qualifying Reasons for Leave, #5, if the employee is caring for a child whose school is closed or if childcare is unavailable. The Department of Labor has not updated their employment poster to reflect this change. The updated poster will be shared once it is available.

Details  see item #56

Every provider is advised to update their employment policy to include this definition of healthcare workers and include all direct care staff and support staff positions that are needed “to maintain the operations of the facility.” This is very important so no staff would be excluded. There is some discretion on this so without a policy, your staff could qualify under the FMLA revision for COVID-19.

CNA/CMA Emergency Training
OSDH reported today that the revised rules for this emergency training are in the final stages of approval, being reviewed by General Counsel before moving to the Governor for approval.

This emergency training requires:
16 hours of federally-required training to include (b) 1-7. LINK  
The individual must also pass the skills test and a registry check would need to be completed. (no fingerprinting background check as these are not open at this time.)
Proposed Rule  LINK
Skills Checklist   LINK
Medication Administration Checklist  LINK

Governor’s Emergency Order
Effective March 29, the Governor has declared an emergency and ALL 77 Oklahoma counties are now under the Governor’s emergency order. This means all non-essential businesses shall close. See items 17-21.

All delivery items at long term care communities must be screened. See item 22.
LINK

Re-Admissions of COVID-19 Residents
LeadingAge OK continues our work with the OK State Dept. of Health to address hospital discharges of residents with positive COVID-19 cases. We believe any readmissions before a negative COVID-19 is received would compromise the health of the residents and staff of the community.

End of Life Care
Governor’s Stitt’s Executive Order was intended to align with similar directions and orders from the federal government’s Department of Health & Human Services, Centers for Medicare & Medicaid Services (CMS). On March 13, 2020, CMS issued a Memorandum which provided in part:
 
“Facilities should restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as end-of-life situations. In those cases, visitors will be limited to a specific room only….For individuals that enter in compassionate situations (e.g., end-of-life care), facilities should require visitors to perform hand hygiene and use Personal Protective Equipment (PPE), such as facemasks. Decisions about visitation during an end of life situation should be made on a case by case basis, which should include careful screening of the visitor (including clergy, bereavement counselors, etc.) for fever or respiratory symptoms. Those with symptoms of a respiratory infection (fever, cough, shortness of breath, or sore throat) should not be permitted to enter the facility at any time (even in end-of-life situations). Those visitors that are permitted, must wear a facemask while in the building and restrict their visit to the resident’s room or other location designated by the facility. They should also be reminded to frequently perform hand hygiene.”

Therefore, Governor Stitt’s Order should be read to permit such “compassionate care” visits to Oklahoma’s nursing homes, long term care facilities, and retirement homes, if conducted in accordance with the guidelines in the CMS Memorandum cited above. Link

Need Staff? Know of Someone Who Needs Work?
LeadingAge Oklahoma has created a clearinghouse to match potential staff with member communities. There are restaurant workers, dental hygienists and others who are not able to work at their current place of employment and would be willing to work in Long Term Care. Needs include everything from food service workers to those willing to provide transportation or run errands to those who have licensure in long term care.

To those who don’t have licensure or certification to work in long term care: Emergency rules will be in place for individuals to work as direct care staff during this time if that would be a position of interest.

If you are in need of staff, let us know and we will forward any inquiries from your area to you. Job Placement form  LINK

OSDH Update
Weekly Update from OSDH

The Oklahoma State Department of Health, Regulation, Prevention and Preparedness will be hosting its second COVID-19 webinar on Wednesday, April 1 from 1:00 to 2:30. The webinar will include information and discussion of the Novel Coronavirus COVID-19 including current guidance, best practices and questions and answer.  The webinar is open to Owners, Operators, Administrator and Executive Staff of Nursing Homes, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Continuum of Care Facilities, Assisted Living Centers, Residential Care Homes and Adult Day Care Centers. Agenda to follow.
 
Join the meeting:
https://meet.ouhsc.edu/orion/joinmeeting.do?ED=joNdKpm7YnAFo6pe5LSn9g==&Rnd=0.23161887940180348
 
Wednesday, April 1, 2020
 
Access Information
Meeting Number:  994 928 563
Password:  (This meeting does not require a password.)
Audio Connection:  (405) 271-2466 (External Access); 12466 (Internal Access)
Access Code:  994 928 563
One tap mobile: +14052712466,,994928563#

Recording of Long Term Webinar on Wednesday, March 25
The Long-Term Care Survey Division, Mike Cook, Service Director, along with James Joslin, Assistant Deputy Commissioner, provided the first in a series of weekly Webex’s on Wednesday, March 25, 2020: Long-Term Care Provider Webex—COVID- 19 Updates. Click here to access the recording of that Webex. You may need to download the Cisco Webex player.

Note: some are unable to play this recording and OSDH is working on an alternate process moving forward.

Sample Policy – Transfer to Hospital
Nursing Facility and Assisted Living Transfer Questionnaire, Link

March 27-28,2020

Hospital Discharge for Positive COVID-19 Patients

The LeadingAge Oklahoma Board has approved the following position: 

LeadingAge Oklahoma does not support the transfer of positive COVID-19 patients from the hospital to skilled nursing facilities, especially given the fatality rate in older individuals and people with serious and chronic health conditions — the very people we serve. Nursing facilities were the first population required to shelter in place and deny any visitors so as to protect all residents. Oklahoma must develop a process for transitional care locations as an intermediate step in order to protect the health of nursing home residents and staff.

Call and email the Governor:
405-521-2342
email:
https://www.governor.ok.gov/contact/leave-comment

Nursing Home Residents with COVID-19 Returning from Hospitals

It is urgent that Oklahoma enact policy that will protect the lives of critical staff and residents in long-term care and nursing facilities across our state.  Oklahoma must create a step-down facility or facilities for all COVID-19 positive patients that will be returning to nursing homes or long-term care facilities from hospitals.  This will allow for timely release from hospitals, while allowing these frail patients to be cared for in an appropriate intermediate setting until they are COVID-19 negative and can be returned to their nursing home or place of residence.

Oklahoma has the unique opportunity to be proactive by creating this model in the midst of this pandemic, by establishing dedicated COVID-19 nursing homes, revitalizing existing closed hospitals and or nursing facilities, protecting our long-term care workforce and residents, and protecting the lives of Oklahoma citizens.  Together we can be the solution!

New Normal
It seems that we will need to consider this our new normal, with on-going updates on all of the changes regarding this crisis. Moving forward, an update will be issues every 2-3 days, knowing your time to sift through this information is very limited. However, an email will be sent immediately for issues of importance.

Important COVID-19 Update                 email title for any immediate updates
COVID-19 Update (date)                       email for ongoing provider updates

LeadingAge Daily Calls
LeadingAge has daily provider calls. One of the most important parts of these calls is to hear from providers regarding what they have done to manage operations during this critical time. There is always a handout with links to the latest updates. You are encouraged to register for these calls.

Medicare Accelerated Payments
CMS is planning to do accelerated payments to providers. LINK

In-House Beauty and Barber Shop Services
If the individuals who do these services come in from the outside, they are not considered essential services and will no longer be allowed in.

OSDH Update
OSDH asked that we share these links:  Know the symptoms of #COVID19 and how they compare to other illnesses. More resources at http://coronavirus.health.ok.gov.

Social Connectedness for Residents
“Supporting Social Connectedness Through Technology,” a 7 minute QuickCast is now available free of charge in the LeadingAge HUB.  It offers ideas to leverage a variety of available technologies to connect older adults during times of social distancing.  Here’s the link:    LINK

CNA/CMA Certification
If the CNA/CMA certification expired prior to the Governor’s declaration, the certification must be reinstated, if it expired after the Governor’s declaration, OSDH doesn’t consider it expired.  If a person has completed CNA/CMA training and is just awaiting their testing, call the Nurse Aide Registry for next steps to receive a waiver on this. 405-271-6868

CNA/CMA Emergency Certification and Training
If you have individuals who want to become trained as emergency CNA/CMAs, it is advised that you to do the 16 hr. training now, check the registry, then once the program has been approved, do the skills training to complete the process. OSDH is working to get this approved as soon as possible.

Medically Necessary Visits
Requirements like Pharmacy Consultations  – keep in mind it is more dangerous to have others in the building, there are no surveys at this time, so restart full compliance once this issue has subsided. OSDH has shared: What is the better action? Right now it is to protect your residents. Note any compliance issues addressed in this manner, your reason, and date it.
For any necessary visits such as hospice, mobile x-ray, etc. providers should require full PPE by the individual who needs to enter your building. (they should provide their own PPE) 

Adult Day Services
DHS has issued a directive that no one 65+ can attend adult day services and if your center is staying open for those under 65, you must keep your participants in different rooms so at no time the number of staff and participants in one area can exceed 10 individuals.   LINK

CARES Legislation
The 3rd stimulus bill summary: LINK
Note: it includes a 6.2% FMAP increases that will go to the states, not providers. DETAILS

OSDH PPE Survey
The OSDH PPE survey was sent today, March 28, to the primary contact of record.

Clarification: this survey will only be for nursing homes.

Survey Details:
Please utilize the link below to access a survey to support the COVID-19 response in Oklahoma. The data you provide in this survey will be used to direct resources from the Strategic National Stockpile (SNS) and other resources in the most appropriate manner.

To meet this goal, necessary changes might need to be made to establish the validity of PPE data collected. Please be aware that the accuracy and completeness of your data submission is crucial for your eligibility to receive state resources. You will be required to use the embedded link to a “PPE Burn Rate Calculator” to determine burn rate of the surveyed items.  Please remember to report INDIVIDUAL ITEMS. Also note that the burn calculator numbers can be manipulated by you to best represent your agencies current rate of burn.

Upon review, NHLTC Agencies that do not submit accurate data in a timely fashion may delay their agency/facility receiving these state resources.

Link for PPE Survey:  https://arcg.is/aKi1T

COVID-19 FMLA & Paid Sick Leave

Family Medical Leave provisions under the second stimulus bill have been a significant source of questions for members. LeadingAge has prepared an FAQ on New Paid Sick Leave and FMLA Leave in the Families First Response Act (FFCRA) to help.

LeadingAge OK continues to work on a position that long term care employees are critical infrastructure employees during time of national crisis, according to FEMA. More to follow on this.

How Coronavirus Lives in the Air and On Surfaces
LINK

March 26, 2020

CNA/CMA Training – Emergency Order
According to OSDH, the CNA/CMA Emergency Order had to be revised and sent back through the General Counsel. Since nurse aide training is in statute, they have to take a different path to allow this exception. The plan is to allow every nursing facility to be approved to “train” nurse aides in-house. Then you can do the 16 hr. training, the skills test, check the registry, and then the staff can work in these positions. It is advised that ANY staff or prospective staff that you have could start the 16 hr. training in your facility and that this would be approved by the time they finish that training. All providers are encouraged to get staff trained as soon as possible so they will be ready to go when the order is approved. Approval is anticipated in a few days.

Executive Order Enforcement
Attorney General Mike Hunter has released the details for enforcement action for individuals and business owners who do not comply with the Governor’s March 24 Executive Order.    Details     Executive Order

Resources
Pathway Health developed a full set of complimentary COVID-19 resources for your use, including policies and procedures, leadership checklists, preparation and response strategies.  DOWNLOAD NOW

Supplies
The OSDH is going to email each licensed facility a survey, expected to be sent in the next 24 hours. The email will contain a link to a Personal Protective Equipment (PPE) survey which will ask for piece counts by type of PPE and use (burn) rate. A burn rate calculator will be provided. 

Please be aware that the accuracy and completeness of your data submission is crucial for your eligibility to receive state resources. Upon review, facilities/agencies that do not submit accurate data in a timely fashion may delay their agency/facility receiving these state resources.  Check spam filters for the email with “PPE Track” in the subject line.

Survey Details

PPE Calculator
The CDC released a Personal Protective Equipment (PPE) Burn Rate Calculator [cdc.gov]. Start using the calculator to gauge your PPE use compared against the benchmark or expected burn rate. The website tells you about the spreadsheet with specific instructions listed as well. Given the extremely limited supply of PPE, all healthcare providers need to understand where you may have opportunities to conserve and optimize PPE use. If you aren’t currently using large amounts of PPE, you are encouraged to track your PPE supply using this spreadsheet. Moving forward, OSDH will be requiring this of all providers.

If your PPE supply isn’t currently secured/locked, or limiting the number of staff having access to it, please take those steps now.

Postal Deliveries
A local postmaster has notified a retirement community that their carriers are now exempt from being screened upon arrival to their campus.  He indicated this was a statewide decision.  Their rationale is that screening is an invasion of their employees’ privacy.   At this time, the postal service is not screening any of their employees prior to their shifts.  They are merely telling them to not report to work if they feel sick.

The option given to the community was to either let the carrier deliver unscreened or for the community to have staff distribute the mail.  LeadingAge is seeking relief nationally for this problem. If you have had postal delivery issues, email: mary@LeadingAgeOK.org

Media
A LeadingAge member from New York participated in the LeadingAge call today. He shared some very important advice from an organization on the frontline of this crisis. They have a policy that no staff should speak to the media under any conditions and if they do, they will be terminated. It was stressed that every organization have one designated spokesperson who is the only authorized media contact.

An important tip that was shared was to keep the TVs on an entertaining station like a game show and not have the news running continuously. This is not just for the morale of the residents, but just as much for the morale of the staff.

Template Media Statement for a COVID-19 Death in your Organization

Template Media Statement for a COVID-19 Outbreak in Your Organization

Planning for a COVID-19 Outbreak in Your Community: Tips for Working with the Media.

Crisis Communications: Messaging Negative Publicity Webinar 

 

LeadingAge Update
LeadingAge Need to Know: Coronavirus (3/26/20) (NEW)

Coronavirus Daily Member Update Recording (3/26/20) (NEW)

 

March 25, 2020

Senate Approves $2 T Emergency Relief Bill
The Senate has passed a $2 T emergency relief bill 96-0. LeadingAge will be providing a summary of the bill which is said to include: cash assistance for families, measures to direct money to small businesses, funding for the increased health care costs for providers, and additional funding for HUD service coordinators.

Critical Infrastructure Sectors
Gov. Stitt amended yesterday’s order to further clarify the business sectors his administration considers “essential”, and therefore exempt from the current shutdown order that went into effect at 11:59 pm March 24 .  Details  This should help all providers know what support businesses will continue to be in operation.

OSDH Enforcement Update
In addition to all surveys being suspended, all POCs in process will also be suspended until April 9.

Resident Engagement
ABCs of Combatting Social Isolation LINK

Employment Screenings
See link for current guidance from OSDH regarding Employment Screening. LINK

PACE Call Summary
Summary of the CMS PACE Call: copy of it in Word

Delayed Implementation of Updated MDS
The Centers for Medicare & Medicaid Services (CMS) is delaying the Minimum Data Set (MDS) 3.0 v1.18.1 release, which had been scheduled for Oct. 1, 2020, in response to stakeholder concerns.

In December 2019, CMS posted a draft of the MDS 3.0 item set v1.18.0 and received feedback from stakeholders which included concerns regarding the proposed changes to the MDS 3.0 item sets and more specifically the removal of the Section G items from OBRA assessments.

The MDS changes CMS planned for Oct. 1, 2020 will now be delayed while CMS engages in continued discussions with stakeholders. Comments or questions can be submitted to: MDSCodinganswers@cms.hhs.gov.

HUD COVID-19 Q&A
HUD issued an updated COVID-19 Q&A document that covers some regulatory flexibility for housing providers. LeadingAge summarized the updates in a new article, and outlined key things we continue to ask HUD to help communities deal with (and pay for) related to COVID-19: LINK

Oklahoma Workforce Issues
COVID-19 is having a unique impact on certain elements of Oklahoma’s Workforce System. This page will serve as an update on unemployment insurance, American Job Centers, companies hiring, resources, and other workforce needs.  LINK

PPE Shortage Solution
As the PPE supply shortage has escalated, Value First has been actively researching and vetting alternative suppliers to supply critical PPE products. Phoenix Textile has been a trusted supplier to LeadingAge members for many years and has identified a potential solution for masks and isolation gowns. Phoenix Textile is sourcing products for some larger health systems and federal facilities in the US.  Our longstanding relationship with Phoenix Textile presents a viable solution, however, it will require aggregating volume across the LeadingAge membership.
If you have questions, please reach out to Jared Schei, Value First via email at jschei@valuefirstonline.comTake this short survey as soon as possible

Guidance from OSDH relating to PPE

OSDH COVID-19 Webinar:  The Oklahoma State Department of Health, Regulation, Prevention and Preparedness will be hosting a COVID-19 webinar on Wednesday, March 25 from 1:00 to 2:00.

The webinar will include information and discussion of the Novel Coronavirus COVID-19 including current guidance, best practices and questions and answer.  It is is open to Owners, Operators, Administrator and Executive Staff of Nursing Homes, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Continuum of Care Facilities, Assisted Living Centers, Residential Care Homes and Adult Day Care Centers.  More information to follow including webinar call in information.

March 23, 2020

Quality Reporting Relief

Quality Reporting guidance from CMS

Revised SNF reporting deadline chart.

LeadingAge will be going back to a live 2:30 CST call starting on Tuesday, March 24. 
(More info)

Long Term Care Job Placement Inquiry
(More info)

Communities with a Positive Case of COVID-19  
https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html
(More info)

From the CDC:  If COVID-19 is suspected, based on evaluation of the resident or prevalence of COVID-19 in the community  
Interim Infection Prevention and Control Recommendations for Patients with COVID-19 or Persons Under Investigation for COVID-19 in Healthcare Settings
Preparing for COVID-19: Long-term Care Facilities, Nursing Homes
(More info)

CMS Survey Guidance
Survey guidance relating to survey processes moving forward. Prioritization of Survey Activities QSO-20-20-ALL   LINK
LeadingAge Summary  LINK
(More info)

3-Day Hospital Stay
Details of the 3 day stay blanker waiver  LINK

HCBS and Adult Day
CMS resources and guidance for state agencies regarding HCBS and including Adult Day Services. LINK

CDC Hosting Webinar on PPE Preservation Strategies
(More info)

Q & A Fingerprinting of Staff  

Visitation of Guests and Opening Windows  
(More info)

 

March 23, 2020

Staffing:  In Oklahoma we realize many businesses are closed and there are many individuals out of work. At the same time, our long term care communities are in real need of workers for a variety of positions We will be sharing notices to let others know that if they need a job, LTC has great positions available. Waiters, drivers, and even individuals who want to do the 16 hr. nurse aide training and be an emergency nurse aide are possibilities. There are doctor’s offices, dental offices, and other health care related businesses whose employees are out of work.  If you have needs, let us know! Email Lisa@LeadingAgeOK.org.  We will organize a process to “match” resources and send people your way.

Childcare:  DHS said that at this time they didn’t see that childcare was an issue that needed immediate attention. Be reminded, a provider can set up a 10-week temporary child care center. If you do this and have excess capacity, let us know and we’ll share that with other providers. If your staff are experiencing childcare needs, contact your local DHS office and let them know.

COVID-testing in Oklahoma:  OK State Department of Health has announced a partnership with Diagnostic Labs of OK to increase our testing capacity. Test results will be provided in 2-3 days compared to our current 5+ days. 24 hr. test results will be provided for vulnerable populations who are tested:

  • Individuals who are age 60 or older
  • Children or adults who have compromised immune systems
  • Where a cluster of individuals are experiencing COVID-19 symptoms, such as a nursing home.

ODSH: For more information about COVID-19, visit coronavirus.health.ok.gov.

4 mobile test units will be deployed this week in OK and could test up to 10,000 individuals. They will be in OKC, Tulsa, McAlester and Ponca City.

The FDA has just approved a test that would detect results in 45 min. LINK  This could be a critical factor in stopping the spread of the virus. It is not known how readily available this test will be in OK.

Skilled Nursing:  The 3-day stay has a national blanket waiver for Medicare A. If an individual has a physician’s order for skilled care when leaving the hospital, the 3-day stay is waived.3 day stay qualifying waiver – March 13, Pres. declared a national emergency and put in place the 1135 waiver process. One of the blanket waivers is the waiver that if ANYONE needs skilled nursing home care, they will qualify without the 3 day stay. Must still have a physician determination that skilled care is needed, for any diagnosis. Providers don’t have to apply for a waiver for this. It is in place. To bill code it DR (Disaster Relief). If the person is on a Medicare Advantage Waiver, you would need to check with them.

Alzheimer’s Residents:  The Alzheimer’s Association’s free 24/7 Helpline is staffed by masters-level clinicians and offers translation services in more than 170 languages.

Transportation:  DO YOU NEED TRANSPORTATION OR MEDICAL NECESSITIES DELIVERED?  Instead of your residents getting out, have their items delivered. SendaRide provides customized, door-to-door transportation. We have expanded our service to offer delivery for prescriptions*, medical supplies and other necessities to those who need it the most. To Schedule your Transportation or Delivery, CALL 1-800-731-1885.  Now serving Oklahoma City and Tulsa metropolitan areas

*some exclusions apply

Return to Work Guidance:  For staff who will return to work after confirmed COVIDF-19 or suspected illness: LINK

Housing:  Latest updates for affordable housing providers LINK
Sample Policies  regarding Visitors, Infection Prevention, Essential Visitors, Employee and Vendor Screening  LINK
Letter for Support for Affordable Housing   LINK

PACE:  Conference Call for PACE providers:
When: Tuesday, March 24, 2020, 4:00 PM-5:00 PM Eastern Time

Where: https://letsmeet.webex.com/letsmeet/onstage/g.php?MTID=eb02e19036c7bf600d451e7f71589e44a

Independent Senior Housing:  The CDC has issued guidance for senior living communities in order to reduce the spread of COVID-19. LINK

Adult Day Centers:  Because of the nature of adult day centers with participants having to come in daily, there is a higher risk of spread of the virus. Please use all precautions with participants as they arrive. For the centers that have closed operations, check out these resources:
Small Business Loan Update – LINK
SBA Disaster Loan Assistance – LINK

Resident-Engagement and COVID-19:  Activity ideas during resident confinement. Resident Engagement and COVID-19 | Linked Senior

CDC Webinar Scheduled for March 24, 2020

Topic: Underlying Medical Conditions and People and Higher Risk for COVID-19

The CDC announced today that they will be hosting a webinar focusing on current information about people who are higher risk for COVID-19 complications because of their age or underlying medical conditions, particularly those that are not well-controlled.

Date: March 24, 2020 

Time: 1:00 PM – 2:00 PM (CST)

Due to the high demand we anticipate for this COCA call, we encourage participants to consider viewing on Facebook. To see the call live, please click on COCA’s Facebook Page. If you are unable to attend this COCA call, the recording of this webinar will be posted a few hours after the live event. A few minutes before the webinar starts, please click the

Or join by iPhone one-tap:

US: +16468769923,,963649423# or +13126266799,,963649423#

Or join by Telephone:

Dial (for higher quality, dial a number based on your current location):

US: +1 646 876 9923 or +1 312 626 6799 or +1 301 715 8592 or +1 346 248 7799 or +1 669 900 6833 or +1 253 215 8782

Webinar ID: 963 649 423

CDC Guidance on Facemasks

HCP use of homemade masks:  In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.  LINK

Educational Opportunities

More Resources on The Learning Hub – The Coronavirus resources on the LeadingAge National Hub are expanding.  They added a new QuickCast “Engagement in a Time of Quarantine.”  The QuickCast “Coronavirus Preparation and Policy” and the webinar “Crisis Communications: Messaging Negative Publicity” are, of course still available. Additional resources on social connectedness and ways to address social isolation are coming next week. LeadingAge members can access these and other resources for FREE, using the code Community through April 30, 2020.  (The code can only be used once per user.)

Engagement in a Time of Quarantine

This 10-minute QuickCast highlights how to apply creative approaches like TimeSlips to bring meaning and joy to elders and others virtually. LINK

For Risk Management topics on the Hub, go to LINK

And, for more Wellness (we are adding to this category each week), go to  LINK   


OCR Announces Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency  LINK

The Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) announced, effective immediately (Friday March 20) , that it will exercise its enforcement discretion and will waive potential penalties for HIPAA violations against health care providers that serve patients through everyday communications technologies during the COVID-19 nationwide public health emergency.

This exercise of discretion applies to widely available communications apps, such as FaceTime or Skype, when used in good faith for any telehealth treatment or diagnostic purpose, regardless of whether the telehealth service is directly related to COVID-19.

In support of this action, OCR will be providing further guidance explaining how covered health care providers can use remote video communication products and offer telehealth to patients responsibly.

“We are empowering medical providers to serve patients wherever they are during this national public health emergency,” said Roger Severino, OCR Director. “We are especially concerned about reaching those most at risk, including older persons and persons with disabilities,” Severino added.

New Coronavirus Stimulus Legislation Must Provide Resources for Long-Term Care Providers
NOTE: this $2T bill just failed in the Senate (Sunday) so lawmakers are going back to negotiating. It was reported to be short on relief for hospitals and health care workers. It excluded Not for Profits that receive take Medicaid from one of the loan programs. LeadingAge will continue to work on this important legislation.  This legislation must include strong support for aging services providers. Urge Congress to include LeadingAge priority provisions in this bill today.

LeadingAge COVID-19 Daily Recordings:

Register here for this weekend’s calls, or a listen to the most recent recording.

LeadingAge COVID-19 Recording – 3/22/20:  Sunday

LeadingAge COVID-19 Recording – 3/21/20:  Saturday

 

FAQs on National Guard Deployment and Public Health Service Corps

CMS issued guidance

Relief Around Quality Reporting Programs

HUD Official: Let’s All Get Through this Together

CDC Issues COVID-19 Guidance for Federally-Assisted Housing

Interim Guidance From CDC for Independent Housing With Support Services for Older Adults With Low and Moderate Incomes

CSH Guidance for Supportive Housing Providers

 

March 20, 2020

Small Business Administration Loans Available to Support Providers through COVID-19

Pandemic Nutrition, FMAP and More in Coronavirus-2

President Signs Families First Coronavirus Response Act; What Does This Mean for Aging Services?

LeadingAge Calls for Support, Guidance from HUD

LeadingAge Urges Congress for COVID-19 Affordable Housing Relief and Resources

Summary of Weekly Call with CMS

Letter to the Postmaster General

Sample Guidance, Policies, and Flyers for Affordable Housing

The LeadingAge Knowledge Center continues to add new, timely content to help you navigate the COVID-19 crisis. LeadingAge members can access these and other resources for FREE using the code: Community through April 30, 2020. (Please note: the code can only be used once per user.)

Medicaltion Skills Checklist 3.20.20

PPE Conservation Strategies_2020_03_Revised

Skills_Performance_Checklist_Model 3.20.20 B

Training Exception Request 3_19_20a

Infection Control COVID-19 (what to do if a staff member test positive or has symptoms)

Oklahoma State Department of Health – COVID-19 Update

Call if you have questions:  405-271-6868
Email your concerns or questions:  ltc@health.ok.gov

Survey – All survey activity has been suspended for ALL licensed providers: ICF, NF, ADC, AL, CCRC, Res. Care for 3 weeks, till April 6.  All enforcement actions have been suspended…stopping on March 16…put on “pause”. That includes DPNA (Denial of Payment for New Admissions)

Infection Control – training conducted for survey staff in order to comply with staff training requirement. Based on acuity of the facility starting with nursing homes, ICF, Assisted Living then down to Adult Day, surveyors will be doing infection control consultation to advise and educate providers. Nothing will be cited…no retaliation, just education.

Staffing  – Work is underway for an Emergency Rule.  Not a request for a waiver, it is a training exception process. A licensed health care professional reviews skills with a staff member and they would need to sign off on the skills performance with demonstrated competence. Document the skills test, put it in the personnel file. Then the staff member could serve in this capacity. Note: some skills might not apply to all settings, only check the skills that would be required in your licensed setting.

MAT, CMA Medication Skills Checklist – if they pass the skills test, they can serve in this capacity. This applies across all lines of licensed LTC providers. Insulin administration has not yet been included in this process.

Effective: DRAFT only, pending approval, but could possibly be approved by Monday. Providers will be notified as soon as possible. Not a certification, only can be used during this emergency time. After this has subsided, there might be some consideration for this to apply toward formal certification. But nothing will be determined on this at this time.

Screening of staff – some issues have been reported with fingerprinting and availability of sites. OSDH will propose that we use OK screen for registry checks then schedule the fingerprinting when it can be done. But the registry check will need to be done. Facilities will be notified of this requirement.

Other provider needs – be reminded that any occupational licenses will automatically renew under the Executive Order of the Governor.  Regarding license renewal – there is a “stay” on this, licenses will remain in good standing until such time as the renewals can be addressed.

Discharges – CMS expectation is that you would receive the resident back from the hospital. OSDH realizes that this is an area of concern and they will be providing additional guidance on this as more information becomes available.

During this lockdown time, if a resident wants to leave, you would have the ability to not accept them back into the facility due to infection control issues in order to protect the health and safety of the residents.

Guidance from CMS – amend your policy to address visitation and leave of residents. The point is to restrict visitation to keep your residents safe. Even if you say they can leave and isolate for 14 hours, you have no control over that isolation to know if it really was true isolation.

PPE – OK received less than 25% of their request for PPE supplies from the national stockpile. Facilities should have a contact with the local or regional emergency resource. Stay in touch with them as they are your best contact.

3 Levels of Management: Conventional, Contingency, and Crisis.  PPE Conservation Strategies_2020_03_RevisedChildcare – providers are able to set up a temporary day care center for up to 10 weeks. There is some concern about the federal legislation that was just passed regarding paid leave for workers whose children are home because school is closed, that these staff could be paid 2/3 of their wages. Legislation

Access by other providers – there is some concern about other provider types entering facilities that could compromise your infection control procedures. It is essential that every provider limit, screen, or assess the medical necessity of the visit. Should it be necessary, they would need to provide their own PPE: face mask, gown, gloves, and sanitize as necessary.

Media Statement in the case a resident is diagnosed (modify if a staff member is diagnosed):

“Earlier today (ORGANIZATION NAME) discovered that one of our residents has contracted the COVID-19 Virus (Coronavirus). As the safety and well-being of the residents and patients is our foremost priority, we immediately isolated the resident to ensure essential medical treatment, and notified the State Department of Public Health of this finding. We have also notified residents, family members and staff of this discovery, and are working closely with state officials to determine that all necessary steps are taken, including potential testing of residents and staff. The patient is currently being treated at XXX (name of facility), and medical officials on-site at (ORGANIZATION NAME) are working to determine if any other residents there have been impacted. Any other media inquiries regarding this particular patients should be referred to the State Department of Public Health.”

 

March 19, 2020

DHS Child Care site:  http://www.okdhs.org/services/cc/Pages/ChildCareLicensing.aspx

Exemption details for 10 week child care center:  item 10 b. – updated to 10 weeks http://www.okdhs.org/services/cc/Pages/ChildCareLicensing.aspx

 

March 18, 2020

OSDH Guidance on Infection Control in Settings other than Nursing Homes

LeadingAge’s COVID-19 funding request to Congress

LeadingAge Summary of CME Guidance for PACE.

LeadingAge Summary of CMS Telehealth Waiver.

LeadingAge and VNAA/ElevatingHOME’s Request for Hospice Relief and LeadingAge and VNAA/ElevatingHOME’s Request for Home Health Relief

Joint recommendations from national hospice groups regarding COVID-19 relief.

During hearings of the House and Senate Appropriations Subcommittees on Transportation and Housing and Urban Development (HUD), Secretary Ben Carson was asked to defend his department’s work to help HUD-assisted communities during the coronavirus pandemic. Read the LeadingAge summary now.

On March 13, HUD’s Office of Multifamily Housing announced a national call to answer questions from housing providers struggling to navigate COVID-19 in HUD-assisted housing. Read the LeadingAge summary now.

Driving the Coronavirus Conversation

 

March 14, 2020

A message from LeadingAge president and CEO Katie Smith Sloan.

CMS Restrictions

LeadingAge summary of CMS Restrictions

CMS March 9 Memo

LeadingAge response to CMS Memo

HUD Office of Multifamily Housing Q & A

LeadingAge response to HUD Q & A

LeadingAge press release re HUD Property Inspections

Coronavirus Preparation and Policy QuickCast

Crisis Communications: Messaging Negative Publicity Webinar

Planning for a COVID-19 Outbreak in Your Community: Tips for working with the media

Template Media Statement for a COVID-19 Outbreak in Your Community

Home Health Infection Control Guidance

Template Letter for Families Regarding Visitor Restriction in Nursing Homes

Template Letter for Resident Regarding Visitor Ban in Nursing Homes

Template Letter for Staff Regarding Visitor Ban in Nursing Homes

Template Letter for Visitors to life plan communities

Special Visitor Guidance for life plan communities

Special Visitor Guidance for assisted living communities

Special Visitor Guidance for affordable housing

Special Visitor and Infection Control Guidance for hospice

Template Letter for Visitors to Patients Receiving Home Hospice Services

Template Letter for Visitors to Patients Receiving Home Health Services

Trusted Links & Information

Centers for Disease Control & Prevention (CDC) Resources

World Health Organization (WHO) Resources

Centers for Medicare & Medicaid Services (CMS)

Please note: the following CMS update was released on Friday regarding compliance with nursing home protocols for COVID-19. While this applies to nursing facilities, other long term care providers such as PACE and Adult Day are advised to take similar precautions regarding staff and prepare to possibly suspend services due to the increased risk of community exposure.

CMS Announces New Visitor Restrictions

At 8:52 p.m. on March 13, CMS issued a revised memorandum related to visitor restrictions in nursing homes which is effective immediately.  This was alluded to earlier Friday in a press conference where CMS Administrator Verma shared that visitation would be restricted “to all visitors and non-essential personnel, with a few exceptions, such as end-of-life personnel.” 

New Directive on Visitors

In the new guidance, CMS directs ALL Facilities nationwide to restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as an end-of-life situation. Facilities are expected to communicate through multiple means to inform individuals and nonessential health care personnel of the visitation restrictions, such as through signage at entrances/exits, letters, emails, phone calls, and recorded messages for receiving calls. 

End-of-Life Care Exception

In cases of compassionate/end-of-life care, CMS specifies that visitors will be limited to a specific room only and shall be required to perform hand hygiene and use Personal Protective Equipment (PPE), such as facemasks. Decisions about visitation during an end of life situation should be made on a case by case basis, which should include careful screening of the visitor (including clergy, bereavement counselors, etc.) for fever or respiratory symptoms. Those with symptoms of a respiratory infection (fever, cough, shortness of breath, or sore throat) should not be permitted to enter the facility at any time (even in end-of-life situations). Those visitors that are permitted, must wear a facemask while in the building and restrict their visit to the resident’s room or other location designated by the facility. They should also be reminded to frequently perform hand hygiene and suggest refraining from physical contact with residents and others while in the facility.

Healthcare Workers

Facilities should follow CDC guidelines for restricting access to health care workers which also applies to other health care workers, such as hospice workers, EMS personnel, or dialysis technicians, that provide care to residents. They should be permitted to come into the facility as long as they meet the CDC guidelines for health care workers. Note that the CMS revised visitation guidance seems to have been based on the new CDC guidance released which provides some additional guidance on essential health care personnel as well. 

Surveyors

CMS and state survey agencies are constantly evaluating their surveyors to ensure they don’t pose a transmission risk when entering a facility. For example, surveyors may have been in a facility with COVID-19 cases in the previous 14 days, but because they were wearing PPE effectively per CDC guidelines, they pose a low risk to transmission in the next facility and must be allowed to enter. However, there are circumstances under which surveyors should still not enter, such as if they have a fever.  (Note from article below regarding CMS emergency action that CMS temporarily suspended non-emergency survey inspections)

Other Key Directives from CMS

  • Cancel communal dining and all group activities, such as internal and external group activities.  
  • Screen all staff at the beginning of their shift for fever and respiratory symptoms. Actively take their temperature and document absence of shortness of breath, new or change in cough, and sore throat. If they are ill, have them put on a facemask and self-isolate at home
  • Implement active screening of residents and staff for fever and respiratory symptoms. Remind residents to practice social distancing and perform frequent hand hygiene.
  • Facilities should identify staff that work at multiple facilities (e.g., agency staff, regional or corporate staff, etc.) and actively screen and restrict them appropriately to ensure they do not place individuals in the facility at risk for COVID-19.
  • Residents still have the right to access the Ombudsman program. Their access should be restricted except in compassionate care situations, however, facilities may review this on a case by case basis. If in-person access is not available due to infection control concerns, facilities need to facilitate resident communication (by phone or other format) with the Ombudsman program or any other entity listed in 42 CFR § 483.10(f)(4)(i).
  • Advise visitors, and any individuals who entered the facility (e.g., hospice staff), to monitor for signs and symptoms of respiratory infection for at least 14 days after exiting the facility. If symptoms occur, advise them to self-isolate at home, contact their healthcare provider, and immediately notify the facility of the date they were in the facility, the individuals they were in contact with, and the locations within the facility they visited. Facilities should immediately screen the individuals of reported contact, and take all necessary actions based on findings.

Members are encouraged to review the revised memorandum and CDC added recommendations for infection control practices in nursing homes when planning to implement these changes. 

Sample letters based on the new restrictions and communication templates for the new restrictions:

Family Sample Letter

Resident Sample Letter 

President Declares National Emergency; CMS Announces Emergency Actions

President Trump declared a National Emergency due to COVID-19.  The declaration of a national emergency grants federal agencies powers to waive provisions of the law to free providers and others to act to address the emergency at hand. 

CMS announced that for the first time since 2009 they will issue 1135 waivers nationally to rapidly expand efforts against COVID-19.  Section 1135 waivers authorize the Secretary to waive certain Medicare and Medicaid waivers.  In a conference call this evening, CMS explained that the Medicare waivers will be issued nationally, while the Medicaid waivers will require state action to request.  Examples of flexibilities available to states under section 1135 waivers include the ability to permit out-of-state providers to render services, temporarily suspend certain provider enrollment and revalidation requirements to promote access to care, allow providers to provide care in alternative settings, waive prior authorization requirements, and temporarily suspend certain pre-admission and annual screenings for nursing home residents.

The national blanket waivers include: 

  • Waiver of the 3-day Stay Requirement for Skilled Nursing Facilities– CMS is waiving the requirement at Section 1812(f) of the Social Security Act for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF) stay provides temporary emergency coverage of (SNF services without a qualifying hospital stay, for those people who need to be transferred as a result of the effect of a disaster or emergency.
  • Extension of Skilled Nursing Facility Benefits-For certain beneficiaries who recently exhausted their SNF benefits, the waiver authorizes renewed SNF coverage without first having to start a new benefit period. Second,
  • Waiver of the MDS Timeframe-CMS is waiving 42 CFR 483.20 to provides relief to SNFs on the timeframe requirements for Minimum Data Set assessments and transmission.
  • Durable Medical Equipment-Where Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) is lost, destroyed, irreparably damaged, or otherwise rendered unusable, contractors have the flexibility to waive replacements requirements such that the face-to-face requirement, a new physician’s order, and new medical necessity documentation are not required. Suppliers must still include a narrative description on the claim explaining the reason why the equipment must be replaced and are reminded to maintain documentation indicating that the DMEPOS was lost, destroyed, irreparably damaged or otherwise rendered unusable or unavailable as a result of the emergency.
  • Home Health Agencies-Provides relief to Home Health Agencies on the timeframes related to OASIS Transmission. Allows Medicare Administrative Contractors to extend the auto-cancellation date of Requests for Anticipated Payment (RAPs) during emergencies.
  • Provider Locations-Temporarily waive requirements that out-of-state providers be licensed in the state where they are providing services when they are licensed in another state. This applies to Medicare and Medicaid.
  • Provider Locations-Temporarily waive requirements that out-of-state providers be licensed in the state where they are providing services when they are licensed in another state. This applies to Medicare and Medicaid.
  • Provider Enrollment-Establishes a toll-free hotline for non-certified Part B suppliers, physicians and nonphysician practitioners to enroll and receive temporary Medicare billing privileges and waives the application fee, criminal background checks associated with FCBS, and site visits.  Also allows licensed providers to render services outside of their state of enrollment and expedites any pending or new applications from providers.
  • Medicare Appeals in Fee for Service, MA and Part D– Extension to file an appeal, waive timeliness for requests for additional information to adjudicate the appeal, processing the appeal even with incomplete Appointment of Representation forms but communicating only to the beneficiary, processing requests for appeal that don’t meet the required elements using information that is available, and utilizing all flexibilities available in the appeal process as if good cause requirements are satisfied.

In addition to the waivers, CMS announced that they will temporarily suspend non-emergency survey inspections to allow providers to focus on the most current serious health and safety threats, like infectious disease and abuse. 

CDC Issues New Guidance for Infection Control

The CDC added recommendations for infection control practices in nursing homes to their website.  The guidance was clearly the basis for CMS’ new visitor restriction policy but also includes other useful information.  The CDC states that these recommendations are specific for nursing homes, including skilled nursing facilities, but that much of this information could also be applied in assisted living facilities. This information complements, but does not replace, the general infection prevention and control recommendations for COVID-19.  

To support members with the new CDC guidance, Infection Control Policy Template (with tracked changes) to include the vast number of updates from the CDC related to resident and employee screening and recommended visitor restrictions. The CDC has developed a website for COVID-19 preparedness specific to nursing homes to include a preparedness checklist and updated guidance and information 

LeadingAge Releases New Crisis Communication Tools

Understanding that your job is to care for people, LeadingAge has created some tips on working with the media in wake of COVID-19.  They have also provided a template for a media statement in case the virus makes it onto your campus. 

 

March 11, 2020

Revised CMS Guidance for Infection Control and Prevention in Nursing Homes (QSO-20-14-NH-Revised) 

Summary of CMS Guidance for Nursing Home Visitation 

Below, find sample letters shared from LeadingAge Iowa. Customize these as you see fit. 

Sample Communication Templates for Counties Affected or Adjacent To 
Sample Resident Letter  
Sample Family Letter 
Sample Staff Letter  
Sample Visitor Vendor Notice
Template Press Release

 

Sample Communication Templates for Counties Not Affected or Adjacent To  
Sample Resident Letter  
Sample Family Letter 
Sample Staff Letter  
Sample Visitor Vendor Notice 
Template Press Release  

 

March 6, 2020

This week, CMS disseminated 3 memos aimed at limiting the spread of the Novel Coronavirus 2019 (COVID-19). Read the press release and memos:

Suspension of Survey Activities

Guidance for Infection Control and Prevention Concerning Coronavirus Disease (COVID-19): FAQs and Considerations for Patient Triage, Placement and Hospital Discharge

Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes

In response, LeadingAge issued this press statement.

a letter to Vice President Pence about lack of guidance from HUD for predominantly older adult HUD-assisted communities.

LeadingAge Sample Media Talking Points

LeadingAge Sample Media Statement

LeadingAge Sample Letter to Employees

LeadingAge Sample Letter to Residents and Families

Pathway Health COVID-19 FREE Toolkit

Leadership Preparation Strategies

Infection Prevention and Control Manual

Resource list

CDC clearinghouse for coronavirus information.

 

March 2, 2020

CDC Information on Coronavirus Disease 2019

World Health Organization Coronavirus Disease Outbreak

CDC Information for Healthcare Professionals

Affordable Housing Providers and the Coronavirus

By The Numbers: A Coronavirus Wake Up Call

 

February 27, 2020

LeadingAge Update

https://leadingage.org/caregiving-resources/coronavirus-time-calm-preparedness-now?fbclid=IwAR3N6dj3Rot7cNR4N-Pt3al44v4y8qLKiLYs_oLjTSWrO3jm_wI86zCO2Fc

CDC Update

The following links to the CDC website provide additional information about the transmission, symptoms, prevention/treatment, and what to do if you or someone you know is sick with the virus:

https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html

https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html

https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html

https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html

CMS Update

CMS Issues Reminder of Infection Control Practices Due to Coronavirus
As concerns arise with the emerging 2019 Novel Coronavirus (COVID19) threat, the Centers for Medicare & Medicaid Services (CMS) is encouraging all healthcare settings to carefully review information provided by the U.S. Centers for Disease Control and Prevention (CDC). 
Because coronavirus infections can rapidly appear and spread, CMS states in a February 6 memorandum to state survey agencies, settings must take steps to prepare, including reviewing their infection control policies and practices to prevent the spread of infection.  The CMS memo emphasizes advance preparation by facilities through self-assessment and review of infection control practices and strongly encourages facilities to note the following:

  • CDC issued a Health Update February 1, with a link to updated infection prevention and control guidance specific to COVID19.
  • CMS recognized the need to consider “emerging infectious diseases” in a provider’s emergency preparedness plans.
  • To ensure health and safety, CMS expects healthcare staff and surveyors (contractors, federal, state, and local) to comply with basic infection control practices.
  • Healthcare settings should review appropriate personal protective equipment use and availability, such as gloves, gowns, respirators, and eye protection.

To assist with self-assessment and review of your community’s own practices, CMS provides links to several resources, including online courses developed in conjunction with CDC focusing on universal infection control practices.

Members should also review infection control practices in relation to COVID19 and be prepared to address questions from DIA about the steps you took should it arise during survey. 
Link A
Link B

OSDH Update

Because guests, vendors, staff, and families travel, it is important to be aware of travel guidelines in case you need to implement a policy to restrict visitation for a specified period of time for anyone who has traveled outside of the US.

Health Officials Update Travel Advisories for COVID-19

In effort to update the public on the evolving global outbreak of Coronavirus Disease 2019 (COVID-19), the Oklahoma State Department of Health (OSDH) is advising the public of new travel advisories issued due to community spread of the virus in Japan, South Korea, Hong Kong, Iran and Italy. 

The Centers for Disease Control and Prevention (CDC) is recommending travelers avoid all nonessential travel to China and South Korea. Additionally, they issued an alert advising older adults and those with chronic medical conditions to consider postponing nonessential travel to Japan, Iran and Italy. The CDC also recommends all travelers reconsider cruise ship voyages to or within Asia.

OSDH State Epidemiologist Laurence Burnsed said it’s important for the public to monitor travel advisories, especially if traveling internationally.

“As public health officials, our goal is to reduce the risk of contracting the virus and returning to the United States after traveling to a destination where the virus is being spread from person-to-person,” said Burnsed. “The immediate health risk to the general American public is still low.”

As the global outbreak continues to evolve, travelers should consider travel insurance in the event their international destination becomes an area with community spread of the virus. At this time, the CDC does not recommend canceling travel to Hong Kong. However, travelers should practice the usual precautions of washing hands frequently, avoiding people who are sick and avoiding touching their eyes, nose and mouth with unwashed hands.

There are no confirmed cases of COVID-19 in Oklahoma. The OSDH continues to work with local, county, state and federal partners to monitor travelers who return to Oklahoma from China. Travelers are contacted by health officials and monitored daily for 14 days following their departure from China.

At this time, there is no vaccine and no cure for the virus. Commissioner of Health Gary Cox said officials are actively working health care providers, medical facilities, hospitals and other relevant partners to prepare them for assessment, testing and treatment of a patient who is showing signs and symptoms after travel to an affected area.

If the United States experiences high rates of community spread, nonpharmaceutical interventions such as avoiding social interaction at school and work will be the best way to prevent spread of the virus. These interventions have the potential to disrupt daily activities for schools, businesses and families. It is important for families and organizations to begin preparedness efforts such as considering sick leave and implementing capabilities for distance learning and telework.

As the COVID-19 situation evolves, the countries impacted are likely to change. To monitor travel advisories and other updates associated with COVID-19 visit the OSDH link to coronavirus updates.