Important Updates and Resources for Long Term Care Providers

COVID-19

COVID-19 Updates, Preparation and Resources

We are closely monitoring the news and guidance concerning COVID-19 and are working with the Governor’s office, the Indiana State Department of Health and AHCA/NCAL, to ensure our member providers receive the necessary guidance to care for the most vulnerable Hoosiers during this public health emergency. Visit this webpage daily to access the latest updates.

May 26: Nursing Facility Staff COVID-19 Testing FAQ

The federal Centers for Medicare and Medicaid Services (CMS) recently issued Nursing Home Reopening Recommendations for State and Local Officials that contemplate nursing facility staff being tested on a weekly basis.  IHCA/INCAL has engaged the Indiana State Department of Health (ISDH) to understand what guidelines or requirements, if any, will be issued in response to the federal guidance.

CONTINUE READING HERE

 

May 26: NHSN Reporting Update and FAQs

As a reminder, nursing facilities were required to submit their first set of data to NHSN by 11:59 pm on May 17, 2020, to be compliant with the Interim Final Rule, a summary of which can be found here. Nursing facilities may choose to report more frequently, but must report at least once every seven (7) days.

CONTINUE READING HERE

 

May 26: Revised OSHA COVID-19 Policies

The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has adopted revised policies for enforcing OSHA’s COVID-19 requirements, which are effective as of May 26, 2020.

As outlined in the updated memorandum, OSHA is increasing in-person inspections at all types of workplaces.  In geographic areas with sustained elevated community transmission or a resurgence, OSHA will prioritize on-site inspections for high-risk workplaces, such as health care providers treating patients with COVID-19.

CONTINUE READING HERE

 

May 26: CARES Attestation Window Extended

On May 22, 2020, the U.S. Department of Health and Human Services (HHS) extended the CARES Act Provider Relief Fund attestation window.  Providers now have 90 days, rather than 45, from the date a provider received a payment to attest to and accept the Terms and Conditions or return the funds.  The Terms and Conditions can be found here, and HHS’s full press statement can be found here.

CONTINUE READING HERE

 

May 21: Division of Aging’s Survey on Availability of Technology to Promote Social Connectivity

We invite to you participate in the Availability of Technology to Promote Social Connectivity Survey on behalf of the Division of Aging. The purpose of this survey is to further explore the utilization of technology within facilities and to help the Indiana FSSA identify opportunities and potential solutions to address social isolation and to better enable meaningful interaction among staff, residents and loved ones. We encourage facilities to respond to this survey no later than June 1, 2020.

TAKE THE SURVEY

 

 

May 19: CMS Nursing Home Reopening Recommendations and AHCA Memorandum on COVID-19 Testing in LTCFs

On May 18, 2020, the federal Centers for Medicare and Medicaid Services (CMS) issued a memorandum on Nursing Home Reopening Recommendations for State and Local Officials.  The CMS memo provides a phased-in approach for the reopening of nursing facilities and, of note, recommends weekly testing for staff.  The CMS memo also recommends twenty-eight (28) days having passed since the onset of any new COVID-19 cases before visitation would be allowed in nursing facilities.

IHCA/INCAL is encouraged by CMS discussing how nursing facilities may open up again, but the CMS memo is only guidance at this time.  Indiana has not altered its own reopening guidance for long-term care facilities and has not issued any guidance on resident or staff testing.

CONTINUE READING HERE

 

 

May 18: ISDH Asks Nursing Homes for Feedback on Testing of Staff

The Indiana State Department of Health (ISDH) sent out a survey on May 18, asking nursing facilities for information on how they could accomplish COVID-19 testing of all staff in a two week period.  The effort is to collect information from facilities to attempt assembly of a more comprehensive and sustained testing strategy.

ISDH is asking each skilled nursing facility to complete the survey by close of business on May 20, 2020.

ACCESS SURVEY  CONTINUE READING

 

 

May 18: Updated COVID-19 Specimen Collection and Submission Guidelines

On May 18, 2020, the Indiana State Department of Health (ISDH) updated its guidance regarding COVID-19 specimen collection and submission.  If a long-term care facility would like to submit a specimen to the ISDH for testing, the ISDH requires all COVID-19 test requisitions to be submitted through its Laboratory Information Management System (LimsNet).  Through LimsNet, the specimen will be directed to be sent to the ISDH’s laboratory or Eli Lilly & Company.

CONTINUE READING HERE

 

 

 

May 18: Updated ISDH Strategies for Memory Care Units

On May 18, 2020, the Indiana State Department of Health (ISDH) updated its strategies for managing COVID-19 in memory care units, providing clarification on the use of outside caregivers and offering additional strategies for those memory care residents who are moved due to COVID-related cohorting.

Previous guidance stated that care in memory care units could be provided by family, volunteers, or staff.

CONTINUE READING HERE

 

May 18: Equal Employment Opportunity Commission COVID-19 Testing Guidance

Throughout the COVID-19 pandemic, long-term care employers may seek to test employees for COVID-19 prior to employment, at regular intervals during employment, and/or at the onset of any illness.  The federal Equal Employment Opportunity Commission’s (EEOC) “Pandemic Preparedness in the Workplace and the Americans with Disabilities Act” guidance is a helpful resource and was recently updated in light of the current public health emergency.  The entirety of the EEOC’s guidance can be found here and sets forth three different employment scenarios before a medical examination, including a test, may be conducted.

CONTINUE READING HERE

 

May 18: Updated Long Term Care Facility Toolkit with Communication, Memory Care and Hospital Discharge Guidance Guidelines

 

 

May 15: New Temporary Rate Increases for COVID-19 Ready Units and COVID-19 Positive Residents in Nursing Facilities

The Office of Medicaid Policy and Planning (OMPP) recently announced two new temporary rate adjustments related to COVID-19:

  • A temporary 2% enhanced reimbursement rate for nursing facilities (NFs) that attest they are “COVID-19 Ready” and comply with a list of requirements established by the Indiana State Department of Health (ISDH).
    • Click here for the attestation statement and list of requirements to qualify as COVID-19 Ready

CONTINUE READING HERE

 

 

May 13: Guidance on Aerosolizing Respiratory Treatments in LTCFs

On May 12, 2020, the Indiana State Department of Health (ISDH) issued a document providing guidance on mitigating the use of aerosolizing respiratory treatments in long-term care facilities to minimize the risk of COVID-19 transmission, including the administration of inhaled medications via nebulizer therapy and noninvasive airway support via C-PAP and Bi-PAP.

The current recommended best practice is to shift to the use of Metered-Dose Inhalers, as opposed to nebulized treatments, for all long-term care residents, as applicable, in consultation with the resident’s medical provider.

CONTINUE READING HERE

 

 

May 13: APIC Indiana Long-Term Care COVID-19 Networking and Open Forum Sessions

Indiana’s Association for Professionals in Infection Control and Epidemiology (APIC), in partnership with Jennifer Spivey at the ISDH, will be conducting Long-Term Care COVID-19 Networking and Open Forum Sessions every Friday through June 26, 2020 from 12 – 1 PM EST.  More about these sessions, including information on to participate, can be found here.

 

May 13: New Weekly Transfer Form for Local Ombudsman

ISDH’s Communication Guidelines for long term-care facilities requires facilities to complete a Weekly Transfer Form detailing the transfer of COVID-19 residents to other long-term care facilities (not hospitals) and email it the local ombudsman every Friday.  On May 12, 2020, the ISDH issued a new Weekly Transfer Form, which requests the number of COVID-19 cases and deaths at the facility.  IHCA/INCAL is seeking guidance on whether the total number or new weekly number of COVID-19 cases and deaths is being requested, as well as how this information will be utilized.

 

 

May 12: SURVEY – Availability of COVID-19 Tests in SNF and AL

AHCA/NCAL is seeking feedback from members on COVID-19 test availability and use in both skilled nursing and assisted living settings. Information from this survey will help identify challenges and advocate for more availability and clearer guidance on how testing should be used and reimbursed on a national level.

Please take a few minutes to complete the survey by Wednesday, May 13 (11:59 PM EDT). 

You may have seen that the White House reportedly told state governors yesterday that they were issuing a recommendation to test all nursing home residents and staff for COVID-19 over the next two weeks. This is not an order from the federal government and as of now, no specific written recommendation has been made.

Please review AHCA/NCAL’s most recent COVID-19 member update and AHCA/NCAL’s updated testing guidance for more information.

TAKE THE SURVEY

 

 

May 11: ISDH Issues “Back on Track” Answers for LTCs

On May 11, 2020, the Indiana State Department of Health (ISDH) provided clarification regarding several questions on the end of Indiana’s Stay at Home Order and the impact on long-term care facilities, including nursing homes, residential care facilities, and assisted living communities.  The entirety of the ISDH guidance can be found here.  A key takeaway from the ISDH document is that individuals are not permitted to visit nursing homes, residential care facilities, or assisted living communities through July 4, 2020, except for end-of-life care.  On or before July 4, 2020, guidance to long-term care facilities regarding visitation will be reevaluated.

READ MORE

 

May 11: Additional COVID-19 Emergency Declaration Waivers for Nursing Facilities

On May 11, 2020, the federal Centers for Medicare and Medicaid Services (CMS) issued additional COVID-19 Emergency Declaration Waivers for Health Care Providers with a retroactive effective date of March 1, 2020, for the duration of the public health emergency.  Specific to nursing facilities and skilled nursing facilities, CMS modified the minimum training requirements for paid feeding assistants and certain Life Safety Code provisions.

READ MORE

 

 

May 11: N95 Decontamination with Battelle – Enrollment Information

The ISDH has partnered with Battelle Critical Care Decontamination System to decontaminate N95 respirators during the public health emergency.  Each N95 respirator may be processed up to twenty (20) times, and the service is free of charge for health care facilities.  Interested facilities can visit www.battelle.com/decon to enroll, and more about Battelle’s registration and decontamination process can be found here.  Specific instructions for health care facilities, including instructions on how to submit used N95 respirators, can be found here.

 

 

May 11: NHSN: Accurately Report Staffing & PPE Shortages

As a reminder, nursing homes must submit their first set of COVID-19 data to the CDC by 11:59 PM on Sunday, May 17, 2020, using the NHSN Long-Term Care Facility COVID-19 Module.  AHCA/NCAL has compiled the following guidance regarding how nursing homes should respond to questions on staffing and PPE.

READ MORE

 

May 11: Hospital to Post-Acute Care Transfer COVID-19 Assessment Form

ACCESS HERE

May 8: Fire Safety Considerations for Hand Sanitizers

READ MORE

 

ACCESS ARCHIVE UPDATES

ISDH Updates & Guidance

May 18: Updated Long Term Care Facility Toolkit with Communication, Memory Care and Hospital Discharge Guidance Guidelines

May 18: Updated COVID-19 Specimen Collection and Submission Guidelines

May 18: Updated ISDH Strategies for Memory Care Units

May 13: Guidance on Aerosolizing Respiratory Treatments in LTCFs

May 11: ISDH Issues “Back on Track” Answers for LTCs

May 11: Hospital to Post-Acute Care Transfer COVID-19 Assessment Form

May 10: COVID-19 Testing Strategies

May 8: ISDH Communication Guidelines to Inform Residents & Designated Representatives of COVID-19 Info & Compliance with CMS Reporting Regulations

May 7: Updated ISDH COVID-19 Guidance for Hospital Discharge to Long Term Care Facilities

May 6: COVID-19 Waivers, Guidance, and Emergency Orders for Residential Care Facilities from ISDH

May 6: COVID-19 Emergency Orders and Waivers for Comprehensive Care Facilities from ISDH

May 6: Updated ISDH COVID-19 LTC Facility Infection Control Guidance and SOP

April 29: Comprehensive COVID-19 Information for Long-Term Care Facilities

April 29: Indiana COVID-19 Testing Sites

April 23: Instructions for RedCap Survey and Invalid Codes

April 20: Fifth Blanket Waiver for Residential Care Facilities and Additional Temporary Nurse Aide Guidance

ACCESS COMPARISON CHART: PCA VS AHCA’S NURSE AIDE

April 18: ISDH approves AHCA Temporary Nurse Aide Program

April 18: ISDH Issues Additional CNA Flexibilities

April 17: New RedCap Survey for COVID-19 Reporting – Effective Monday, April 20, 2020

April 17: ISDH Guidance on Family Visitation for End-of-Life Care

April 14: State Health Commissioner Order on the Relocation of LTCF Residents

April 13: ISDH Issues PPE Request Guidance

April 10: ISDH Provides Guidance on COVID-19 Considerations for Weather Watches and Warnings

April 10: Indiana Health Care Workforce Needs Request Form

April 8: State Requirements and Guidance For Creating Dedicated COVID-19 Long Term Care Facilities

April 8: Personal Care Attendants Ages Sixteen (16) and Seventeen (17) to Continue Indefinitely

April 6: ISDH Issues Professional Liability Guidance

April 2: Fourth ISDH Blanket Waiver for Residential Care Facilities

April 2: Fifth ISDH Blanket Waiver for Comprehensive Care Facilities

April 2: ISDH Emergency Orders Permitting Minors Age 16 and 17 to Serve as Personal Care Attendants

April 2: ISDH COVID-19 LTC Facility Infection Control Guidance and SOP (UPDATED VERSION)

March 28: ISDH Issues 4th Waiver of Comprehensive Care

March 23, 2020: Commissioner Box Letter Updating Mask Guidance, PPE and Testing

March 23, 2020: ISDH Issue Regulatory Waivers for Nursing Home and Residential Care Facility Operations

March 22, 2020: ISDH Issues Guidance on Volunatry Leaves of Absence 

March 21, 2020: ISDH Approves Temporary COVID-19 Person Care Attendant Eight Hour Course

March 20, 2020: ISDH Requests LTC Workers Use Masks

March 20, 2020: Letter from State Health Commissioner to Indiana Long Term Care Faciliries on COVID-19 Testing

March 20, 2020: ISDH Changes Certain TB Testing Requirements

March 19, 2020: ISDH Addresses “LTC Strike Teams” in lie of Regulatory Surveys

March 19, 2020: ISDH Strategies for Optimizing N95 Supply

March 18, 2020: ISDH COVID-19 Checklist for Healthcare Professionals

March 17, 2020: ISDH Guidance for Out-Of-Hospital Mitigation Strategies

March 17, 2020: Area Agencies on Aging Guidance from Division of Aging

March 14, 2020: ISDH Issues Revised Guidance for Visitation

Weekly Webinars

ISDH Webinar For Long Term Care Facilities with Dr. Dan Rusyniak 

Join Dr. Rusyniak for this weekly webinar where he will share latest information on COVID-19 and provide important updates for long term care providers. These webinars are also a great platform for member providers to offer feedback and ask questions to the ISDH.  These webinars are complimentary and are available to all long term care providers of Indiana.

When: Every Thursday from 12- 1 p.m. EST

 

[UPCOMING WEBINAR] May 28: ISDH Webinar For Long Term Care Facilities

LEARN MORE

 

May 21: ISDH Webinar For Long Term Care Facilities

ACCESS WEBINAR RECORDING ACCESS WEBINAR HANDOUT

 

May 14: ISDH Webinar For Long Term Care Facilities

ACCESS WEBINAR RECORDING ACCESS WEBINAR HANDOUT

 

May 7: ISDH Webinar For Long Term Care Facilities

ACCESS WEBINAR RECORDING ACCESS WEBINAR HANDOUT

 

April 30: ISDH Webinar For Long Term Care Facilities

ACCESS WEBINAR RECORDING ACCESS WEBINAR HANDOUT

 

April 23: ISDH Webinar For Long Term Care Facilities

ACCESS WEBINAR RECORDING ACCESS WEBINAR HANDOUT

 

April 16:  ISDH Webinar For Long Term Care Facilities

ACCESS WEBINAR RECORDING  ACCESS WEBINAR HANDOUT

 

April 9: ISDH Webinar For Long Term Care Facilities

ACCESS WEBINAR RECORDING   ACCESS WEBINAR HANDOUT

 

EMResource

EMResource – ISDH’s COVID-19 PPE Inventory Tracking Tool

EMResource is a web-based resource management and communication tool used to monitor and notify changes in resources statuses. ISDH is asking you to update your PPE supplies daily in this tool so that resources can be distributed efficiently.

ISDH will be adding all the statewide skilled nursing facilities to their EMResource database. Once added, each facility will provide a daily upload of their current PPE stores. The ISDH is asking long term care facilities to register to use EMResource.

Here are two helpful resources:

WATCH THIS VIDEO

DOWNLOAD USER MANUAL

Please request your login from ISDH to be able to begin updating your information on PPE supplies:

LOGIN REQUEST – CLICK HERE

WEBSITE LOGIN – CLICK HERE

CMS

CMS Guidance | IHCA/INCAL & AHCA/NCAL Guidance Summaries

CMS Resources

Focused COVID-19 Infection Control Survey Tool: Federal and state surveyors will conduct targeted infection control surveys of providers identified together with CDC and the HHS Assistant Secretary for Preparedness and Response (ASPR). They will use this survey tool to review infection prevention and control practices.

Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit: CMS has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. This document contains electronic links to reliable sources of information regarding telehealth and telemedicine, including the significant changes made by CMS in response to the National Health Emergency.  Most of the information is directed towards providers who may want to establish a permanent telemedicine program, but there is information here that will help in the temporary deployment of a telemedicine program as well.

 

 

CDC

CDC Guidance

CDC Resources

State News

Temporary Aide Programs

The ISDH has approved two temporary aide programs for both skilled nursing and residential care facilities to use during the public health emergency:

  • AHCA/NCAL Temporary Nurse Aide
  • Temporary Personal Care Attendant

Both programs are active and both can be used. Details about each individual course and related training providers are noted in the sidebar at left.

ACCESS COMPARISON CHART: PCA PROGRAM VS AHCA’S NURSE AIDE PROGRAM

AHCA Temporary Nurse Aide Program

On April 18, 2020, the Indiana State Department of Health (ISDH) issued a Sixth Emergency Order for Comprehensive Care Facilities that adds the AHCA Temporary Nurse Aide program as an option for training individuals to assist with patient care during the public health emergency.  This is additive to the currently approved Personal Care Attendant program.

The AHCA program is an 8-hour fully online program and resources for this program are:

  • AHCA Temporary Nurse Aide Program website
  • AHCA Temporary Nurse Aide competency checklist
    • Note – while ISDH has waived certain part of state regulation for CNA training, state and federal regulations still requires facilities to ensure nurse aides can demonstrate competency (42 CFR 483.35(c).  This checklist must be used and in the TNA’s employee file.  This checklist does not have to be performed by an ISDH-certified Nurse Aide Program Instructor and can be performed by any qualified person (such as an RN or LPN)

This approval is additive to the Personal Care Attendant program previously approved, but contains some key differences. Both programs are active and both can be used.

ACCESS COMPARISON CHART: PCA PROGRAM VS AHCA’S NURSE AIDE PROGRAM

 

Temporary Personal Care Attendant

The COVID-19 Personal Care Attendant (PCA) Course permits comprehensive care facilities (nursing homes) to employ a trained Personal Care Attendant to perform defined resident care procedures that do not require the skill or training required for a Certified Nurse Aide (CNA).

  • The Indiana State Department of Health’s March 21, 2020 “Emergency Order Authorizing Temporary Personal Care Attendant Positions and Training for Nursing Homes” (“First PCA Order”) is AMENDED as follows:
    • Effective March 16, 2020 through May 1, 2020, minors age 16 and 17 are also eligible for training and work as Personal Care Attendants (“PCAs”). 
  • Please note that ANY NATCEP training waiver prohibition of training is being waived for this course, so if your facility is currently not able to provide formal CNA training, that facility CAN train this temporary PCA role, but as this is currently written, the trainer must be a nurse who has completed an ISDH-approved training program as outlined in the NATCEP administrative standards.
  • Access the related COVID-19 Personal Care Attendant Simulation/Competency Check-Off 
  • Access the PCA PROCEDURE CARD developed by ISDH to assist the PCA and other staff in identifying the procedures the PCA is trained to perform.
  • The ISDH Division of Long Term Care and the Nurse Aide Registry is requesting that following the successful completion of PCA training, the spreadsheet linked below to be used to submit the new PCAs name to the registry.  The spreadsheet should then be emailed to: aides@isdh.in.gov  To access the spreadsheet, please click here and look for Personal Care Attendant section.
  • The temporary PCA role is available to both nursing facilities and residential care facilities (March 23).

External PCA Training Options

  • Ivy Tech Community College is providing, free of charge to facilities, the five- (5) hour didactic portion of the PCA class. This class will be taught virtually using Zoom by an Ivy Tech CNA Program Director. After completion of the class, the candidate will perform the three (3) hours of skills training at their facility with qualified facility staff.
    • Classes are taught twice daily on weekdays with offerings from 8 a.m. – 1 p.m. OR 1 p.m. – 6 p.m.
    • Content is meant to be delivered to the facility where the PCA is employed and is not intended for the PCA to participate independently.
    • Learn more and register here.
  • Associate member Senior1Care, under their Legacy CNA training arm, is also providing two in-person PCA training programs at their Mishawaka and Noblesville locations. Details here:

 

Indiana's Caring Heroes PCA Recruitment Program

As part of the newly launched Indiana’s Caring Heroes Program, IHCA/INCAL has temporarily retooled its Indiana.carefortheaging.org platform to assist members with the recruitment of the Temporary Personal Care Attendant (PCA). As of April 19, IHCA/INCAL is currently working to update the Indiana’s Caring Heroes program to include details for both the PCA and Temporary Nurse Aide roles.

ACCESS MEMBER TOOLKIT

DOWNLOAD PROMOTIONAL VIDEO

 

PPE

Using and Conserving PPE

FEMA COVID-19 Pandemic Response: Nursing Home PPE Packages

The Indiana State Department of Health has shared information regarding a FEMA program that will distribute masks, gloves, eye protection and gowns to Medicare/Medicaid certified nursing facilities across the country.  The shipments are from first week of May to mid-June and done in order of COVID hot spots.

[May 2, 2020] FEMA Fact Sheet

[May 2, 2020] FEMA Advisory

[Spreadsheet] Indiana LTC Facilities – PPE Push

[April 24, 2020] FEMA Talking Points & FAQs

 

OSHA

Vendors

 

 

Communication Resources

IHCA/INCAL Contact: Deeksha Kapoor | dkapoor@ihca.org

Communication Templates and Guidance

Early preparations, speed and accuracy of information is essential to managing an urgent situation. Refer to these resources and put together a communications plan for all stakeholders including employees, clinical staff, residents, families etc.

CARENOTCOVID.COM

This has been a challenging time for everyone: staff, residents and their loved ones. We know many of you are going to extraordinary lengths to keep your residents safe from this virus, as well as help keep them engaged while they’re unable to visit with family members, volunteers, and even each other due to social distancing. With many individuals now staying home, we thought this would be a good opportunity for members of the public to send some messages of support to our residents.

AHCA/NCAL has released www.carenotcovid.com to make it easy for anyone to send a video message to our seniors and individuals with disabilities. They are collecting stories from around the internet, so everyone can feel uplifted and inspired to chip in where they can. Whether it’s encouraging donations of hand sanitizer to your local facility, or asking children (who are at home while schools are closed) to create a homemade card, we hope you’ll show your residents www.carenotcovid.com every day to let them know that we’re all thinking about them.

Reimbursement Resources

IHCA/INCAL Contact: Elizabeth Eichhorn |  eechhorn@ihca.org.

REIMBURSEMENT RESOURCES & UPDATES

 

April 27: AHCA/NCAL Grant & Loan Management Resource Guide

April 27: COVID-19 Related Loss and Cost Calculator

April 27: Updated – Accelerated and Advance Payments FAQs

 

April 24:

The Office of Medicaid Policy and Planning (OMPP) has asked IHCA to remind nursing facilities that when requesting non-emergency medical transport (NEMT) for members, to indicate if your resident is confirmed COVID positive, has had direct exposure, or is symptomatic. This notification allows transportation providers to send the appropriate vehicle and for its drivers to have the appropriate PPE to keep everyone safe.   OMPP reports some recent cases where transportation providers were not informed of a COVID positive resident.  The drives arrived without the proper protection  and were exposed to the virus.  In these situations, the drivers must self-isolate for 14 days and cannot transport.  If drivers continue to be put at risk, the network capacity will diminish, and it will be difficult to find transportation for residents.  You can find instructions  from SET on COVID positive transport here

In order to incentivize Emergency Medical Services (EMS) providers to transport COVID positive individuals, OMPP published this Bulletin, which states that EMS providers will be reimbursed at a minimum basic life support (BLS) rate when transporting members that are COVID-19 positive or symptomatic. The effective date of this rate change is March 1, 2020 and continues until the end of the national emergency.

April 22: AHCA Skilled SNF Coverage Decisions Under COVID-19 Waivers Flowcharts

April 2, 2020: MDS Isolation Coding Guidance Remains Unchanged

Members have been asking if CMS has made any changes to the MDS coding guidance associated with item O0100M – Isolation for active infectious disease (does not include standard precautions) located in Chapter 3 of the MDS 3.0 RAI Manual v 1.17.1 October 2019 . Below is an excerpt from the current coding requirements describing the four specific conditions that must be met to check the O0100M item box for the presence of isolation for active infectious disease.

Code for “single room isolation” only when all of the following conditions are met:

  1. The resident has active infection with highly transmissible or epidemiologically significant pathogens that have been acquired by physical contact or airborne or droplet transmission.
  2. Precautions are over and above standard precautions. That is, transmission-based precautions (contact, droplet, and/or airborne) must be in effect.
  3. The resident is in a room alone because of active infection and cannot have a roommate. This means that the resident must be in the room alone and not cohorted with a roommate regardless of whether the roommate has a similar active infection that requires isolation.
  4. The resident must remain in his/her room. This requires that all services be brought to the resident (e.g. rehabilitation, activities, dining, etc.).

In a recent email received from CMS the Agency indicates that providers should continue to code residents for the O0100M isolation item per current MDS-RAI manual instructions

We recognize that many providers have applied recent CMS and CDC guidance and 1135 waivers during the COVID-19 emergency and have sometimes cohorted beneficiaries in the same isolation room when the residents have tested positive for COVID-19 or are presumed to be positive. We also recognize that with respect to payment models including PDPM, State case-mix, and Medicare Advantage, the current inability to code for isolation in situations where residents were required to be cohorted into the same room may result in a lower payment rate. CMS is aware of this concern. AHCA will share updates as they become available.

April 2, 2020: CMS Updates PDPM ICD-10 Mappings for New COVID-19 Diagnosis Code

CMS has responded to member concerns that the ICD-10-CM diagnosis codes identified by the CDC as appropriate to code for COVID-19 were not compatible with the Medicare Part A SNF PPS PDPM payment model. Specifically, none of the CDC identified codes could be used to represent the Primary Reason for SNF Stay on the MDS assessment Item I0020B.

On March 31, CMS posted an updated FY 2020 PDPM ICD-10 Mappings file (.zip) which adds the ICD-10-CMS code ‘U07.1 – 2019-nCoV acute respiratory disease’ as an appropriate code to enter in the MDS I0020B Primary reason for SNF stay item field. If entered, this code will map to the PDPM ‘Pulmonary’ default clinical category used for the PT, OT, and SLP components. This new code does not impact the PDPM Nursing or NTA component classifications at present.

This new code U07.1 is ONLY in effect for assessments with target date April 1, 2020 and later. For assessments with an assessment reference date March 31, 2019 or earlier, providers will need to enter the most appropriate ICD-10 code available that is not listed as a ‘return to provider’ code in the MDS I0020B item field.

Additional files related to coding specifications necessary for software companies to implement this change are located on the MDS 3.0 Technical Information webpage. Providers do not need to review these files but should check with their MDS software vendors to confirm when these updated have been applied or you will see a ‘return to provider’ error in your MDS software

April 2, 2020: CMS Suspends Most Medicare Dee-For-Service Medical Review

CMS released a COVID-19 Provider Burden Relief FAQ document that states that the Agency has suspended most Medicare Part A and Part B Fee-For-Service (FFS) medical review during the emergency period due to the COVID-19 pandemic.  This includes pre-payment medical reviews conducted by Medicare Administrative Contractors (MACs) under the Targeted Probe and Educate program, and post-payment reviews conducted by the MACs, Supplemental Medical Review Contractor (SMRC) reviews and Recovery Audit Contractor (RAC). No additional documentation requests will be issued for the duration of the PHE for the COVID-19 pandemic. Targeted Probe and Educate reviews that are in process will be suspended and claims will be released and paid. Current postpayment MAC, SMRC, and RAC reviews will be suspended and released from review.

This suspension of medical review activities is for the duration of the PHE. However, CMS may conduct medical reviews during or after the PHE if there is an indication of potential fraud. Other topics in the FAQ are related to proof of delivery beneficiary signature waivers for drugs and DME, and for pausing non-emergent ambulance and home health review choice demonstrations Providers should contact their Medicare review contractor if there are questions.

Medicaid Eligibility Updates

As some of the LTC providers may have experienced, there have been Medicaid processing issues recently due to closure of local DFR offices as well as with faxing issues and obtaining required documentation.  We have heard that Medicaid members are getting termination notices as well during the emergency, which we assume are pre-programmed. The IHCA/INCAL worked with the NAELA (elder law attorneys) chapter to develop certain requests of OMPP during and due to the emergency.  The requests and OMPP’s responses are available here.

PASRR Waiver Guidance

The Division of Aging has developed guidance to address the PASRR Level 1 and Level 11 assessment section of the 1135 waiver.

Telehealth Toolkit

CMS recently issued an electronic toolkit regarding telehealth and telemedicine for Long Term Care Nursing Home Facilities. CMS has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility.

This document contains electronic links to reliable sources of information regarding telehealth and telemedicine, including the significant changes made by CMS in response to the National Health Emergency.  Most of the information is directed towards providers who may want to establish a permanent telemedicine program, but there is information here that will help in the temporary deployment of a telemedicine program as well.

There are specific documents identified that will be useful in choosing telemedicine vendors, equipment, and software, initiating a telemedicine program, monitoring patients remotely, and developing documentation tools. There is also information that will be useful for providers who intend to care for patients through electronic virtual services that may be temporarily used during the COVID-19 pandemic.

Medicare and Coronavirus: What You Need To Know by Seema Verma

Southeastrans Pandemic Response Plan

  • Southeastrans has developed a plan that outlines its response to a pandemic outbreak, including steps the Company takes to safeguard employees’ health while also maintaining essential operations and providing vital services to our customers and members. In addition, it provides guidance on how the Company intends to respond to specific operational and human resource issues in the event of a pandemic.

Factsheet: Medicare Coverage and Payment Related to COVID-19

  • Medicare covers all medically necessary hospitalizations, as well as brief “virtual check-ins,” which allows patients and their doctors to connect by phone or video chat.

Federal and State Guidance & Updates

March 20, 2020: Indiana Medicaid Announces Filing Extensions for Cost Reports and Other Filings

  • Due to the COVID-19 outbreak, the Office of Medicaid Policy & Planning will be postponing any onsite reviews and associated requests for documentation for 60 days.  This will apply to all our long term care providers, nursing facilities and group homes.

March 17, 2020: CMS Issues 3-Day Stay Detailed Billing Guidance

  • CMS issued this guidance with all details on billing under the waiver of the 2 day inpatient hospital stay.  The waiver is a blanket waiver and applies to all states without any state-specific action.  The waiver is currently in effect. Read IHCA/INCAL summary here.

March 17, 2020: Area Agencies on Aging Guidance from Division of Aging

  • This guidance was issued by the Indiana Division of Aging to Area Agencies on Aging to clarify AAA operations during the national emergency.  The DA is permitting all Care Management and Options Counseling activities to be performed via telephone. This will likely create new challenges. As you encounter issues with these protocol please keep IHCA/INCAL aware as the DA has asked us to keep them informed of member issues.  Please contact Elizabeth Eichhorn at eeichhorn@ihca.org.

March 12, 2020: CMS Releases COVID-19 Medicare FFS and Medicare Advantage Plan Guidance

Education & Programming

IHCA/INCAL Contact: Katie Niehoff | kniehoff@ihca.org.

COVID-19 and Loneliness in Nursing Homes

LEARN MORE

 

CDC COVID-19 Prevention Messages: Mini Webinar Series for Long-Term Care Staff

Trainings for nursing home and long-term care facility staff to protect residents from COVID-19

CDC has launched a new mini webinar training series for frontline long-term care and nursing home staff.  This series of 5 short webinars reviews basic infection prevention steps including proper use of personal protective equipment (PPE) and facemasks, how and when to perform hand hygiene, how and when to clean surfaces, and the need to check residents and staff daily for symptoms of COVID-19.  Learn more about your role in protecting residents and keeping COVID-19 out of your facility.

Webinar Series:

Coronavirus Resources and Training through Healthstream

LEARN MORE

 

Emergency Preparedness: Caring for persons living with dementia in a long-term or community-based care setting

LEARN MORE

 

COVID-19 Clinical Tips for Respiratory Assessment

ACCESS TIPS

 

Division of Aging Tips for Preventing Social Isolation in Assisted Living

ACCESS TIPS

 

COVID-19 Webinar Series for Food & Nutrition Professionals

Becky Dorner & Associates is offering COVID-19 resources and webinars for Food and Nutrition Professionals. Click HERE for details. Use code CV19 to receive a 20% discount (expires 5/31/20)

LEARN MORE

 

Promoting MDS Accuracy During the COVID-19 Pandemic

Despite rapid changes in our daily operations during the Coronavirus (COVID-19) Public Health Emergency (PHE), the RAI User’s Manual remains the driver for accuracy of MDS assessments. This session will focus on MDS items likely impacted by the suspected or confirmed presence of COVID-19 infection. Attendees will gain insight for best practices for accurate coding to support the conditions and services delivered to residents, and apply best practices for supportive documentation based on RAI guidelines. Also included in this session are real case studies of coding opportunities with reimbursement implications and examples of effective supporting documentation for MDS coding.

LEARN MORE

 

Assistance for Certification and Renewal

NCCAP understands the severe impact COVID-19 is having on our activities community. It may also be impacting your certification renewal. In light of the current situation, we are happy to provide a variety of assistance for you renewal.

LEARN MORE

Advance Care Planning During a Crisis – FREE 12-Minute Webinar

COVID-19 makes it more important than ever that we talk with residents and families about goals and treatment preferences. Advance Care Planning During a Crisis is a FREE 12-minute webinar that addresses issues specific to COVID-19. This video was developed by experts at Indiana University to support nursing facility staff in advance care planning. Additional resources include a resident and family handout, a discussion guide, and links to other helpful websites. There are also slides and recommendations about Symptom Management in the Nursing Home During COVID-19 to help support residents with possible or confirmed COVID-19 who are treated in the facility. For more information, please click on this link:

LEARN MORE

Ideas for Continued Social Connectivity for Nursing Facilities and Families by The Division of Aging

The Division of Aging recognizes the need to balance health protection and social connectivity for those within nursing facilities, especially given the recent visitation restrictions due to the COVID-19 pandemic. To help encourage nursing facilities and families to stay connected, here are some general ideas for continued social connectivity.

Click Here

Psychological First Aid Training

The Indiana Family and Social Services Administration, in partnership with the American Red Cross Indiana, has made available a series of trainings in Psychological First Aid for Hoosier health care and social services professionals. Psychological First Aid is an approach to helping people who have been exposed to a disaster or traumatic event, in this case the COVID-19 pandemic. Many of you have registered for this training, and many more have been placed on a wait list due to the incredible demand for this resource.

While new instructors are in the process of being certified in order to increase capacity to offer additional trainings, interested individuals can opt to take a web-based, on-demand version of this training through the American Red Cross by going here. Once you register you can search for “Psychological First Aid” and click on the blue square for the online learning. If you experience difficulty accessing the course, please email disastertraining@redcross.org for assistance.

COVID-19 Pandemic Response Webinar Series

The Novel Coronavirus 2019 (COVID-19) has challenged all long-term care facilities to make modifications to their day-to-day care and services to achieve compliance with all of the Infection Control restrictions being mandated by Federal, State, and local governments.  This pandemic will have a significant impact on the psychosocial well-being of residents and staff due to the limitations on movement within the facility environment, a moratorium on visitation, and a shrinking caregiving staff as the virus continues to spread exponentially. Learn more about the newly launched
three-part webinar series

Activity Programming Ideas

Enrichment On Demand

Due to the CDC restriction on all group activities, Enrichment On Demand is offering as a community service 8 hours of continuous digital engagement available daily on YouTube.

DOWNLOAD FLYER   

WEBSITE

ACTIVITIES ON DEMAND

Enrichment on Demand is offering senior communities interested in experiencing CONNECTIONS, a two week free trial subscription.  If interested, please contact Paula Stokes McDowell at paula@enrichmentondemand.com or (480) 223-8114

Informative Read

What Does This Make Possible? Surviving and Thriving in Tough Times by Dennis McIntee, CEO, Leadership Development Group.

Cluster Programming Planning Tool

Access a free cluster programming planning tool designed to give you a foundation as a start point for planning for long term safety and well being of residents in assisted living, memory care, long term and dementia care neighborhoods in skilled nursing during this time.

Learn More

Workforce Resources

IHCA/INCAL Contact: Emily Berger| eberger@ihca.org

Last updated 5.5.20 at 10:45 p.m.

INDIANA’S CARING HEROES PROGRAM – PCA Recruitment Assistance for IHCA/INCAL Members

 

As part of the newly launched Indiana’s Caring Heroes Program, IHCA/INCAL has temporarily retooled its Indiana.carefortheaging.org platform to assist members with the recruitment of the Temporary Personal Care Attendant (PCA). As of April 19, IHCA/INCAL is currently working to update the Indiana’s Caring Heroes program to include details for both the PCA and Temporary Nurse Aide roles.

ACCESS MEMBER TOOLKIT

DOWNLOAD PROMOTIONAL VIDEO

 

General Information and Resources

Marriott Community Caregiver Rate

Marriott International has established a “Community Caregivers Rate” has been established to expedite the booking process for healthcare and relief professionals and support staff. This rate will be available from March 26, 2020 through June 30, 2020 at participating hotels. Learn more.

April 20, 2020: AHCA Updates

Please read the summarized detail circulated by AHCA/NCAL related to the following:

  • Occupational Safety and Health Administration Notices on Respirators, PPE, and Reporting
  • PBJ Waiver Reminder and Update

 

Department of Labor Guidance on New Leave Benefits Excludes Health Facility Employees – UPDATED 3.29.2020

April 20, 2020: AHCA Updates 4

In response to AHCA/NCAL’s advocacy to include nursing home, assisted living, and ID/DD staff in their definition of “health care provider,” the Department of Labor has published guidance to address exemptions and employer requirements to the expanded Family Medical Leave Act and sick leave benefits included in the recently passed Families First Coronavirus Response Act.

Of note, the Department’s exemptions FAQ (see #56) states that the “health care provider” exemption to these new leave requirements applies to “anyone employed at any… nursing facility, retirement facility, nursing home, home health care provider… This includes any permanent or temporary institution, facility, location, or site where medical services are provided that are similar to such institutions.”  The exemption also applies to employees of contractors with the above institutions who “provide services or to maintain the operation of the facility.”  Employers with over 500 employees are also exempted.  Please review this FAQ closely.

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.

Additionally, the Department of Labor has posted an Employer Fact Sheet and an Employer Notice Requirements FAQ.

 

Governor’s “Stay At Home” Order

IHCA/INCAL has developed this Essential Healthcare Personnel form for you to place your facility logo on and provide to each of your staff members so that they can have this with them while they travel for work during the Stay at Home Order issued by Governor Holcomb.

 

Staffing Emergencies

  • IHCA/INCAL hosted an all-member call on 3/26 on Operationalizing CMS’s Infection Control Protocol. That webinar is recorded and available here, and slides are posted here. During the webinar, IHCA/INCAL shared guidance on preparing for a staffing emergency in your facility (see page 10, slide 29 of the “IC Protocol Webinar PPT” document, shared roughly 75 minutes into the webinar recording).
  • AHCA/NCAL (4.27.20) has created a resource document Addressing Workforce Shortages Due to COVID-19.

 

Personal Screening and Return to Work Screening

During the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention
(CDC) are directing facilities to screen healthcare personnel (HCP) prior to allowing them to work or provide services in the facility. AANAC, AAPACN, and AADNS have created a screening questionnaire for health care professionals, as well as screening questions for HCP’ returning to work. Access the questionnaire here.

 

Child Care Resources

IHCA/INCAL engaged the Indiana Family and Social Services Administration Office of Early Childhood and Out of School Learning (OECOSL) regarding available child care options and supports for our workforce and their children.  There are two main options:

  1. The OECOSL can work with employers to establish “pop-up” child care for any facility, in partnership with Early Learning Indiana and resources in your local area.  This opportunity may permit employers to pay for all of the child care facility directly for use by employees and children or partner to establish new child care options for employees to access with their own resources.  Daycare options can be set up rapidly – within days to a week.
  2. Another option offered by the OECOSL is by engaging their team to scout out open slots at existing daycare centers in areas of need to then generate a list of availability that employer can provide to employees.

For assistance with either of these options contact Nicole Norvell, Director, Office of Early Childhood and Out of School Learning, 317.234.3313 or Nicole.Norvell@fssa.IN.gov.

 

 

Hiring and On Boarding

Indiana Health Care Workforce Needs Request Form

The Indiana State Department of Health (ISDH) now has an online request form for health care facilities, including long-term care facilities, with workforce needs to request assistance from those health care professionals who have volunteered or who are otherwise available to assist during this public health emergency, including health care professionals previously assigned to elective surgeries and those who have received a temporary license to practice, such as retired health care professionals and recent graduates of accredited medical, nursing, physician assistant, and respiratory care programs.

The Health Care Workforce Needs Request Form can be found here.

ISDH, in partnership with the Bowen Center, will then distribute information about employment opportunities within your facility to individuals who indicated willingness to serve and meet the specified criteria/need as outlined in your request.

 

TB Testing Requirements

The Indiana State Department of Health issues two orders that had been requested by the IHCA. Seperate orders apply to nursing facilities (March 20) and residential care facilities (March 20). The orders do the following:

  • Changes the TB testing requirements for new hires to be completed within 90 days of employment;
  • Suspends the required diagnostic chest X-ray for residents; and
  • Changes the TB testing requirement for new admissions to be completed within 90 days of admission.

 

Physicals

  • Waives the requirement that a pre-employment physical examination of employees be completed 1-mohth prior to employment (410 IAC 16.2-3.1-14(t).
  • The current order applies only to nursing facilities (March 23).

 

Background Checks

  • Limited Criminal History checks are still available and providing an instantaneous response via the ISP website. If you are experiencing delays on LCH background checks via your 3rd party vendors, the fastest way to meet your statutory LCH background check requirement is to have your facility or HR staff directly enter applicant info to the site. We are aware that fingerprinting for follow ups on inconclusive results is currently unavailable. Please refer to the details below from March 28 guidance issued by ISDH.
    • On-Boarding Employees Fingerprinting – Clarifying Guidance for Comprehensive Care Facilities  – Health care facility includes residential care facility (even though the ISDH newsletter announcement only referenced comprehensive care facilities.)
      • ?C § 16-28-13-4(a) (“Criminal History of Nurse Aides and Other Unlicensed Employees”) provides:
        (a)   Except as provided in subsection (b), a person who:
        (1)   operates or administers a health care facility; or
        (2)   operates an entity in the business of contracting to provide nurse aides or other unlicensed employees for a health care facility; shall apply within three (3) business days from the date a person is employed as nurse aide or other unlicensed employee for a copy of the person’s state nurse aide registry report from the state department and a limited criminal history from the Indiana central repository for criminal history information under IC 10-13-3 or another source allowed by law.This statute requires that the facility owner or staffing agency “apply” for the limited criminal history, but not that the requested report actually be obtained. All ISDH requires as proof of compliance is documentation that a facility has applied for either the limited criminal history or the more extensive fingerprint-based history available through the Indiana State Police.This guidance does not affect or relax the requirements of IC 16-28-13-3 (“Crimes barring employment at certain health care facilities”) or 42 CFR §483.12(a) (“Freedom from abuse, neglect, and exploitation”).
      • This statute requires that the facility owner or staffing agency “apply” for the limited criminal history, but not that the requested report actually be obtained. All ISDH requires as proof of compliance is documentation that a facility has applied for either the limited criminal history or the more extensive fingerprint-based history available through the Indiana State Police.This guidance does not affect or relax the requirements of IC 16-28-13-3 (“Crimes barring employment at certain health care facilities”) or 42 CFR §483.12(a) (“Freedom from abuse, neglect, and exploitation”).
  • Fingerprinting: IHCA/INCAL been working closely with the Indiana Department of Administration, who administers the third-party fingerprint vendor contract for the state, and they have listed to our recommendation to allow our mission critical LTC sector to continue signing up for fingerprints.
    • LTC facilities may now schedule the fingerprinting online using the unique “COVID-19 Criminal Record Review” option from the dropdown menu. Please note that many of the former fingerprinting sites are still unavailable, which may mean that you have to send your prospective employees further away to get fingerprinted. The ISDH guidance regarding background checks still stands, but know that you do now have availability of some fingerprinting options and we encourage you to use them, as well as the MyCase check and/or your third party vendor to make sure you are protecting your company and residents.
    • As of 4.10.20 minors are NOW ABLE to complete the fingerprint scheduling using the COVID-19 Criminal Record Review designation via the Indiana State Police fingerprinting registration portal. Please contact Emily Berger at eberger@ihca.org if you experience any issues with this functionality..

 

Workforce update: Bureau of Child Labor

Indiana DOL has add several updates to its website related to youth employment:

  • Effective March 16, 2020 UNTIL FURTHER NOTICE: In conjunction with Governor Holcomb’s mandated school closing, the Indiana Department of Labor is suspending enforcement of the requirement for employers to have on-file work permits for minor employees.
  • As of April 1, 2020, various updates have taken effect in the newly-titled Youth Employment division for the state of Indiana. Please download this training document to see and learn all new laws involving employing minors.

 

SnapShyft Dynamic Recruitment Intro Webinar

LTC providers can learn how to recruit and hire hospitality and food service workers who may be looking for temporary work. Leaders from SnapShyft will walk through the SnapShyft process, with a brief demo of the desktop software and mobile app, and provide and opportunity for Q&A. Visit the SnapShyft website, or access their intro flyer.

SnapShyft Contact: Thor Wood, Founder/CEO, Thor@snapshyft.com

 

RestUp

RestUp is an app and website that healthcare facilities use to find RNs, LPNs, QMA’s, CNAs, HHAs and now PCA’s for open shifts that need to be filled immediately or within the next few days/weeks.  Simply put, RestUp is like the Uber/Lyft of staffing for facilities.  We have a licensed HFA as our COO who completes all the credentialing of our caregivers to ensure compliance with your regulations.  There is no minimum use requirement.  You just use it when you need it and only pay for what you use. http://www.restup.today

RestUp Contacts: Clifton Dennis, CEO and Founder, clifton@restup.today, or Heather Soots, COO and CoFounder, heather@restup.today

 

 

Licensed and Certified Positions

 

Temporary Aide Programs

Click here to view details related to the Personal Care Attendant (PCA) and Temporary Nurse Aide (TNA) programs.

 

Certified Nurse Aides

  • Status of Testing – As of March 24, Ivy Tech Community College still had testers available to schedule CNA testing at facilities and third-party training sites.
  • CNA Instruction and Testing Extensions (March 21, 2020) ISDH issued a temporary waiver extending the testing and instruction window for CNAs.
    • CNA employment prior to completion of training and testing is expanded to eight (8) months rather than four (4) months.
    • CNA required completion of classroom instruction from date of employment is expanded to two hundred forty (240) days rather than one hundred twenty (120) days
  • Lapsed CNAs – The Sixth Emergency Order for Comprehensive Care Facilities issued by ISDH on April 18, 2020, waives or modifies the following:
    • Permits former CNAs with expired or lapsed certifications to be temporarily employed by facilities when:
      • The expiration or lapse was when the CNA was in good standing with no findings in the nurse aide registry on abuse, neglect, or misappropriation
      • The expiration or lapse occurred after January 1, 2019
      • The CNA worked at least 40 hours in the 1 year prior to the expiration or lapse
      • The facility ensures the former CNA provides competent services required by 410 IAC 16.2-3.1-1-14(b)(1)
    • Facilities may request use of CNAs that do not meet the above criteria on a case by cases basis so long as competency can be demonstrated. To request a case by case approval, email Jan Kulik at jkulik@isdh.IN.gov

Dining Assistant Training

  • Dining Assistants training is waived and is waived and modified as follows (410 IAC 16.2-3.1-53).  Read the formal language and guidance for nursing facilities (March 21) and residential facilities (March 23).

 

Executive Orders related to LTC workforce licensure and practice flexibility

  • Executive Order 20-09 (signed 3/23/2020) – Extends all State Issued Licenses until Friday, May 22nd. Applies to occupational, professional, and firearms licenses.
  • Executive Order 20-05 (signed 3/19/2020)
    • Suspends telehealth restrictions and requirements for face-to-face encounters
    • FSSA may modify or suspend provider staffing requirements for FSSA providers/facilities
    • Suspension of the requirement that a health care provider hold an Indiana license if he or she: (1) has an equivalent license from another State, and (2) is not suspended or barred from practice in that State or any State.
    • Mental health professionals are permitted to practice via telemedicine.
    • Advanced Practice Registered Nurses are permitted to provide services in multiple locations while under a single written collaboration agreement.
  • Executive Order 20-13 (signed 3/30/2020)
  • COVID-19 Temporary Health Care Provider Registry In response to Executive Order 20-13, which expanded those who are able to provide health care services in Indiana in response to the public health emergency, the Indiana Public Licensing Agency (“IPLA”) has created a registry for individuals who do not hold a valid license to practice in Indiana but can be mobilized to help fight COVID-19 through temporary permits to practice.  The registry is open to out-of-state health care providers, retired health care professionals, and recent graduates of accredited medical, nursing, physician assistant, and respiratory care programs.An individual who utilizes the registry may obtain temporary authorization to provide health care services in Indiana for an initial period of 90 days, which may then be renewed for 30-day increments.  Once the public health emergency expires or is otherwise withdrawn, the temporary licenses issued will expire.IPLA’s COVID-19 Temporary Health Care Provider Registry can be found here and will be updated each day at 7:45 AM EST. To access the full summary, please click here.

 

Archive Daily Updates

Please see the daily updates below:

May 10: COVID-19 Testing Strategies

May 10: Required IOSHA COVID-19 Safety Plans

May 8: ISDH Communication Guidelines to Inform Residents & Designated Representatives of COVID-19 Info & Compliance with CMS Reporting Regulations

May 6: COVID-19 Waivers, Guidance, and Emergency Orders for Residential Care Facilities from ISDH

May 6: COVID-19 Emergency Orders and Waivers for Comprehensive Care Facilities from ISDH

May 6: Updated ISDH COVID-19 LTC Facility Infection Control Guidance and SOP

May 6: CMS Releases Memo on Interim Final Rule Updating Requirements for Reporting and Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes

May 5: Updated CDC Guidance on Return to Work Criteria and Discontinuation of Transmission-Based Precautions

May 3: CMS Issues Additional Blanket Regulatory Waivers

May 3: Effective Date of CMS Interim Final Rule on COVID-19 Reporting for Nursing Homes

May 3: CMS Issues Additional Blanket Regulatory Waivers

May 1: CMS Issues Interim Final Rule with New Requirements for COVID-19 Reporting for Long-Term Care Facilities

April 29: CDC Webinar Trainings for LTCF COVID-19 Module: New Mandatory Reporting

April 29: Indiana COVID-19 Testing Sites

April 29: Comprehensive COVID-19 Information for Long-Term Care Facilities

April 27: AHCA/NCAL Grant & Loan Management Resource Guide

April 27: COVID-19 Related Loss and Cost Calculator

April 27: Updated – Accelerated and Advance Payments FAQs

April 25: Five Star Updates, Nursing Home Staff Counts, and FAQs

April 25: CMS Updates COVID-19 FAQs on Medicare FFS Billing

April 24: CMS Releases CMP Reinvestment Application for Communication Technologies

April 23: Instructions for RedCap Survey and Invalid Codes

April 23: Available “Quickinar” on Best Practices for Transition of Care between Nursing Facilities and Dialysis Centers

April 20: IHCA/INCAL Summary on Fifth Blanket Waiver for Residential Care Facilities and Additional Temporary Nurse Aide Guidance

April 20: Reminder: New RedCap Survey for COVID-19 Reporting – Effective Monday, April 20, 2020

April 20: Stay-at-Home Order Extended until May 1, 2020

April 18: ISDH Issues Additional CNA Flexibilities

April 17: Updated CDC Guidance for Return to Work Criteria and Source Control

COVID-19 April 16, 2020

COVID-19 April 14, 2020

COVID-19 April 13, 2020

COVID-19 April 11, 2020

COVID-19 April 10, 2020

COVID-19 April 9, 2020

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COVID-19 April 6, 2020

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COVID-19 April 2, 2020

COVID-19 April 1, 2020

COVID-19 March 31, 2020

COVID-19 March 30, 2020

COVID- 19 March 28, 2020

COVID-19 March 26, 2020

COVID-19 March 25, 2020

COVID-19 March 23, 2020

COVID-19 March 22, 2020

COVID-19 March 20, 2020

COVID-19 March 19, 2020

COVID-19 March 18, 2020

COVID-19 March 17, 2020

COVID-19 March 16, 2020

COVID-19 March 14, 2020