State Requirements and Guidance for Creating Dedicated COVID-19 Long-Term Care Facilities
The Indiana State Department of Health and Family and Social Services Administration issued guidance to long-term care facilities, specifically nursing facilities, to create dedicated COVID-19 buildings. Those interested in transitioning a nursing facility into a dedicated COVID-19 building must adhere to the qualifications outlined in the guidance, a full summary of which can be accessed below, and should email Dr. Daniel Rusyniak (Daniel.Rusyniak@fssa.IN.gov) and Matt Foster (MFoster@isdh.IN.gov) to begin the process. The proposed benefits to creating dedicated COVID-19 buildings include:
- The conservation of personal protective equipment
- The creation of facility expertise
- The provision of facilities/spaces for employees with COVID-19 to continue working
- The ability to transition patients requiring skilled nursing out of hospitals to specific locations when they no longer need acute care
Those interested in transitioning a nursing facility into a dedicated COVID-19 building must adhere to the qualifications outlined in the guidance, which can be found in the full summary below.
Dedicated COVID-19 buildings will receive a 50% increase to the current average nursing facility rate of $215.36. Further, all nursing facilities will receive a 4.2% increase in rates independent of whether they are dedicated COVID-19 facilities. These rate increase will be applicable to the duration of the public health emergency and an appropriate, to-be-determined transition period afterward.
IHCA/INCAL issued comments to the ISDH regarding the requirements and guidance for creating dedicated COVID-19 facilities, but many details remain to be determined, including the point of contact for the approval process, the starting date for enhanced reimbursement, the criteria for the required operations plan, and more. IHCA/INCAL will continue to provide updates as more details are confirmed.
ISDH Orders Enhanced Reporting of COVID-19 Test Results
On April 8, 2020, Indiana State Department of Health (ISDH) Commissioner, Dr. Kristina Box, issued a State Health Commissioner’s Order requiring certain reports of COVID-19 information to ISDH. The Order is not guidance and should be followed by all long-term care facilities, including nursing facilities, skilled nursing facilities, and assisted living facilities.
Effective April 10, 2020, long-term care facilities are required to report positive COVID-19 test results for all patients, residents, and/or employees to ISDH within twenty-four (24) hours of receipt of a positive result. All long-term care facilities are also required to report any COVID-19 related deaths or suspected COVID-19 related deaths of patients, residents, and/or employees to ISDH within twenty-four (24) hours of a facility’s knowledge of the death in a manner prescribed by ISDH.
The goal of the required reporting is to improve data collection and help ISDH and local health departments more quickly deploy necessary resources to help limit the spread of the disease.
Details regarding how to report the required information were not included in the Order, but IHCA/INCAL will working with ISDH to obtain further information and will provide additional details as soon as they are available. For now, the ISDH Long Term Care Division has advised IHCA that reports of COVID-19 positive test results and deaths be reported as an Incident Reporting System. This can be done through the Gateway or via email to incidents@isdh.in.gov.
Personal Care Attendants Ages Sixteen (16) and Seventeen (17) to Continue Indefinitely
On April 8, 2020, the ISDH issued two additional amended Emergency Orders that update earlier amended Emergency Orders authorizing comprehensive care facilities and residential care facilities to utilize Personal Care Attendants (“PCAs”) to perform resident care procedures that do not require the skill or training of a CNA. The previous amended Emergency Orders permitted minors ages sixteen (16) and seventeen (17) to temporarily train and serve as PCAs in both comprehensive care facilities and residential care facilities.
The amended Emergency Orders released today allow minors ages sixteen (16) and seventeen (17) to serve as PCAs in comprehensive care facilities and residential care facilities continuing indefinitely, retroactive to March 16, 2020. All PCAs will still be required to first complete the applicable eight (8) hour training.