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[May 8, 2020] ISDH Communication Guidelines to Inform Residents & Designated Representatives of COVID-19 Info & Compliance with CMS Reporting Regulations - IHCA

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[May 8, 2020] ISDH Communication Guidelines to Inform Residents & Designated Representatives of COVID-19 Info & Compliance with CMS Reporting Regulations

Posted May 3, 20204 min Read

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The Indiana State Department of Health (ISDH) has released updated communication guidelines that require nursing facilities and assisted living communities to inform residents and their designated representatives of COVID-19 information.  The effective date is Monday, May 4, 2020.  The updated ISDH communication guidelines more closely track with the federal reporting regulations recently issued by the Centers for Medicare and Medicaid (CMS).

The main updates to the ISDH communication guidelines are:

  • Positive cases of staff must be included in the daily reporting of COVID-19 cases (CMS requires staff to be included in the count).
  • Daily reporting of COVID-19 deaths will not be required (CMS does not require deaths to be reported daily). However, it is still part of the ISDH policy as information that should be provided to residents and resident representatives upon request.
  • Daily reporting to residents without decision making capacity is not required, but it is required to make daily reports to that resident’s representative.
  • There will also be pathways for residents and resident representatives to opt-out of the daily communications if they so choose.
    • Resident representatives may opt out of receiving daily reports.
    • Residents may opt out of receiving daily reports, only if both the resident and resident’s representative consent to the opt-out.

While the state’s Communication Guidelines are still more stringent in that the state requires reporting within twenty-four (24) hours rather than by 5 PM the next day, complying with the state guidance will ensure compliance with the CMS regulation. However, it is important to note that if a resident and/or their designated representative opt out of Indiana’s daily reporting requirements as permitted by the Communication Guidelines, a nursing facility with a positive case of COVID-19 must still comply with the CMS requirements of reporting new cases/respiratory symptoms and weekly updates as discussed below.  The CMS reporting requirement does not apply to assisted living providers.

Under the federal regulations, nursing facilities must inform residents, their representatives, and families of those residing in facilities by 5 p.m. the next calendar day following the occurrence of:

  • Either a single confirmed infection of COVID-19; or
  • Three (3) or more residents or staff (including contractors and volunteers) with new-onset of respiratory symptoms occurring within 72 hours of each other; and
  • This notification must occur at least weekly to provide a cumulative update.

The CMS reporting requirement may be accomplished through a variety of ways, including website postings, email listservs, paper notification, and/or recorded telephone messages.

In summary, under the state’s Communication Guidelines beginning May 4, 2020, all long-term care facilities must send daily group emails, automated voicemails, or automated electronic communications to residents and their designated representatives informing them of:

  • The total number of COVID-19 positive cases among residents and staff, and out of the cumulative total, how many tested positive in the past fourteen (14) days;
  • The number of new COVID-19 cases in the last twenty-four (24) hours among residents and staff; and
  • If there are three (3) or more new cases of respiratory illness that have occurred in the last seventy-two (72) hours among residents and staff.
  • Facilities should also let residents and their designated representatives know what actions are being taken to prevent the spread of COVID-19 and how to reach a staff person if they have questions.

The daily communications must occur Monday through Friday at a minimum, and Monday’s communication must include numbers since Friday if weekend communications do not occur.  Per ISDH, facilities do not need to document every communication, but facilities should document their communication procedure and which residents and designated representatives are included in that procedure.

As a reminder, facilities should continue to complete the Long Term Care Ombudsman Facility Emergency Transfer Form weekly regarding the transfer of COVID-19 residents to other LTC facilities, not hospitals, and email it to the local ombudsman every Friday beginning May 1, 2020.  Facilities must still complete the monthly transfer log to their local ombudsman, which would include transfers to hospitals, but the new process outlined in the communication guidelines is to track the transfer of COVID-19 residents among LTC facilities.

About the Author

Laura Brown, Director of Legislative and Legal Affairs