Given the Governor’s direction, please consider preparing and issuing appropriate documents for your staff. Two example letters are attached for reference.
Gov. Eric Holcomb is telling Hoosiers to “hunker down” and stay at home for the next two weeks, except for what’s deemed “essential” business and activity. The order raises plenty of questions about what’s allowed. Here are some answers. READ MORE
Important Notice From CMO
At the request of Dan Rusyniak, MD and Chief Medical Officer at Indiana FSSA
 
All LTC facilities need to use this CDC check list to prevent the spread -  Coronavirus Disease 2019 (COVID-19) Preparedness Checklist for Nursing Homes and other Long-Term Care Settings HERE
 
All LTC facilities should use this sheet to track their infection control activities and to track employees and patients with respiratory illness.
 
All LTC facilities should have a plan to rapidly implement, or implement now, how they will cohort confirmed or presumed covid-19 patients in their facility. This can be by wing, floor, or if available, by building(s). This should be done with expediency. See this from CMS QSO.
 
All LTC facilities should limit patient contact to only essential direct care providers (Nurse, CNA, QMA, Hospice, EMS etc), Notice
 
Once you have access to EMResources, every facility needs to update their status daily. This information is critically important for tracking PPE needs.
 
All LTC facilities should require those involved in direct patient care to wear a mask during their entire shift. Mitigation Strategies

a.       If national and local supplies are at conventional capacity, then all staff in LTC facilities should wear a facemask per standard recommendations.
b.      If national and local supplies are at contingency levels, only direct care staff should wear a mask and they should use one mask per shift.
c.       If national and local supplies are scarce <1 week supply, then only direct care staff should wear a mask and they should use the same mask for multiple days
d.      If national and local supplies are at crisis capacity, then direct patient care staff should wear a mask if available. If masks are not available, they should use alternative methods to cover their mouth and nose and decrease respiratory droplet spread. 
 
All LTC facilities need to have updated lists of all residents’ code status. Plans should be in place for how to provide hospice and comfort care to those patients with DNR orders who develop COVID-19.
 
ISDH has a team available to come into facilities to rapidly test residents and staff who are suspected of having COVID-19. If your facilities have patients or providers who are symptomatic and need to be tested, please contact COVID-19 Outbreak Response Logistics Coordinator Tami Johnson at 317-412-2127 or   tamjohnson@isdh.in.gov   to schedule testing at your facility.    

If you would like to discuss the need for testing at your facility or COVID-19 prevention such as PPE donning and doffing, please contact Casey Cummins, COVID-19 Outbreak Response Chief Nurse Consultant, at 317.954.2591 or   ccummins@isdh.in.gov . 

  1. Dr. Box - LTC Directors - COVID-19 Letter_March 22 2020.pdf
  2. Dr. Box - LTC Directors - COVID-19 Letter_March 23 2020.pdf
CMS Updates
CMS is Delaying Implementation of the October 1, 2020 MDS Update

The Centers for Medicare and Medicaid Services (CMS) announced that they are delaying the Minimum Data Set (MDS) 3.0 v1.18.1 release, which had been scheduled for October 1, 2020. The MDS item sets are used by Nursing Home and Swing Bed providers to collect and submit patient data to CMS. This MDS data informs payment, quality, and the survey process.
This delayed release will eliminate the need for significant SNF MDS training during the upcoming months as well as avoid increased documentation nationwide. 
CMS staff continues to be actively engaged in discussions with AHCA and various other stakeholders, regarding the various changes, the impacts of these changes, as well as, the timeline to educate and train facility staff and update software and IT systems.
 
 
Medicare Advantage Plan Requirements during a State-declared Emergency

During disaster or emergency (declared by the Governor of a state or Protectorate) the following are in effect until the end date identified in the State declaration or for 30 days, if no end date is identified in the declaration. 
  1. Cover benefits furnished at non contracted facilities if the facilities have participation agreements with Medicare.
  2. Waive, in full, requirements for gatekeeper referrals where applicable.
  3. Provide the same cost sharing for the enrollee at a non-contracted facility as if it were a contracted facility.
  4. Changes that benefit the enrollee can be effective immediately without the 30-day notification requirement (examples include reductions in cost sharing and waiving prior authorizations). 
 
CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19

The Centers for Medicare & Medicaid Services (CMS) announced unprecedented relief for the clinicians, providers, and facilities participating in Medicare quality reporting programs including the 1.2 million clinicians in the Quality Payment Program and on the front lines of America’s fight against the 2019 Novel Coronavirus (COVID-19). READ MORE
Helpful Resources From Associate Members
Helping Organizations & Families Navigate COVID-19 Relief - WEBINAR
In light of COVID-19, Congress recently passed the Families First Coronavirus Response Act, and the IRS and U.S. Department of the Treasury extended the tax payment deadline to July 15, 2020. Find out what we’ve learned so far about these response efforts, including answers to some commonly asked questions, as well as future relief measures we expect to see. We’ll also discuss planning strategies to help with financial protection for your families and communities during this time of economic uncertainty.
Thursday, March 26 • 2–3 p.m. Central time
CPE Credits: 1
LeadingAge Indiana is happy to provide a list of suppliers with which we have a relationship for your reference. Please note, we do not track their inventory and cannot estimate to what extent they might be able to fill orders at this time.  These are challenging times; Leading Age Indiana and our partners are here to serve you.