March 23, 2020
Important Updates

ISDH Data Collection and COVID-19 PPE Inventory Tracking
 
The Indiana State Department of Health issues a request to nursing facilities, licensed residential care centers/assisted living communities to register to use EMResource. This is a web-based resource management and communication tool to monitor and notify changes in resources status, ISDH is asking you to update your PPE supplies daily in this tool so that resources can be distributed efficiently.
 
Updated Information:
EMResource has been backlogged and NF and AL ID’s were not being set up. Please review the user manual the attempt to set-up your user ID. EMResource User Guide Found HERE

Please contact me with any question or problems  tmiller@hoosierownersandproviders.org

Question: Are taking steps to dedicate wings, units or floors for COVID-19 treatment?

By taking these steps you will be able to better able manage your PPE’s, and staff more efficiently. Today’s situation is defined as a national and state emergency and hoping you will not have COVID-19 patient is unrealistic. Plan now, be ready and have designated units will also help contain the spread. This was addressed by CMS in this QSO.

Indiana’s 1135 waiver once approved , will facilitate your efforts to set up dedicated COVID-19 treatment areas. Indiana Submits a 1135 waiver request foun d HERE

AHCA has good information and interim guidance on SNF’s accepting admissions from hospitals during COVID-19 pandemic HERE


MARCH 22, 2020
 
March 22 ISDH Newsletter HERE
 
ISDH Updates:


 
MARCH 20, 2020

ISDH Authorizes Additional Staffing Options: Temporary COVID-19 Personal Care Attendant (PCA)  
Please contact Nancy Adams 317-233-7119 or  nadams1@isdh.in.gov  with questions. 
 
Personal Protective Equipment Available
Dr. Kristina M. Box, MD, State Health Commissioner, has requested that all long term care facilities have all healthcare workers wear a face mask during their work shift. Staff should be instructed to mask up at the beginning of the shift and wear the mask until they leave. The mask does not need to be a N95 mask. 
From this guidance, the ISDH Division of LTC has been informed that Indiana Local Public Health Departments (LHD) have personal protective equipment availability for comprehensive care facilities and residential care facilities. Facilities should contact their local public health department for details.

Link to ISDH Latest Newsletter with this article : newsletter  
 
IMPORTANT - H OPE Offers Additional Observations to PPE Available
  • Please note, the article does not suggest or require staff to wear N-95 masks
  • I have confirmed that supplies are reaching county health departments and you should contact you contact them as soon as possible. Indiana Local Public Health Departments
  • Due to critical hospital shortages it has been reported that some county health departments sent these supplies to hospitals. This was reported in Vanderburgh County.
 
Emergency Order Granting Temporary Blanket Waivers
Comprehensive Care Facilities
Pursuant to the “Declaration of Public Health Emergency for Coronavirus Disease 2019 Outbreak” issued by Governor Eric Holcomb on March 6, 2020 and IC4-21.5-4-1, and as authorized by IC 16-28-1-10 and the September 18, 1991 resolution of the Executive Board of the Indiana State Department of Health (ISDH), the Indiana Health Commissioner hereby ORDERS as follows:
  1. Living Arrangements
  2. Transfer and Discharge Rights
  3. Personnel 
  4. Personnel
  5. Physician Services
  6. Activities
  7. Dining Assistant
Residential Care Facilities
Pursuant to the “Declaration of Public Health Emergency for Coronavirus Disease 2019 Outbreak” issued by Governor Eric Holcomb on March 6, 2020 and IC4-21.5-4-1, and as authorized by IC 16-28-1-10 and the September 18, 1991 resolution of the Executive Board of the Indiana State Department of Health (ISDH), the Indiana Health Commissioner hereby ORDERS as follows:
  1. Resident Rights
  2. Health Services

 
MARCH 19, 2020
 
Indiana Submits a 1135 Waiver Request Found HERE
Summarized, if approved by CMS, the waiver seeks to:
  • The ability to temporarily allow modifications to PASRR process allowing a level 1 screen to be conducted by the admitting facility within 24 hours of admission and level 2 screen to be delayed until 30 days after admit.
  • The ability to waive prior authorization requirements for select providers most impacted by COIVD-19.
  • The ability for providers to gain extended prior authorizations through the termination of the emergency declaration.
  • The ability to temporarily allow modifications to PASRR process allowing a level 1 screen to be conducted by the admitting facility within 24 hours of admission and level 2 screen to be delayed until 30 days after admit.
  • The ability to waive prior authorization requirements for select providers most impacted by COIVD-19.
  • The ability for providers to gain extended prior authorizations through the termination of the emergency declaration.

Emergency Order Granting Temporary Blanket Waivers
Pursuant to the “Declaration of Public Health Emergency for Coronavirus Disease 2019 Outbreak” issued by Governor Eric Holcomb on March 6, 2020 and IC4-21.5-4-1, and as authorized by IC 16-28-1-10 and the September 18, 1991 resolution of the Executive Board of the Indiana State Department of Health (ISDH), the Indiana Health Commissioner hereby ORDERs as follows:

Tuberculosis screening for employees and nonpaid personnel of facilities:

CMS – 1135 Authority – Immediate Jeopardy Duties Only and LTC Strike Teams
With CMS using 1135 authority to require nursing home surveyors to limit their duties to immediate jeopardy only, we will be using this workforce to form LTC strike teams. These teams will go to facilities (those with a presumed case will be prioritized) to do PPE training and communicate risk mitigation strategies with essential staff (those who provide healthcare to patients with presumed or confirmed COVID-19 cases). These teams will also do targeted test collection. We hope to fully utilize this workforce and their expertise to assure that the facilities that care for our most vulnerable residents are as prepared as possible to continue to do so safe and effectively. This is not a regulatory visit and there will be no report given to the facility. The team will rely upon the facility’s screening of the residents to prioritize testing. Please have a nurse available to assist with the resident during the testing. Your staff will be appreciated by both the resident and the strike team staff to comfort the resident.
 
See complete ISDH Newsletter HERE
As always, please consult the following websites for more complete information on COVID-19

Other excellent resources:
hoosierownersandproviders.org