Lawyers reviewing order to release COVID-19 info to nursing home residents, families
COLUMBUS — Despite Monday's promise to increase clarity around coronavirus outbreaks in nursing homes, the state has not yet provided guidance on how this information will be made public.
When asked about the order that would require the release of this information Gov. Mike DeWIne said during the state coronavirus briefing Tuesday it's currently being reviewed by lawyers.
Although the order is not yet available, "We've also indicated that this is what people should be doing, and we fully expect that they're going to do it," said DeWine.
But that hasn't been the case. Though Windsor House Inc. officials have not returned Mahoning Matters repeated calls, John Masternick, CEO of Windsor House, on Monday told The Vindicator that while the long-term care provider is dealing with outbreaks at four facilities — Windsor House in Canfield; O'Brien Memorial Health Care Center in Masury; Masternick Memorial Health Care Center in New Middletown; and St. Mary's Alzheimer's Center in Columbiana — it's declining to release the number of cases among residents or staff.
In a call with reporters this morning, Mahoning County Health Commissioner Ryan Tekac said though the county health board is aware of cases at local nursing homes, it is waiting on the state to release the official order, as well as the statistics.
Medicare waiver
DeWine is submitting a waiver application to the federal government that would provide flexibility regarding Centers for Medicare and Medicaid Services regulations during the pandemic.
The state's 1135 waiver, which is filed in emergency circumstances, would permit the state to:
- Bolster telehealth services
- Waive signature requirements for a variety of providers to promote safe distancing
- Ease obstacles to access nursing home care
- Allow services to be provided at alternative locations
- Remove staffing level requirements
The waiver would be retroactively effective, starting March 1.
"Removing restrictions like these during this pandemic will allow healthcare workers to focus on meeting the needs of their fellow Ohioans," DeWine said.
Cassandra Valentini, spokesperson for Direction Home of Eastern Ohio, the Mahoning Valley's aging agency, said Tuesday it's still unclear what's included in the state's waiver application, as it's yet to be passed to the local level.
Nursing home staffing requirements used to mandate a ratio between healthcare workers and residents, though that was removed years ago to allow facilities to focus on staffing levels that simply fit residents' needs, she said.
As Mahoning Matters noted in its series earlier this year on nursing home inspections in Mahoning and Trumbull counties, many infractions stem from understaffing.
"The expectation is they're going to have the staff to care for the residents," Valentini said.
Under new state guidelines, the nursing home placement process has been streamlined, she said.
The majority of Direction Home's staff is now working remotely and completing visits and assessments required before a nursing home placement by phone. Some placements are being completed even without a required response from Medicaid, she said, on expectation, the centers will be retroactive.
The Centers for Medicare and Medicaid Services has also waived the three-day waiting period for a Medicare patient to be transferred from a hospital to a nursing home, Valentini said.
Hospital capacity build-out
During the update, Columbus Mayor Andrew Ginther discussed the state's plan for dealing with the anticipated COVID-19 surge and its effect on Ohio hospitals.
On April 6, DeWine announced that the state will prepare to convert six facilities across the state — including the Covelli Centre in downtown Youngstown — into field hospitals. At field hospitals, COVID-19 patients who no longer require acute care can recover.
Local officials are awaiting direction from the Ohio National Guard — which is overseeing the state's hospital build-out — on when or how to use the convention center, said Dr. James Kravec, Mahoning County Public Health's chief medical officer and Mercy Health's chief clinical officer.
Some nursing home residents discharged from local facilities to hospitals for COVID-19 testing have ended up in a no-man's land — unable to return to their nursing home until they test negative, yet unable to be admitted to the hospital unless they test positive, said John Saulitis, director of Direction Home's ombudsman program, which advocates for nursing home residents and their families.
"Those test results can sometimes take days, some go quick. Some may say we need two negative [results]," he said.
"Then the question becomes: There's not many tests for hospitals to be using the resources," Saulitis said. "Those people are staying in hospitals longer than medically necessary."
Kravec said Mercy is continuing to work with those long-term care facilities, residents' case managers and families.
"It's something we have to continue to work through as far as the best way to get those patients moved," he said. "It's really not something that's ideal right now, considering [virus testing capacity] is more limited than we would like."
In the last two weeks, Ginther has worked with Columbus hospital systems and other public and private partners to convert the Greater Columbus Convention Center into a 1,000-bed overflow hospital.
"Our greatest hope and goal is if we never have to open," said Ginther. "But it is incumbent upon us as leaders to be prepared."
The sites in Columbus, Cleveland and Cincinnati — Greater Columbus Convention Center, Case Western Reserve University's Health Education Campus and Duke Energy Convention Center — have ramped up efforts in the last two weeks to prepare for Ohio's coronavirus surge.
The other three designated sites — Covelli Centre, Seagate Convention Center and Dayton Convention Center — have remained on standby, as the state determines if they will be necessary.
Other coronavirus news
• According to the latest figures Tuesday from the Ohio Department of Health, the state is reporting 7,153 confirmed cases of the coronavirus. There have been 469 confirmed cases in Mahoning County; 190 in Trumbull County; and 115 in Columbiana County.
• Statewide, there have been 324 deaths, including 35 in Mahoning County; 14 in Trumbull; and 8 in Columbiana. Mahoning County's 35 reported COVID-19 deaths remains the highest among Ohio's 88 counties; Cuyahoga County is second with 33.
• State Reps. Tom Patton, R-Strongsville, and Brigid Kelly, D-Cincinnati, have proposed legislation giving workers in grocery stores and food packaging and processing facilities "access to compensation" should they contract COVID-19 while working.
• According to the Pennsylvania Department of Health on Tuesday, there are 25,345 COVID-19 cases in the state which have led to 584 deaths. There are 51 cases in Lawrence County with 4 deaths; 44 cases in Mercer County with no known deaths.
• Car dealerships appear to be the next priority for Pennsylvania House GOP members after a committee advanced a measure granting the industry a waiver from the coronavirus shutdowns by approving House Bill 2388 on a vote of 15-10 on Monday.
• A new petition seeks the release of Federal Correctional Institution Elkton inmates who are the most vulnerable to COVID-19. Meanwhile, a government employee union is suing for hazard pay due to the pandemic.
• Meanwhile, a fourth Federal Correctional Institution Elkton inmate has died amid the COVID-19 outbreak at the prison. The federal Bureau of Prisons has confirmed 39 cases of the virus at the prison, including 24 inmates and 15 employees.
• Ohio Attorney General Dave Yost has alerted creditors and financial institutions that COVID-19 stimulus checks are protected under existing Ohio law from bill collectors and exempt from state and federal attachment, garnishment or execution.
• U.S. Rep. Tim Ryan announced Tuesday $7.8 million in federal COVID-19 funds were made available through the CARES Act to local airports, including $69,000 for Youngstown Warren Regional Airport.
This story was originally published April 15, 2020 at 4:11 AM with the headline "Lawyers reviewing order to release COVID-19 info to nursing home residents, families."