Combating the Novel Coronavirus (COVID-19): Weeks of Aug. 31 and Sept. 7
Posted on September 11, 2020
The MHA continues to keep members apprised of developments affecting Michigan hospitals during the pandemic through email updates and the MHA Coronavirus webpage. Important updates are outlined below.
Requirements Clarified on Quarantines for Ill Employees
Executive Order (EO) 2020-166, which mandated a 10-day home quarantine period for an individual who exhibited any COVID-19 symptoms, was recently rescinded and replaced with EO 2020-172.
The previous order had provided no exception for a subsequent negative COVID-19 test or an alternative medical explanation for the symptoms. EO 2020-172 clarifies the symptoms of COVID-19, stipulates that two or more symptoms must be present to require quarantine, and allows an employee to avoid quarantine if their symptoms can be explained by another medical or physical condition. In addition, healthcare professionals and workers at specifically defined healthcare facilities are exempted from a requirement to stay at home for 14 days following close contact with someone who is COVID-19 positive.
Although the new EO does not address all the MHA's concerns, it provides beneficial clarity. Members with questions should contact Amy Barkholz at the MHA.
Dr. Birx Meets with Governor, Healthcare Leaders in Michigan
A small group of healthcare leaders were invited to meet Sept. 2 with Deborah Birx, MD, the response coordinator of the White House Coronavirus Task Force. Birx came to Michigan to meet with the governor in Lansing and with healthcare leaders at St. Mary Mercy Livonia about Michigan’s efforts to fight COVID-19 and the continuing challenges that could be aided by additional federal action.
Part of the conversation with the healthcare group focused on growing concerns over inadequate lab and testing supplies for diagnosing both COVID-19 and other conditions. The MHA expressed several concerns related to lab supplies and other issues that were also outlined in a letter to Birx.
Birx provided input on a range of issues, including urging hospitals to be “efficient” in their use of lab supplies for COVID-19 testing, offering praise for how Michigan and Detroit, specifically, have managed COVID-19 outbreaks and the public health response, and more.
The MHA will keep members apprised of any additional communication from the White House Coronavirus Task Force in follow-up to this meeting.
Visitor Restrictions for Residential Care Facilities Updated
The Michigan Department of Health and Human Services (MDHHS) issued an order Sept. 10 that will allow outdoor visits at residential facilities while continuing to require precautions to protect against COVID-19. Residential facilities are not required to allow visitors under this order, which takes effect Sept. 15; it simply allows the visits if they meet the requirements and wish to allow guests.
The order is based in part on recommendations from the governor’s Nursing Home Preparedness Task Force and creates exceptions to the governor’s order that temporarily restricts visits at healthcare, residential, congregate care and juvenile justice facilities. The MDHHS also considered the flattening of the COVID-19 curve and the impact of the visitor restrictions on residents of these care facilities in issuing the order. Residential facilities are required to ensure that outdoor visitation areas allow for at least 6 feet of separation between all people and provide adequate protection from weather elements. Someone trained in infection control must also be within sight range for compliance reasons.
Facilities must meet certain criteria, including having had no new COVID-19 cases originate at the facility within the previous 14 days. Additional requirements and a description of the facilities the order affects can be found in the emergency order.
Authorized Use of Remdesivir Expanded
The Food and Drug Administration recently expanded the authorized use of remdesivir for treating COVID-19 patients. Remdesivir can now be used for all hospitalized COVID-19 patients, confirmed or suspected, whether the patient is on oxygen, off oxygen or intubated. This is a departure from the previous policy that restricted such treatment to those who required oxygen. For additional details, members can review the complete authorization letter issued Aug. 28.
Webinar Recording to Focus on PPE Strategies and Trends
The Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response will hold a webinar Sept. 24 on personal protective equipment (PPE) preservation strategies, trends and lessons learned. Although the HHS webinar appears to be at maximum capacity, recordings of the event will be available upon request. The COVID-19: Optimizing Healthcare Protective Equipment and Supplies webinar will include public and private sector presenters on optimizing supplies of respirators and PPE, including crisis capacity strategies, respirator and mask testing programs, disinfection and decontamination procedures, and acquisition and distribution policies. An online flyer provides more information on the topics to be covered and how to receive the recording.
CMS Releases Guidance for Reporting Requirements for Labs and Long-term Care Facilities
The Centers for Medicare & Medicaid Services (CMS) released COVID-19 reporting requirements Sept. 8 for laboratories and long-term care facilities. The new guidance complements a Sept. 2 interim final rule. Laboratories are expected to comply with the new requirements by Sept. 23. Those not in compliance will be subject to civil monetary penalties. The CMS also released new enforcement information for long-term care facility reporting requirements.
The MHA continues to work with both the MDHHS and the HHS to streamline the reporting process. Members with questions on data reporting should contact Jim Lee at the MHA.
Recording COVID-19 Federal Payments on the Medicare Cost Report
A recently updated CMS COVID-19 FAQs clarifies that COVID-19 Provider Relief Fund payments and Paycheck Protection Program loan forgiveness funds from the Small Business Administration should not be recorded as offsets to expenses on the Medicare cost report. This information is particularly important for critical access hospitals’ and other hospitals’ cost-based Medicare reimbursements, which would have been reduced if COVID-19 funding were to offset costs. The answers specific to Cost Reporting begin on page 98 of the document. Members with questions should contact Laura Appel.
Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC). Members with MHA-specific questions should contact the following MHA staff members:
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