The Academy of Senior Health Sciences, Inc. (formerly The Ohio Academy of Nursing Homes, Inc.) seeks to provide public education and awareness initiatives to the long-term care community in Ohio. Our membership represents a true cross-section of the skilled nursing facility profession, from small sole proprietorships to larger Ohio-based multi-facility companies, as well as those businesses that service our industry. Through our public education and awareness efforts, the Academy brings the collective influences of the members together into a single voice on vital issues affecting our profession.
Founded in 1966, the Academy then identified one of its core purposes as "To foster a spirit of goodwill among those persons engaged in the nursing home industry, to promote ethical practices in their relationships with each other, their employees, and the general public to the end that all interests may be served fairly..." Though the organization has undergone several transformations over the years, most notably in 2011, its dedication and commitment to Ohio's most frail and elderly remains the same.
| The Academy Weekly Headlines from 2 Weeks Ago|
ODH releases TNA update related to expired waiver
The Ohio Department of Health issued a memo last week that provided guidance on the requirements for TNAs to become STNAs due to the expiration of the CMS waiver. The memo notes: "Beginning June 7, 2022, any temporary nurse aide who was hired prior to June 7, 2022, and has not completed the 75 hours required by 42 CFR §483.152 (a) and (b) will be required to complete nurse aide training either through training in the LTC facility or via a State Approved Nurse Aide Training Competency Evaluation Program (NATCEP) and take the state test within four months. Any individual hired after June 7, 2022 will be required to complete training through a State Approved NATCEP and complete the state test within four months. This was the process prior to COVID-19 and the STNA waiver provided by the Centers for Medicare and Medicaid. If an individual is unable to take the test prior to October 6, 2022, due to testing availability, they must have documentation from the testing location indicating they have attempted to register. This documentation can be in the form of an email or notification from the testing registration system. This documentation should be maintained in the TNAs file. Consistent attempts to schedule should be every 2 weeks, and that documentation is maintained until the individual is able to take the test. This information will be reviewed on survey after October 6, 2022." Please click here to view the memo.
ODH LSC meeting notes
The Ohio Department of Health met with nursing home representatives in their quarterly LSC meeting. Below are notes from the meeting:
- QSO-22-15: Providers are reminded that the LSC waivers have expired. Fire drill requirements are back to normal, as are inspection requirements. Furthermore, facilities are no longer permitted to use temporary barriers. Providers can apply for a waiver if necessary. ODH said providers have taken more permanent steps to help with isolation for infectious disease, including installing doors in the hallways that meet code. ODH is willing to work with providers on finding solutions that meet code.
- Review emergency plans: ODH is asking providers to review their emergency plans. New maintenance staff and CHOPs have created situations where there may be gaps in the maintenance staff and knowledge of the EP. For example, know which HVAC system is responsible for which zones so if one goes out, they can direct staff where to move residents into an area that has a working system. Providers should also review contracts for generators, portable air conditioners, or other supplies and services they may require during an emergency.
- Maintenance manual: ODH noted that the maintenance manual is a guidance document and does not contain the answer to every LSC situation. Providers should still check with the NFPA to ensure compliance. They have received feedback on the manual and may be making some updates soon.
Notes from the ODH survey and certification meeting
ODH meets with long-term care representatives on a monthly basis. Below are the notes from last week's June survey and certification meeting:
If you have a survey and certification question or concern for ODH, please let us know and we will get it addressed at the next meeting in August.
- HHA licensing rules: Rules are still pending. ODH does not think they will be done in time for the Oct 1 start date in statute.
- Positive case notification: ODH said that providers do not have to notify ODH for survey purposes after the first positive case. There is no need to notify ODH survey and certification, even if it is a new outbreak. Just once for the first positive and never again.
- QSO-22-17-ALL: ODH noted that as required in memo QSO-22-17-ALL, they would only be surveying for the vaccine requirement during annual surveys and complaint surveys related to the vaccine requirement. If there is an actual harm level finding, ODH has to consult with Chicago before issuing a citation. This is expected to continue until QSO-22-11 is updated.
- High heat, review plans: ODH sent an EDIC notice to providers to remind them to check their HVAC and review their emergency plans for power outages during high temperatures. They also recommend reviewing contracts related to those plans.
- Survey update: ODH has almost completed all back logged complaint surveys (37 remaining). They did 61 NH annual surveys last month and still hope to increase that number this month.
Up to date vaccination status: ODH said they are not making any changes to how they are surveying facilities as it relates to "up to date" vaccination status and the additional booster shots.
- Citation trends: ODH noted the following citation trends: Elopement and staff supervision related citations. Unsafe discharges. Still seeing IPC citations. HVAC/ air conditioning not working. Lack of staff citations including residents missing meals and medications.
- Offsite review for surveys: ODH said they are trying to move most of the surveys to onsite, including access to documents. However, there are circumstances when offsite access will speed the process. For example, if a survey has to stop because of a complaint survey, they may review documents while offsite.
- R3AP program: Director McElroy noted limited use of R3AP, especially the crisis staffing. Providers are reminded that the service is available and there is no reason to receive an IJ or serious harm citation directly related to a lack of staff.
- Isolation/cohorting for COVID: ODH said they would not cite providers that isolate in place despite CDC guidance recommending creating wings or grouping COVID positive resident rooms together. The associations requested this information be provided in writing.
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