March 26, 2020
EMResource - ISDH's COVID-19 PPE Inventory Tracking Tool

The ISDH is Urging long term care facilities to register to use EMResource, a web-based management and communication tool used to monitor changes in supply inventory. ISDH is asking each Nursing Facility to update your PPE supplies DAILY using EMResource so resources can be distributed efficiently. Please call me if you are unable to register or use the tracking tool. or 812-470-8256

FSSA’s Chief Medical Officer Urges Action
During today’s briefing with ISDH, Dan Rusyniak, Chief Medical Officer at FSSA re-emphasized of the importance that all LTC provider to do the following:

  • Complete the 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.
  • Limit patient contact to only essential direct care providers (Nurse, CNA, QMA, Hospice, EMS etc.), Notice
  • All LTC facilities should require those involved in direct patient care to wear a mask during their entire shift. Mitigation Strategie
  • If national and local supplies are at conventional capacity, then all staff in LTC facilities should wear a facemask per standard recommendations.
  • 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. 
  • 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
  • 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 anddecrease respiratory droplet spread
  • Invite ISDH’s “Strike Team” to come to your building and check your readiness for COVID-19. The Strike Team is not a regulatory “got-you” visit. It is intended to be a check-up for readiness and to offer suggestions
  • 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.
  • 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 

March 25, 2020
CMS Approves Indiana’s 1135 Waiver. This is another important step intended to help SNF’s mount a quick and effective LTC response to COVID-19.
Stay Tuned: Work remains on how this will be operationalized before individual SNF move forward on this waiver.   Read the complete details here
  1. Temporarily suspend Medicaid fee-for-service prior authorization requirements. Section 1135(b)(1)(C) allows for a waiver or modification of pre-approval requirements, including prior authorization processes required under the State Plan for particular benefits.
  2. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency.
  3. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days
  4. State Fair Hearing Requests and Appeal Timelines
  5. Provider Enrollment
  6. Provision of Services in Alternative Settings
  7. Duration defined

ISDH Issues “Complete Tool Kit for COVID-19” HERE

March 23, 2020- Updated