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COVID-19: What You Need To Know

LHA Trust Funds has compiled a quick reference of resources and information about COVID-19. This page will be updated frequently with materials regarding the virus, hospital and facility protocols, CDC instructions and more.


LHA Trust Funds Advisories

Telemedicine: It’s Covered
Your professional liability coverage with the LHA Trust Funds already includes telemedicine visits as long as the patient is located in the state of LA. This guide explains your telemedicine coverage.

Telemedicine Licensing Requirements In Other States
With the issuance of CMS waivers for telemedicine services, we have received many questions as to whether state by state telemedicine licensing requirements have been lifted. While LA Governor Edwards has waived many of Louisiana’s requirements in his recent proclamation (38 JBE 2020), those waivers are only applicable to care provided in Louisiana.

Use Of Nurse Practitioners In The Emergency Department During A Public Health Emergency
The Louisiana State Board of Nursing requires formal education and certification as an Acute Care NP for NPs to treat patients in the Emergency Department who present with critical, traumatic and/or unstable conditions commonly associated with acute care. The LSBN has not waived this requirement during the statewide public health emergency.

Coverage For Medical Volunteers
Given the rapidly-changing circumstances facing our Participants, including the potential utilization of medical volunteers, we thought it would be helpful to remind you that there is limited coverage for volunteers under your Trust Fund coverage agreement.

Liability And Postponing Procedures
LDH released an updated Memorandum March 21, 2020, that directs all “medical and surgical procedures” SHALL be postponed until further notice. Mr. Robert Robison, Jr. of Watson, Blanche, Wilson & Posner advises LHA Trust Funds members of their professional liability due to the new Memorandum.

eStat: COVID-19 and Childcare
As COVID-19 continues to be a threat to our communities and your emergency preparedness plans are in effect, please be aware of these key points related to child care services.


General/Administrative

National Emergency Declared Over COVID-19 Coronavirus
This article explains what the recent national emergency announcement really means for hospitals in the midst of this crisis. It also defines regulatory relief, extra resources and the flexibility that is created from the declaration.

Trump Administration Approves 1st Medicaid Waiver to Combat Coronavirus
Florida received the first CMS waiver following President Trump’s national emergency declaration. The waiver allows the state to waive prior authorization requirements making it easier for out-of-state providers to provide care, allow care in alternative settings from hospitals or doctor’s office, suspend certain nursing home screening requirements to lower administrative burden and to extend deadlines for appeals and state fair hearing requests.

Eight COVID-19 Developments Healthcare Systems Need to Know
This article addresses the top eight developments that healthcare leaders should be familiar with as plans are established to address the surge of patients.

Enterprise VPN Security
As many organizations may be transitioning employees to working remotely from home offices, the Department of Homeland Security warns about hackers taking advantage of possible vulnerabilities associated with VPNs for telework. This article discusses the threat and recommends actions to reduce cybersecurity risks.

Guidance on Preparing Workplaces for COVID-19
OSHA issued this guidance to assist employers and workers in identifying COVID-19 transmission risks in the workplace and determine necessary control measures to reduce them. Although not all organizations fall under the jurisdiction of OSHA, the guidance is great information for any employer regarding how to protect workers from COVID-19.

CMS COVID-19 Toolkit
The Centers for Medicare & Medicaid Services (CMS) is taking action to protect the health and safety of our nation’s patients and providers in the wake of the 2019 Coronavirus (COVID-19) outbreak. CMS has released a Virtual Toolkit to help you stay up-to-date on CMS materials available on COVID-19.

Waiver or Modification of Requirements Under Section 1135 of the Social Security Act
This is a summary of the Waiver or Modification of Requirements under Section 1135 of the Social Security Act that was issued on March 13, 2020. The summary details regulations currently being waived or modified by HHS during the COVID-19 pandemic and relate to EMTALA, pre-approval processes, health care provider licenses, physician referral, etc.

Medicare Will Now Cover Telehealth to Fight Coronavirus
This article discusses President Trump’s announcement that Medicare will temporarily cover telemedicine services as part of the response to COVID-19.

OSHA Relaxes Fit-Testing Enforcement Under Certain Circumstances
This information addresses OSHA’s decision to relax Fit Testing requirements during the COVID-19 pandemic. These efforts have been implemented in recognition of the short supply of N95 respirator availability.

Section 1135 Waiver Flexibilities – Louisiana Coronavirus Disease 2019
This article includes the Section 1135 Waiver Flexibilities approved for Louisiana during the COVID-19 pandemic. It also features a link to the blanket waivers approved by CMS and effective for all hospitals, long term care facilities, home health agencies, etc. The topics of the approved waiver include PASRR Level I & II assessments, state fair hearing requests and appeals, provider Medicaid enrollment and provision of services in alternative settings.

Updated Notice: Medical and Surgical Procedures
This updated Memorandum from LDH released March 21, 2020, directs that all “medical and surgical procedures” SHALL be postponed until further notice. The only exceptions are procedures needed to treat an emergency medical condition, as defined in the memorandum, or to “avoid further harms from underlying condition or disease.”

Emergency Rule for Chloroquine and Hydroxychloroquine Rescinded
On March 22, 2020, the Louisiana Board of Pharmacy issued an Emergency Order to limit the dispensing of chloroquine and hydroxychloroquine. The Board has rescinded the Emergency Order based upon new information that the drug is not in short supply. Pharmacists are encouraged to dispense the medications as appropriate.

CMS Eases Quality Payment Program Reporting Requirements in Response to COVID-19
CMS has announced it is granting exceptions and extensions to Quality Payment Program reporting for those participating in the program but are currently on the front lines of the COVID-19 pandemic.

Bulletin: Civil Rights, HIPAA, and the Coronavirus Disease 2019
The Office of Civil Rights (OCR) published a bulletin on March 28, 2020, reminding organizations that their obligations to prohibit discrimination have not changed. This bulletin reminds organizations of obligations to serve certain populations of the community and it gives guidance to ensure all segments of the community are served.

Sweeping Regulatory Changes to Help U.S. Healthcare System Address COVID-19 Patient Surge
CMS has relaxed numerous rules and issued waivers of federal requirements to assist healthcare organizations in making it easier to care for patients during the COVID-19 pandemic. Some of the actions taken include increasing hospital capacity by using hospitals without walls, the ability to expand the healthcare workforce, reduction in paperwork, promotion of telemedicine.

CMS Suspends Restrictions On Care Venues As Providers Tackle COVID-19 Surges
The Hospitals Without Walls initiative is effective immediately until the end of the COVID-19 pandemic. This will allow hospitals to free up bed capacity by utilizing other types of organizations for patients who DO NOT have COVID-19. Other types of organizations may include rehab hospitals, ambulatory surgery centers, college dorms, etc.


Clinical

Checklist for Healthcare Facilities: Strategies for Optimizing the Supply of N95 Respirators during the COVID-19 Response
The CDC provides a checklist with strategies for optimizing the supply of N95 respirators during COVID-19 response. The checklist offers help in prioritizing the use of the respirators during the crisis.

CMS Reminds Providers About EMTALA Obligations with COVID-19 Patients
This article includes information regarding CMS EMTALA obligations during the COVID-19 response. It discusses ED responsibilities to patients seeking medication attention and the screening of suspected patients. CMS guidance on nursing home and hospice visitation is also covered.

COVID-19 Testing Algorithm for Clinicians and Discontinuation of Isolation Guidance for Healthcare Workers with Suspected or Confirmed COVID-19
This updated information released by the Louisiana Health Alert Network addresses the COVID-19 testing algorithm for clinicians and discontinuation of isolation guidance for healthcare workers with suspected or confirmed COVID-19.

Information for PACE Organizations Regarding Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19)
The CDC has released guidance for All-Inclusive Care for the Elderly Organizations (POs) to help protect the health and safety of individuals during the COVID-19 pandemic. The guidance provides actionable and accepted policies and procedures with respect to infection control for these organizations that serve a high-risk population reliant on them.

COVID-19 Prioritization of Diagnostic Testing
the Infectious Disease Society of America has released an updated tiered approach to COVID-19 testing.

How to Talk to Your Kids About Coronavirus
Information on how to talk to children, including pediatric patients, about COVID-19. Being in the hospital is scary enough, but all of the chaos surrounding the pandemic makes things even scarier. This article offers clinicians practical advice about discussing the situation with children using resources and language they can relate to.

Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings
The CDC issued updated guidance on March 23, 2020, related to discontinuation of transmission-based Precautions for COVID-19 patients.

Duke Health to Begin Reusing N95 Masks
Duke Health has announced a method to sterilize N95 masks for reuse using aerosolized hydrogen peroxide. Although this practice is not typically recommended, the lack of masks during the COVID-19 pandemic has changed rules and spurred innovation. This technology does not damage the integrity of the masks and it kills the virus.

Optimizing Ventilator Use during the COVID-19 Pandemic
Ventilators are in short supply nationally. As an extreme measure, organizations may have to consider co-ventilating patients in an effort to optimize their use. In this article, the Surgeon General offers guidance with ventilator splitting but cautions that it should be a last resort.


Environmental Services

ADVISORY: Novel Coronavirus EVS Advisory
The advisory provided by the Association for the Health Care Environment provides CDC recommendations for environmental hygiene and hand hygiene related to COVID-19.


Facilities

ASHE Issues Recommendations on COVID-19 for Facilities Managers
This article featured direction to facility managers about managing the transmission of COVID-19. It offers recommendations related to patient entrances and flow patterns, negative pressure rooms, emergency and security plans. ASHE has also provided other valuable resource links.

Guidelines for Environmental Infection Control in Health-Care Facilities
CDC Guidelines for Environmental Infection Control in Healthcare Facilities provides details related to environmental air quality and air changes per hour to effectively remove airborne contaminants.

COVID-19 Resources Address Physical Environment Concerns
An article from The Center for Health Design that has pulled together resources to minimize transmission of infectious diseases, including COVID-19, within a healthcare facility. This article discusses airflow patterns, isolation rooms and HVAC filtration.


Workers’ Compensation

Occupational Safety and Health Administration (OSHA) Standards
While OSHA does not have any specific standard covering COVID-19, other OSHA standards related to preventing occupational exposure apply and can be found here. It is important to note that COVID-19 is a recordable illness when a worker is infected on the job.

U.S. Department of Labor Coronavirus Resources
This list of resources from the U.S. Department of Labor addresses issues concerning employees. It includes workplace safety, wage, hours & leave, unemployment insurance flexibilities, support for dislocated workers and states and many other topics of importance during the COVID-19 pandemic.