Coronavirus Update #52

“Keep doing the right things for the right reasons, no matter what
anyone else is doing. Your consistency will shine through and more
people are watching than you know,” Dr. Jen Welter, first female NFL Coach.
Friends:

I know I say this a bunch, but I mean it now more than ever : “Thank you for all your teams are doing to provide quality care to Marylanders in need and to save lives.” By some models we are days away from the Maryland COVID-19 acute-care surge. During this time, care will be more integrated and transfers across all settings will increase in efforts to ensure lifesaving care capacity.

As I wrote last week, I am seeing data that shows Governor Hogan’s orders, especially around social distancing and staying home, are making a difference in the acute-care projections.  That said, now is NOT the time to stop these efforts. Now more than ever before, SNFs and ALs MUST operate with observation and isolation areas and operate DRIVEN by your infectious disease protocol.

IMPORTANT NOTE:  In our setting, without broad state sponsored sector testing a month ago with our first COVID-19 case (and since), we are to some extent fighting blind. So the infectious disease protocol diligence and the separate units are critical.  ALSO:

  • Appreciate, support, and over communicate with your care teams.
  • Over communicate with families, residents, patients, and staff.
  • Operate DRIVEN by your infectious disease protocol.
  • Execute your observation and isolation beds.
  • Work closely with your acute-care hospital partners and home health partners.
  • Stay in contact with local health offices and the Office of Health Care Quality (OHCQ).

Recent Broadcast Media Clips:
                                     



Thank you. You are doing all you can! Remain diligent on infectious disease protocol, observation and isolation areas. 

“Do not let what you cannot do interfere with what you can do,”
Coach John Wooden.
Joseph DeMattos
President and CEO, HFAM
Special Thank You Audio Message

HFAM has recorded a   special thank you   to those of you working in Maryland skilled nursing and rehabilitation centers and on assisted living campuses. Please distribute broadly to your teams.

We are all navigating together in these uncharted waters of the COVID-19 pandemic.   Now more than ever, it is important that we recognize we are in this together, and that we are stronger together.
CMS Issues FY 2021 SNF Proposed Payment Rule 

Late last week, The Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2021 update.
 
The proposed rule includes a net market basket increase of 2.3 percent. CMS estimates that the net market basket update would increase Medicare SNF payments by approximately $784 million in FY 2021. 

In regard to PDPM monitoring, CMS indicates the Agency will continue to monitor the impact of PDPM implementation on patient outcomes and program outlays. CMS notes that it would be premature to release any information related to these issues based on the amount of data currently available.” 

Finally, of note, as part of updating CBSAs, CMS is capping decreased in wage indices at 5 percent to prevent precipitous drops. 

The team at AHCA team has developed a summary (please note you will need to log in to see this summary) of the payment updates, the SNF value-based purchasing program, and the IMPACT Act quality reporting additions.  In addition, you can see AHCA's statement on this topic here.
Notification Guidelines for Confirmed COVID-19 Cases

Last week, AHCA/NCAL released new guidance  and a press statement on notifying public health officials and stakeholders about confirmed cases of COVID-19 in long term care facilities. This guidance reinforces much of what long term care providers are already doing and are currently required to do in their states. This guidance suggests that long term care providers should also report to the state survey agency, if you are not already, so that CMS and other federal agencies have another way to gather national information.
 
When a COVID-19 case is confirmed (whether resident or personnel) in a long term care facility, several notifications need to occur.

For the initial case of confirmed COVID-19 in the facility:


  • Notify all employees working in the facility.

For each resident in the facility who has a COVID-19 positive test (including each additional case after initial cases):

  • Notify the resident and/or their representative when they have a positive COVID-19 test. 

  • Notify state survey agency that you have a case.

  • Notify the local and state health departments with information per state reporting requirements. 

  • CDC guidelines state the health department should be notified about residents with severe respiratory infection or a cluster of respiratory infections (e.g., 3 or more residents or Health Care Professional (HCP) with new-onset respiratory symptoms over 72 hours) of residents or HCP with symptoms of respiratory infections.

  • AHCA/NCAL NOTE: COVID-19 would constitute a severe respiratory infection and should be reported; required information may vary by state.

  • Notify the primary physician for the resident who has a confirmed case. 

  • Notify all employees working in the facility.

For each staff member of the facility with a COVID-19 positive test (including each additional case after initial cases):

  • Notify state survey agency that you have a case.

  • Notify the local and state health departments with information per state reporting requirements. 

  • CDC guidelines state the health department should be notified about Health Care Professional (HCP) with symptoms of respiratory infection. Required information may vary by state.

For all communications above, keep records of notifications that have been made.
Did you miss HFAM's previous alerts?

Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
Thank you.

We cannot thank you enough for the dedication and diligence in doing all that you can for the residents in your communities. HFAM continues to monitor the COVID-19 pandemic with our state and national partners and will do all we can to support you during this time.