Coronavirus Update #69
Testing Request to Gov. Hogan, Preparing for Testing,
MDH Webinar Recap, Documentation, Avoiding Scams
Sector Requests Testing for All Residents & Staff

Together with our partners at LifeSpan and LeadingAge MD, we have issued a letter to Governor Larry Hogan requesting the State allot some of its newly-acquired 500,000 COVID-19 test kits to implement testing for all residents and employees in Maryland nursing homes and assisted living communities. Testing of all patients and workers – including those who are not exhibiting symptoms – is vital in order to stop the current surge of outbreaks in skilled nursing and rehabilitation centers and assisted living campuses.  

Statement from Joe DeMattos, HFAM President & CEO:
“During the COVID-19 pandemic nursing home and assisted living staff members are proving themselves not just as essential employees, but frontline heroes. From managing a virus that can spread without symptoms, to dealing with a shortage of adequate testing and PPE, to being forced to rightfully isolate residents from loved ones, the challenges are immense, unprecedented, and heartbreaking. Nursing home and assisted living employees are truly healthcare heroes. They are working hard and doing all they can to save lives and we need to ensure that they are protected and safe.” 

The Centers for Medicare and Medicaid Services (CMS) has recently emphasized the importance of testing for COVID-19 in nursing facilities. In addition, a growing number of states are requiring testing of all residents and/or staff. When accessing testing, we recommend providers ensure that the tests are FDA approved PCR tests (versus Antibody/Serology tests) and that the lab will bill Medicare directly. Providers need to have a plan in place to isolate residents  who test positive, and follow CDC guidance for staff that test positive. More information and guidance on preparing for widespread testing is available in here . 
MDH Webinar Recap

Today, the Maryland Department of Health held a webinar call to update the long-term care sector on COVID-19 developments and best practices. You can view the webinar's  PowerPoint presentation here.

The call was recorded if you were unable to join or would like to review the topics discussed. We will share the recorded call once it becomes available.

If you have any questions, please email   [email protected] 

Law firm Husch Blackwell lays out some general steps for documenting activities and response efforts to be prepared for surveys and potential litigation. AHCA/NCAL also recommends working with your legal counsel to develop practices. This resource is available to AHCA/NCAL members (log in required). 

AHCA/NCAL has developed a resource to warn providers about potential scammers posing as government officials. Learn more about how to screen callers claiming to be representing a state or federal agency or official or claiming to be from the IRS, Department of Commerce, or a Bank or other financial institution without first verifying the caller’s identity. This resource also includes ways to protect residents from scammers and some safety tips to confirm legitimate outreach calls from CMS or the CDC. 

Separately, AHCA/NCAL had previously created a resource on how to beware of scams when working with vendors offering personal protective equipment. 

Two weeks ago, we learned that skilled nursing would be included as part of the stimulus bill’s (aka the CARES Act) $100 billion Provider Relief Fund, when HHS distributed the first $30 billion from the fund and all skilled nursing facilities received 6.2% of their 2019 Part A and Part B Medicare payments. Yesterday, HHS announced an additional $40 billion in distributions , with checks going out as early as this Friday. Here is what we know so far. 

  1. SNFs are clearly part of a tranche of funds that HHS is using to pay providers based on their total revenue. It will distribute $20 billion of the $40 billion based on a percentage of providers total revenue, but will make some adjustment for Medicare revenue, that was recognized in the prior payment. We do not know the exact formula yet, but providers who have a high level of Medicaid and/or Medicare Advantage, will do proportionally better than those who do not. 
  2. HHS is also distributing $10 billion to those in COVID-19 hotspots. This may be for hospitals only. We are verifying that and if we are not part of these funds, we will seek reimbursement for SNF and AL COVID hotspots in future funding. 
  3. HHS is also distributing $10 billion to rural hospitals.  

AHCA/NCAL’s FAQs on the Provider Relief Fund has been updated to include information on the additional funding to be released this week. The FAQ will continue to be updated, as an increase of $75 billion is expected to pass the House and be signed by the President.  
Reminder: Stimulus Payments and Medicaid Eligibility

The Maryland Department of Health (MDH) has received a number of inquiries regarding whether the stimulus payment will be counted for Medicaid eligibility purposes.

According to MDH, the Department of Human Services has advised that "(any) income received as a result of COVID-19, including "stimulus payments" or "recovery rebates" or “Pandemic Unemployment Compensation” (otherwise known as the “$600 unemployment boost”) are not to be counted as income for MAGI and NonMAGI Medicaid applicants and recipients. Likewise, the payments are not to be counted as a resource for Non-MAGI Medicaid if spent within 12 months of receipt. NOTE: Traditional unemployment compensation continues to count as income."
Reminder: Daily Bed Availability Reporting Tool

As we shared recently, our partners at the Maryland Hospital Association (MHA) and CRISP have been working with post-acute providers and hospitals to streamline nursing home daily bed availability reporting. The hope is that this reporting tool will be an easier and more comprehensive way to understand bed availability than current processes.

The intent is to ask nursing home for key pieces of information that will not be overly burdensome and still provide enough information for hospitals to streamline post-acute care placement. Facilities will be allowed to enter data more than once per day if bed availability changes from first entry, but daily submissions will need to be completed by 10:00 am each morning.

All entries will be processed to provide a single source capacity directory that discharge planners and care managers can use to locate needed beds. Initially, this will be in the form of a spreadsheet emailed back to the discharge planners. Over time, it will also include display in CRISP.

Facilities that submit data will also be able to see daily bed availability across the state. You will need to be credentialed in CRISP to view data, but no credential is needed to submit.

Nursing homes can input information via this link:
Who are your healthcare heroes?

During the COVID-19 pandemic, nursing home and assisted living healthcare workers are proving themselves not just essential workers, but frontline heroes. From managing a virus that can be spread without symptoms, to dealing with a shortage adequate testing and PPE, to being forced to rightfully isolate residents from families and loved ones, these challenges are immense, unprecedented, and heartbreaking. Nursing home and assisted living healthcare heroes are truly working hard and doing all they can to save lives.

As we previously shared, this week is national  Careers in Aging Week . This week is happening in the most unusual of circumstances -- we are realizing more than ever before that for our best teams, this work is a calling. This week we will celebrate Maryland's Healthcare Heroes.

There are so many amazing stories of dedication, sacrifice, and compassion by long term care professionals who are going above and beyond to ensure the safety, health, and happiness of residents during this unprecedented time. These individuals are saving lives; they are heroes.

We want to hear your stories! Please email  [email protected]  to share a current story and picture of members of your team who are going above beyond to provide quality care during this unprecedented time. 
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.