COVID-19 UPDATE #73
September 1, 2020
STRINGS ATTACHED TO NURSING HOME FUNDING
Last week, nursing home providers around the country received an infusion of Infection Control Provider Relief Funds (PRF) from the US Department of Health and Human Services (HHS). On average, providers received $150,000 to help with upcoming testing costs and other infection control expenses.  The provider should be aware that the Terms and Conditions are different from previous Terms and Conditions and can be found here. 

By accepting the funding, the Recipient certifies that the Payment will only be used to reimburse the Recipient for costs associated with the following items and services (“Infection Control Expenses”):
  • Costs associated with administering COVID-19 testing, which means an in vitro diagnostic test approved by the FDA;
  • Reporting COVID-19 test results to local, state, or federal governments
  • Hiring staff, whether employees or independent contractors, to provide patient care or administrative support
  • Expenses incurred to improve infection control, including activities such as implementing infection control “mentorship” programs with subject matter experts or changes made to physical facilities
  • Providing additional services to residents, such as technology that permits residents to connect with their families if the families are not able to visit in person
  • The Recipient certifies that it will not use the payment to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse.

Discussion
Below are quick explanations by highlighted bullet.
TERMS AND CONDITIONS STATEMENT
INTERPRETATION
Hiring staff, whether employees or independent contractors, to provide patient care or administrative support
The staff hiring discussion is placed under the new Infection Control Expenses discussion. All staff hired using this allocation must be engaged in Infection Control activities with clear documentation demonstrating this.
Providing additional services to residents, such as technology that permits residents to connect with their families if the families are not able to visit in person
As part of Infection Control efforts and to mitigate the impacts of social isolation, the Infection Control Allocation dollars may be used to pay for technology such as iPads, etc. As with staffing, above, fund use must be clearly documented.
The Recipient certifies that it will not use the Payment to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse.
This new clause is the clearest statement from HHS that is expects other sources of reimbursement to be used before the PRF funds. This would mean Medicare and Medicaid funds should be used to cover costs and PRF used for any remaining costs. Previously, only a FAQ alluded to this point. AHCA/NCAL is asking that HHS make a clearer statement about Medicaid and PRF relative to precedence but this new Terms and Conditions provision should be helpful in dialogues with State Medicaid Agencies on future rate setting.
NEW CMS COVID-19 TESTING REQUIREMENTS FOR SKILLED NURSING EFFECTIVE TOMORROW
The Centers for Medicare and Medicaid Services (CMS) has issued an interim final rule with requirements for routine COVID-19 testing in nursing homes. This rule goes into effect on September 2, 2020. The American Health Care Association (AHCA) has developed several resources to help members understand and meet these new requirements. Read more.
AHCA/NCAL PROVIDES RESOURCES FOR PROVIDERS WHO APPLIED FOR HHS FUNDING
The Department of Health and Human Services (HHS) has released letters to some providers indicating they had not submitted financial information needed for Phase 1 Provider Relief Fund documentation. The letters do require financial information to be submitted and should not be disregarded. Read more.

AHCA/NCAL has also developed a template cover letter to help members include relevant information when communicating with HHS about the use of Provider Relief Fund dollars. Read more.
UPDATE ON HHS PRIVATE PAY FUNDING FOR ASSISTED LIVING PROVIDERS
We have notification from Argentum sharing they learned that the Office of Management and Budget has approved a distribution from the Department of Health and Human Services (HHS) provider relief fund for private pay licensed assisted living providers. While they are not sure when a public announcement will be made by HHS announcing the distribution, they believe it will be within the next few days. Argentum continues to monitor this funding, and when the announcement is made, they will immediately notify us so we can provide information on the application details and deadline, and offer resources to assist you in the process.
LTC WAIVERS EXTENDED TO OCTOBER 1
On August 31, the Washington Legislature’s “four corners” approved an extension of LTC-related COVID-19 waivers. Here is the letter affirming the extension until October 1, 2020. These waivers, which have been in effect since the statewide COVID-19 emergency was declared, must be extended by legislative leadership to remain in effect. 

As the provisions of Proclamations 20-37 and 20-38 are now contained in 20-65 and 20-66, it is unnecessary to extend them separately. For a complete listing of waivers, click here for the WHCA waiver tracker. Please note that the hyperlinks to proclamations are not yet updated; we are waiting for that information to be posted by the Governor’s office. Expiration dates are updated for your ease of review.

If you have questions or need additional information regarding waivers, please email Lauri St. Ours or call her at (800) 562-6170, extension 104.
ADDITIONAL RESOURCES
WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.