HFAM Update and Reminders
COVID Surge, Workforce, Legislative Session, Looking Ahead, AHCA RCM Academy
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Friends:
The good news is that as predicted the Omicron Surge is rapidly subsiding, and deaths caused by COVID-19 during this most recent surge among vaccinated individuals were extremely rare. Thank you for the quality care you provided Marylanders in need during this most recent surge. While the virus was less severe during this surge, you and our teams fought it with fewer staff on hand, strapped with outdated state and federal policies, and with a preventable lack of testing capacity.
For the most part, staffing ratios remained high 2021 and heading into 2022; and, direct and agency workforce costs remain historically high – CLICK HERE for an article on workforce and agency use that recently appeared in Skilled Nursing News.
Skilled nursing and rehabilitation centers in Maryland are completing state grant paperwork and receiving emergency grants from the $25 million announced by Governor Hogan in December. This year’s 444th meeting of the Maryland General Assembly is particularly busy in terms of advocating for and against proposed legislation. We have already reviewed literally hundreds of pieces of legislation. One of our main priorities is always the budget and funding of the Medicaid rate. Of course, this work is unique in Maryland and it remains a priority before, during, and after the legislative session. This session is made even more complicated by an upcoming historic election – by the end of 2022, Maryland will have a new Governor, Lieutenant Governor, Attorney General, Comptroller, and State Treasurer. Perhaps even a new US Senator. For those of you watching the Olympics and preparing for Super Bowl Parties this weekend, that’s sort of where we are with this legislative session taking in to account politics, elections, redistricting, and the important issues we are debating. To see some of the work we have been doing, please see this example letter that we recently sent to all members of the Maryland General Assembly.
Looking forward to the next month – three things:
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In our sector and other healthcare settings in Maryland, we have had some of the best COVID vaccination and booster rates in the country. Looking forward, I believe there will be continued federal and state pressure to keep up the vaccination and the boosters – perhaps even second booster among residents and patients in our sector. To that end, huge thanks to all of you that are stepping up and helping with the State’s Antibody Testing Research.
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The National Guard deployment was critical and positive in terms of helping with testing distribution and more recently with care extension work in our sector. Looking forward, I expect the Guard deployment to end soon. Together, we must offer our heartfelt thanks and appreciation.
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I want to commend you all. On the first day of the new PROPS online reporting tool, 210 out of 225 centers completed the reporting. More recently, 215 of 225 centers completed the reporting. The state is troubleshooting and reporting rates continue to go up. Looking forward, with the Maryland Department of Health’s increased reliance on PROPS, it is likely that weekly reporting directly to NHSN will become necessary.
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AHCA's Revenue Cycle Management (RCM) Academy:
As reimbursement models move from fee-for-service toward value-based reimbursement, more complex patient characteristic-based methodologies and accurate claims processes must extend beyond billing offices. SNFs operating without successful and integrative Revenue Cycle Management may be receiving insufficient payment for the care they deliver. Developing and implementing successful Revenue Cycle Management (RCM) strategies will coordinate the clinical and administrative functions necessary to improve patient outcomes, ensure timely and accurate collections, and lower administrative costs.
AHCA has launched Revenue Cycle Management (RCM) Academy, an online training program that educates facilities of all sizes on the interdisciplinary approach toward revenue management. RCM Academy covers the process from pre-admission to payment, and includes topics such as claims submission, third-party follow-up, strategies to navigate managed care, and best practices associated with coordinating with MDS coding leads. Participants will learn about the attributes of high performing teams, systems to assure proper and timely payment, and best practices for managing all payer sources to maximize revenue and minimize avoidable losses. To bolster the learning experience RCM Academy includes short videos profiling providers’ experiences running effective RCM programs, and additional webinars and resources will be developed throughout the year.
The cost of the course is $350 for AHCA/NCAL members and $650 for non-members. Upon successful completion, the course is approved for 6.75 NAB CEs. Participants will need to login to ahcancalED with their AHCA/NCAL usernames and passwords to register for Revenue Cycle Management Academy. For assistance obtaining usernames and passwords, members should e-mail educate@ahca.org with their name and facility contact information.
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As Always:
- Focus on what is in your control and not what is out of your control.
- Let’s get those boosters and the flu vaccine in the arms of people.
- Overcommunicate – with residents, patients, families, staff, and government partners.
- Adapt and innovate.
- Rely on your partnerships.
- Speak up when you need help.
- Double efforts on infectious disease protocols, training, and operations.
- Take and document your action; keep a timeline.
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CLICK HERE for the Dr. Katz Video, and please see the Donning and Doffing Checklist we have been sharing.
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Joe DeMattos
President and CEO
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Opportunity for CMP Funds
We recently heard from the Office of Health Care Quality (OHCQ) that the Centers for Medicare and Medicaid Services (CMS) has identified another opportunity to the use of CMP funds:
Question to CMS: Are there best practices for improving air quality to reduce risks during visitation?
Answer: Yes, a facility may consider a number of options related to air quality such as:
- Adding ultraviolet germicidal irradiation (UVGI) to the heating ventilation and air conditioning system (HVAC).
- To avoid having multiple groups of people or multiple visitors for a resident within small rooms or spaces, designate special visitation areas that are outdoors when practical or in designated large-volume spaces with open windows and/or enhanced ventilation.
- Adding portable room air cleaners with high-efficiency particulate air (HEPA, H-13 or -14) filters to communal areas.
- Ensure proper maintenance of HVAC system to ensure maximum outdoor air intake.
For additional information on air cleaning, disinfecting, and UVGI, see CDC’s Ventilation FAQs or the American Society of Heating, Refrigerating and Air-Conditioning Engineers site on Filtration and Disinfection.
Question to CMS: Is there funding available for environmental changes which reduce transmission of COVID-19?
Answer: Yes, a facility may request the use of Civil Money Penalty (CMP) Reinvestment funds to purchase portable fans and portable room air cleaners with HEPA filters to increase or improve air quality. A maximum use of $3,000 per facility including shipping costs may be requested.
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Take advantage of your credit union membership benefit!
As a reminder, HFAM has partnered with First Financial Federal Credit Union to offer our members access to all that the credit union has to offer. Credit Unions provide the same services as a bank, but offer lower loan rates, higher dividend rates, little or no fees, and maintain a commitment to the communities that they serve. You are eligible to join as an HFAM member, plus your immediate family members are eligible to join.
Join First Financial and open a new account from now through March 4th and you will receive $25!
To join online, simply go to firstfinancial.org/open or visit any branch. Choose Partner Group Promo Application and enter promo code: PROMO25. You will need your ID and $5 to open your account – your $25 cash deposit will be made after the promotional period ends. First Financial FCU looks forward to having you join the credit union family!
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Reminder: Updated CDC Healthcare Setting Infection Control Guidance
Some changes include:
The use of "up to date" instead of "fully vaccinated"
Empiric use of Transmission-Based Precautions (quarantine) is recommended for residents who are newly admitted to the facility and for residents who have had close contact with someone with SARS-CoV-2 infection if they are not up to date with all recommended COVID-19 vaccine doses
A test-based strategy and (if available) consultation with infectious disease experts is now recommended for determining the duration of Transmission-Based Precautions for patients with SARS-CoV-2 infection who are moderately to severely immunocompromised.
Patients placed in empiric Transmission-Based Precautions based on close contact with someone with SARS-CoV-2 infection should be maintained in Transmission-Based Precautions for the following time periods.
- Patients can be removed from Transmission-Based Precautions after day 10 following the exposure (day 0) if they do not develop symptoms. Although the residual risk of infection is low, healthcare providers could consider testing for SARS-CoV-2 within 48 hours before the time of planned discontinuation of Transmission-Based Precautions
- Patients can be removed from Transmission-Based Precautions after day 7 following the exposure (day 0) if a viral test is negative for SARS-CoV-2 and they do not develop symptoms. The specimen should be collected and tested within 48 hours before the time of planned discontinuation of Transmission-Based Precautions
Patients with mild to moderate illness who are not moderately to severely immunocompromised:
- At least 10 days have passed since symptoms first appeared and
- At least 24 hours have passed since last fever without the use of fever-reducing medications and
- Symptoms (e.g., cough, shortness of breath) have improved
Patients who were asymptomatic throughout their infection and are not moderately to severely immunocompromised:
- At least 10 days have passed since the date of their first positive viral test.
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Reminder: CMS Updated Nursing Home Visitation FAQs
The updates provide important clarifications, such as:
- Suggestions on how to conduct visits that reduce the risk of COVID-19 transmission.
- Best practices for improving air quality to reduce risks during visitation.
- Ways a facility can improve and/or manage air flow during visitation.
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Availability of funding for environmental changes, which reduce the transmission of COVID-19. Facilities can request CMP reinvestment funds to purchase portable fans and portable room air cleaners with HEPA filters.
- Visitor testing as a condition of entering a facility.
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New Resources from AHRQ
The Agency for Healthcare Research and Quality has several new resources that may be helpful to long-term care facilities.
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Want to see previous HFAM updates?
Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
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