COVID Update #236

HFAM Update, Winter Weather Alert,
Medicare Accelerated and Advance Payment (AAP) Repayment
HFAM Update

Friends:
 
Due in no small part to your efforts, vaccination, and the decline of the surge brought on by the holiday season, the presence of COVID-19 in Maryland skilled nursing centers and assisted living campuses has massively declined in recent days and weeks. Still, with the new strains and hotspots in the community-at-large, we all MUST remain vigilant. I know of one center that went three weeks without a single COVID-19 case and had begun more family visitation. A single new patient case was discovered this week and therefore, the center had to put severe visitation restrictions back in place—as required by federal rule.
 
Let us all remember that we have covered a great deal of ground in our fight against COVID-19 over the last year. The fact that we are talking about vaccine distribution is a credit to our scientists and our medical-industrial complex. A year ago, the only way to test for COVID-19 in Maryland was through the State Lab and in cooperation with the CDC, with only dozens of tests being conducted per day. 
 
It was not until March 2020 that commercial labs and hospitals in Maryland stood-up their PCR testing capacity. Around this time while we were at the beginning of the first dramatic COVID-19 surge, skilled nursing and rehabilitation centers began initiating and paying for testing in advance of government orders. Without the actions of these leaders, we would not have known how desperate the situation was and fewer lives would have been saved.
 
I remember getting a very welcome call from Andy Diamond at Diamond Labs last March. He told me that his lab was prepared to be a critical resource for our members and the entire sector. Going forward, we increasingly stressed the importance of COVID-19 testing and highlighted how Diamond Labs could help. From April 2020 to today, Diamond Labs’ and Maryland's commercial lab PCR testing capacity has been going FULL STEAM AHEAD, with massive ongoing testing volume.
 
From our experience over the last year, it is essential to note: 
 
  • When public and consumer demand for testing increased over the past year, all healthcare settings struggled to get clinically actionable results from labs within 48 hours.

  • Labs with the most experience before the pandemic, such as Diamond, consistently met the 48-hour turnaround requirement.

  • When skilled nursing and rehabilitation centers cut back on PCR testing volume due to the increased availability of point-of-care testing (POC), and then again needed to contract for PCR testing, it was often challenging to sign up with the same lab.

  • The way forward on testing is to maintain PCR commercial lab testing augmented by point-of-care testing.

  • As visitation increases, there will likely be a role for point-of-care testing relative to visitation.
 
Also, here is a link to our latest update to government leaders.
 

2021 HFAM Conference: Together We Re-Imagine
 
We are excited to announce that the 2021 HFAM Conference, “Together We Re-Imagine,” will be held October 4 – 7, 2021 at the Maryland Live Hotel and Casino in Hanover, Maryland.
 
Hundreds of long-term care leaders will connect, share best practices and discuss actionable insights on how we can reflect, reform, rebuild, and revolutionize quality care. You and your teams will not want to miss this opportunity as we come together again. Please see the below flyer and click here for the conference website.
As Always:
 
  • People first, quality counts.
  • Be prepared to deploy people and PPE around your organization.
  • Our sector MUST double our efforts on infectious disease protocol, staffing, PPE, observation, and testing.
  • Train, train, and train teams again on infectious disease protocol.
  • Recognize that COVID-19 fatigue is an issue across the county, not just in our sector.
  • Overcommunicate with residents, patients, families, staff, and government partners.
  • Sound alarms early.
  • Know that WE WILL get through this and that you are saving lives!
  • Work with your hospital partners, and coordinate with local and state regulatory partners.
  • Take and document your action; keep a timeline.
  • CLICK HERE for the Dr. Katz Video, and please see the Donning and Doffing Checklist we have been sharing. 
Joe DeMattos
President and CEO
***Weather Alert***
Winter Storm Warning from
Thursday 3:00 AM until Friday 6:00 AM EST
 
As we all know, Maryland winter weather can be unpredictable. Beginning at 3 AM Thursday until 6 AM Friday, we are expecting a winter storm with heavy snow, along with sleet and freezing rain.

Snow will mix with sleet and freezing rain, with potential power outages and tree damage due to ice. Travel could be very difficult and hazardous conditions could impact commutes.

Be sure to check local weather alerts for updates specific to your location. And, regardless of your location, we remind everyone to plan, act and adjust to the situation at hand in any weather or other emergency situation.
 
Per established protocols, nursing and rehab centers are expected to work with local emergency management and government officials during a severe weather event and report problems and failures as outlined in disaster plans and state regulations. We urge HFAM members and all skilled nursing and rehabilitation centers in Maryland to be proactive:

 
It is difficult to predict precise paths and severity of storms that may hit our area. Consider appointing a “weather watcher” and have them check the NOAA Storm Prediction Center and The Maryland Emergency Management Agency websites for updates.
Medicare Accelerated and Advance Payment (AAP) Repayment – Two Months and Counting

AAP repayments for all Medicare providers who received AAP payments begin one year from date of the AAP receipt. Repayment start dates are specific to SNF providers associated with their date of AAP receipt. For many SNFs, repayment dates begin in April 2021. Providers do not need to take any action to repay. 

Rather, Medicare Administrative Contractors (MACs) automatically will begin to recover payment amounts reducing paid claims until the AAP is repaid. AHCA was successful with ensuring SNFs were including in the Continuing Appropriations Act, 2021 and Other Extensions Act.  This law extended and modified the repayment schedule. Additionally, the law fixed the interest rate at 4%. Normally, AAP payment extensions are subject to the Treasury Department’s given interest rate. Access to these provisions offer more time to repay and more predictability through a fix interest rate. 

Based on the statutorily defined schedule, SNFs should assess their cash flow for quarter two of 2021. For an AHCA overview of the repayment schedule, additional AAP information (including options to request payment extensions), and MAC webpages, click here. To review the CMS FAQs, click here.
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.