Money to SNFs - HHS has made an announcement that all SNF members should be receiving new funds in their accounts this week. It is believed this is the $2.5 billion initial payment out of the $5 billion allocation announced by HHS and the President in late July. See more here.
- Based upon (national) member reports, it looks like the formula is $10,000 per nursing home + $1450 per bed. This aligns with scenarios HHS had discussed with the trades in recent weeks.
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See HHS' terms and conditions for these funds. The use of these funds will be limited to "infection control expenses", which are outlined in more detail in this article.
- Monthly testing in counties with less than 5% positivity
- Weekly testing in counties with 5-10% positivity
- Bi-weekly testing in counties with greater than 10% positivity
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Positivity rates should be monitored every other week here (the data will be available beginning August 28). Nursing homes have the flexibility to choose whether this testing is conducted via point-of-care antigen tests or nucleic tests processed in an off-site lab (PCR testing), provided test results are returned within 48 hours.
- The guidance addresses how to respond to residents and staff who refuse testing, and exactly what documentation is required for a multitude of circumstances (outbreaks, symptoms, testing residents, testing staff, refusals, lack of access to testing, etc.).
Nursing Home COVID-19 training. Please see an article today related to the new COVID-19 training that CMS announced yesterday. There is still no indication at this time that this training is linked to Provider Relief Funding. The training is available online and has 15 modules targeted to front-line staff and nursing home management.
3-day stay saga continues. There is still a rumor that nursing homes are being told by hospitals that the 3-day stay waiver is no longer in effect or will soon be terminated. This has been confirmed twice with CMS to be un-true.
NHSN updates. NHSN updates are scheduled for today – Friday 8/28/2020. Those who are responsible for group reporting should check the NHSN site for updated templates. NHSN will also be working to transition all users to enhanced security levels within the next 2 months. This is optional and users will be contacted by NHSN in the coming weeks with information on how they can take part. Required reporting will not be interrupted while a user transitions to the upgraded enrollment.
Meeting on PRF Reporting. LeadingAge met with other provider associations including acute care and post acute care organizations where we learned that HHS draft guidance on required reporting for the Provider Relief Fund includes a different interpretation of “lost revenues” than what our understanding has been based on the HHS FAQs. We were told that we misinterpreted the FAQ definition around “lost revenues” and according to an HHS General Counsel, it is their view that it does NOT include reductions in occupancy or shorter lengths of stay or similar items. Their view is that COVID-related costs that exceed revenue or reimbursement are the only things that count. We are hoping this is just a miscommunication between different parts of HHS and can be resolved before the final reporting guidance is issued. The associations have requested and will renew its request to meet with HHS to resolve this issue prior to its issuance of the final guidance
Provider Relief Fund (PRF) and Paycheck Protection Program (PPP) Funds Reporting on Medicare Cost Reports. HHS released updated FAQs (press release here) with more details on how providers should report funds received from PRF and PPP on their Medicare Cost Reports. Side note: Final guidance is anticipated in September prior to the reporting system launching around October 1. This reporting applies for Skilled Nursing Facilities, Home Health Agencies and Hospice providers who received funds. PRF and forgiven amounts of PPP funds are to be recorded on the cost report under the “statement of revenues for informational purposes.” Any PPP amounts that aren’t forgiven are Providers whose PPP funds are not reported on the Medicare cost report. Any interest paid on PPP loans may be reported on the cost report as interest expense, similar to other interest expenses. Providers should not adjust their Medicare cost report expenses based upon PRF payments received but instead need to follow PRF Terms and Conditions related to the use of the funds. Likewise, forgiven PPP amounts should not be offset against expenses “unless those amounts are attributable to specific claims such as payments for the uninsured.” See also: at https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html; https://www.sba.gov/funding-programs/loans/coronavirus-relief-options/paycheck-protection-program and https://home.treasury.gov/system/files/136/PPP--Loan-Forgiveness-FAQs.pdf.
Elder Justice Reauthorization. The bicameral “Elder Justice Reauthorization Act” (summary here) has been introduced by House Ways & Means Chairman Richard E. Neal (D-MA), Senate Finance Ranking Member Ron Wyden (D-OR), Senator Bob Casey (D-PA), and Congresswoman Suzanne Bonamici (D-OR). The bill reauthorizes and funds the Elder Justice Act for five years. The bill does not add any new provisions to the current EJA, but does substantially increase funding by $2.2 Billion for: Elder Abuse forensic centers; the grant program for LTC staffing and technology; Adult Protective Services; the ombudsman program; and LTC investigation systems and training (training for state surveyors who investigate allegations of abuse or neglect and for LTC facilities).
