Coronavirus Update #68
MDH Update on Stimulus Payments, Additional Provider Relief Funds Distributed,
NHSN Reporting, Blanket Waivers for ICFs/IID, ASPR Webinar
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MDH Update on 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."
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Additional Provider Relief Funds Distributed
HHS will begin distribution of the remaining $20 billion so that the whole $50 billion general distribution is allocated proportional to Medicare providers' share of 2018 net patient revenue less Medicare fee-for-service which was included in earlier distributions. On April 24, a portion of providers will automatically be sent an advance payment based off the revenue data they submit in CMS cost reports. Providers without adequate cost report data on file will need to submit their revenue information to a portal opening this week on the
Provider Relief Fund website
for additional general distribution funds. Providers who receive their money automatically will still need to submit their revenue information so that it can be verified. Payments will go out weekly, on a rolling basis, as information is validated, with the first wave being delivered starting on April 24, 2020.
A future distribution will focus on Medicaid only providers who do not have Medicare cost reports. As we learn additional detail about the distribution formula, we will provide more information.
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Update on Pending Requirement for National Healthcare Safety Network (NHSN) Reporting
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As announced in
CMS memo
earlier this week, CMS will be issuing a new requirement for nursing homes to report to CDC’s National Healthcare Safety Network which is the nation’s most widely used healthcare-associated infection tracking system. Our partners at AHCA, along with other stakeholders, met with staff from CDC NHSN to seek more information about accessing NHSN and the reporting requirements.
Key takeaways providers should be aware of are:
- There will be an option for an expedited registration and credentialing process for new users of NHSN. It is estimated to take one hour via email communication to complete this process.
- Reporting to NHSN will likely be required weekly.
- There will be a probable grace period from enforcement to allow for rollout of this new requirement. CMS will determine the length of time of that grace period which is not known at this point.
The goal of reporting to NHSN is to:
- Augment case reporting to understand facility specific impact
- Identify resource needs and prioritize public health action
NHSN will be providing training and support such as office hours and a user support desk in the coming weeks. We will share more information as it becomes available from CDC NHSN and when CMS issues the rule for these requirements.
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COVID-19 Emergency Declaration Blanket Waivers for ICFs/IID
Today, CMS released
additional blanket waivers
to the healthcare community in order to provide the flexibilities needed to take care of patients during this public health emergency. Staffing and training modifications in
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID)
were included in this release. More waivers are yet to come down the way for ICF/IID providers. A summary can be found below of what flexibilities are being provided for these providers in the release from CMS today.
- Staffing Flexibilities. CMS is waiving the requirements at 42 CFR §483.430(c)(4), which requires the facility to provide sufficient Direct Support Staff (DSS) so that Direct Care Staff (DCS) are not required to perform support services that interfere with direct client care.
- Suspension of Community Outings. CMS is waiving the requirements at 42 CFR §483.420(a)(11) which requires clients have the opportunity to participate in social, religious, and community group activities.
- Suspend Mandatory Training Requirements. CMS is waiving, in-part, the requirements at 42 CFR §483.430(e)(1) related to routine staff training programs unrelated to the public health emergency. CMS is not waiving 42 CFR §483.430(e)(2)-(4) which requires focusing on the clients’ developmental, behavioral and health needs and being able to demonstrate skills related to interventions for inappropriate behavior and implementing individual plans.
- Modification of Adult Training Programs and Active Treatment. CMS recognizes that during the public health emergency, active treatment will need to be modified. The requirements at 42 CFR §483.440(a)(1) require that each client must receive a continuous active treatment program, which includes consistent implementation of a program of specialized and generic training, treatment, health services and related services. CMS is waiving those components of beneficiaries’ active treatment programs and training that would violate current state and local requirements for social distancing, staying at home, and traveling for essential services only.
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ASPR Webinar - Protecting Our Frontline Health Facilities from Evolving Security Threats during COVID-19
On
Friday, April 24, at 1:00 pm EDT,
the Department of Health and Human Services (HHS) is partnering with the Department of Homeland Security (DHS) and InfraGardNCR on a webinar series to inform the private sector, state and local government first responders, and public healthcare professionals of potential increased threats to HPH facilities.
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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:
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Thank You Messages from Congress
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Congressman Sarbanes
Please watch and share with your teams this
special message
from Congressman John Sarbanes to thank all caregivers, residents, and families for all they are doing during this difficult time. Congressman Sarbanes offers words of encouragement to residents in Maryland's skilled nursing and rehabilitation centers and assisted living campuses and salutes the frontline caregivers as heroes during this health emergency.
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Congressman Harris
Please watch and share with your teams this
special message
from Congressman Andy Harris as he shares words of
encouragement to caregivers, residents, and families of the Maryland long-term and post-acute care sector during the unprecedented COVID-19 pandemic. Congressman Harris thanks staff in nursing homes and assisted living communities and reassures residents and families of those in long-term care centers.
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Be on the lookout for more messages!
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Reminder: Upcoming CMS COVID-19 Calls
CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.
COVID-19 Office Hours Calls (Tuesdays and Thursdays at 5:00 – 6:00 PM Eastern)
Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:Increase Hospital Capacity – CMS Hospitals Without Walls; Rapidly Expand the Healthcare Workforce; Put Patients Over Paperwork; and Further Promote Telehealth in Medicare.
Thursday, April 23
5:00 – 6:00 PM EST
Toll Free Attendee Dial In: 833-614-0820
Access Passcode: 5899488
Lessons from the Front Lines: COVID-19 (Fridays at 12:30 – 2:00 PM Eastern)
Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters.
Friday, April 24
12:30 – 2:00 PM EST
Toll Free Attendee Dial-In: 877-251-0301
Access Code: 5096006
Weekly COVID-19 Care Site-Specific Calls
CMS also hosts weekly calls for certain types of organizations to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.
Dialysis Organizations (Wednesdays at 5:30 PM Eastern)
Wednesday, April 22
5:30 – 6:00 PM EST
Toll Free Attendee Dial-In: 833-614-0820
Access Passcode: 1796168
Nurse Specific Calls (Thursdays at 3:00 PM Eastern)
Thursday, April 23
3:00 – 3:30 PM EST
Toll Free Attendee Dial-In: 833-614-0820
Access Passcode: 6004019
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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.
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Additional Resources and Guidance
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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.
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