Coronavirus Update #140
HFAM Update, MDH Webinar Recap, Resources for Frontline Workers,
AHCA/NCAL Virtual Convention, Additional Reminders
HFAM Update

Friends:

Thank You:  The care you and your teams provide is a people helping people enterprise that is driven by quality and compassion. Once again, words are inadequate to thank you and your teams for the lives you are saving. Today, during this time of COVID-19, more people in your care are recovering and living than are dying. Every single death is a tragedy to be mourned, and every life saved is to be cherished.

The Truth:  Maryland and our nation will be fighting COVID-19 until there is a broadly available vaccine. We are NOT out of the first wave, and there will be future surges in the community-at-large, and our centers and campuses. When this happens, we will apply what we have learned and we will double our efforts for meaningful government support in Washington DC, Annapolis, and throughout local government.  Honestly, I think with more community opening and some bars and restaurants now voluntarily re-closing with outbreaks, we sadly may see new nursing home hotspots sooner rather than later.

If a hotspot develops in a nursing home or assisted living campus:

  • Have adequate PPE on hand and re-train employees on donning and doffing.
  • TEST for COVID-19.
  • Review and retrain on operational plans, layout, and patient segregation.
  • Be DRIVEN by your infectious disease protocol.
  • Overcommunicate with staff, residents, and families.
  • Work in an active partnership with your state, local, and hospital partners.

NOTE : See this case study (sent earlier in March) and this donning/doffing checklist .

Testing:  I am proud and uplifted that all 227 skilled nursing and rehabilitation centers are participating in mandated universal testing with the State of Maryland. I am very concerned that some centers may be under testing with the state, perhaps because of those centers contracted testing. In our work behind the scenes there are some indications that, compared to the rosters submitted on July 3, some centers are requesting significantly fewer test kits from the State. Absent their own contracted documented and sufficient individual testing— that would be a problem.


***What HFAM Asks of You***

  Please email Hope Morris at [email protected] if your center has returned state specimen collection kits to CIAN this week. Include how many collection kits were returned and why.


Our continued ask in the near term is for the State of Maryland to provide this critically needed testing in Maryland skilled nursing and rehabilitation centers beyond the current August 1, 2020 state-imposed deadline. We estimate that the Maryland Medicaid rate would need to increase by 13 percent just to cover the cost of weekly universal testing in skilled nursing and rehabilitation centers. This in addition to the inflated costs for PPE, rightfully increased labor costs, and also with historical declines in as fewer Marylanders are being discharged to centers from hospitals.

THE LATEST, CMS POC TESTING MACHINES AND KITS

Many of us were on the CMS call earlier this week, and in our earlier update , we foretold the coming of POC testing. Yesterday afternoon we had an AHCA/NCAL on CMS provided POC Antigen/Active tests from two US manufacturers.  Here are some topline points:

  • CMS plans to distribute 1500 of these machines to skilled nursing and rehabilitation centers (SNFs) in the next eight weeks (as you know there are about 15,000 SNFs in the US and 227 in Maryland).

  • Current hotspot states will take priority: Arizona, Florida, Texas, Nevada, maybe PA (not Maryland).

  • States with hotspots and low hospital capacity will be next (not Maryland).

  • Skilled nursing and rehabilitation centers will need CLIR Waivers to use these tests, I suspect near 100 percent of MD SNFs have these; 92 percent of SNFs nationwide have them. If a SNF is doing finger stick tests now, they have such a waiver.

  • It will take several months for all states/centers (including Maryland) to receive these machines from CMS.

  • The machines will come with a limited number of test kits, say 400; additional test kits will need to be purchased by SNFs from manufacturers.

  • It is HIGHLY likely that SNFs will be able to bill Medicare for the testing, but at a lower rate because these are low throughput tests. AHCA/NCAL will send sector information on this.

NOTE:  These POC tests are thought to be 80-90 percent accurate versus 90-100 percent accurate in terms of the current Gold Standard PCR test. Related to this, commercial lab lag time is predicted to only increase in the coming weeks and months, it can range from 6-12 days now, which is not useful in preventing spread of the virus.  Putting in place the POC test with 15-minute feedback is a policy/public health trade-off—valuing immediate results and accepting potential high presumed negative results.

I am 100 percent vested and committed to the success of each of you and thankful for the quality care you provide! I’m All IN.  Again, very important:  Please email Hope Morris at [email protected] if your center has returned state specimen collection kits to CIAN this week – include how many and why.

Deep thanks for all you do. Onward together. Saying we are in a critical marathon is an understatement.  WE WILL get through this together!

Be well,
Joe DeMattos
President and CEO
MDH Webinar Recap

Yesterday, the Maryland Department of Health held a webinar call to update the long-term care sector on COVID-19 developments and best practices. The call was recorded, in case you were unable to join or would like to review the topics discussed, which included:

  • Review current situation of COVID-19
  • Testing Taskforce Updates
  • CDC Updates
  • OP&R Updates
  • Q & A


PPE Material Request form and Points of Contact

In addition, here is the application to obtain PPE from the local health department and points of contact for each local health department.
Resources for Frontline Workers in LTC Facilities

Below are three documents regarding free counseling to frontline workers in nursing homes and long term care facilities. Please review this documents and share with your teams.



Registration Is Now Open for the
AHCA/NCAL Virtual Convention!

October 8, 15, and 22

The past few months have been full of unprecedented challenges to the long term and post-acute care sector. That's why it's more important than ever that we gather for the 71st AHCA/NCAL Virtual Convention & Expo to review the past year, recognize the heroic work that you and your staff have done, and design solutions for what lies ahead.

Join your colleagues as we come together to reflect, share, and learn.
CMS COVID-19 Lessons from the Front Lines Call – Friday, July 17

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.

This Week’s Lessons from the Front Lines:
Friday, July 17th at 12:30 – 2:00 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; 
Access Code: 3096434
**ATTENTION ASSISTED LIVING PROVIDERS**

CARES Act Provider Relief Fund Portal

ACTION:  If you are serving Marylanders on Medicaid, we strongly encourage you to go to the Federal CARES Act Portal TODAY to seek federal emergency grant payment of relief. The Congress enacted and the President set aside those limited dollars for the benefit of Medicaid providers, even on assisted living campuses.

Here is a link to the portal: https://cares.linkhealth.com/#/

BACKGROUND:  As we shared in our 114th and 115th sector wide coronavirus email updates, the U.S. Department of Health and Human Services (HHS) launched a web application portal for Medicaid providers other than SNF Medicaid providers. The new Provider Relief Fund Payment Portal will initially be used for new submissions from Medicaid and Children’s Health Insurance Program (CHIP) providers seeking payments under the Provider Relief Fund including assisted living communities, ICFs/ID-DD, and home and community-based providers.

In the meantime, if you do provide Medicaid funded care, take action
and go online to apply for CARES Act relief today.
Reminder: Patient Driven Payment Model/New Minimum Data Set (MDS)

The Maryland Department of Health (MDH) has released a memorandum to nursing facilities administrators regarding CMS Minimum Data Set (MDS) version 1.17.2, which will be effective October 1, 2020. Please click here to view the full memo.

If you have any questions, please contact Mary Tarenyika at [email protected].
Reminder: Medicaid Provider Partnership Required to Support COVID-19 Testing Goals

Earlier this week the Maryland Department of Health (MDH) shared  this memorandum regarding Governor Hogan's established goal of testing 10 percent of the Maryland population. Per the memo, MDH requires the support of Medicaid providers in contacting Medicaid participants and encouraging them to seek a COVID-19 test.
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.