Forward This Update to Co-Workers |
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Leadership Network Calls
Earlier this month LeadingAge Indiana launched our Leadership Network series. These regional calls are on Zoom and last 30 minutes. They're facilitated by Eric Essley and it provides participants with an opportunity to check in during the pandemic and share. What's working? What's challenging? Think of it as a pulse check!
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Member Information Forms Due 9/15
Provider members will be receiving the Member Information Form (formerly Millage) very soon.
The form is completed each year for LeadingAge Indiana to calculate annual membership dues.
You will receive the letter and form in the mail, and it will be emailed with a fillable form attached. You will also have the option to access the form by logging into your account on the LeadingAge Indiana website
Forms are due back to Tina Bowman by no later than September 15th.
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Patient Characteristics & Success with PDPM |
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The Patient-Driven Payment Model (PDPM) went into effect on October 1, 2019. This payment model is built using patient characteristics, diagnoses, and nursing services, and also includes cognitive deficits as well as function scores to calculate a Health Insurance Prospective Payment System (HIPPS) code that is used for billing the claim. With the numerous services, diagnoses, conditions, and other items that impact payment, it’s critical that Minimum Data Set (MDS) personnel develop a consistent process for gathering information. Holding a daily “Medicare Huddle” during the information collection phase can help increase communication and produce better MDS completion outcomes.
The initial step for PDPM is that the Medicare team chooses a primary diagnosis for the skilled stay. This diagnosis must map to one of 10 clinical categories under PDPM. CMS has developed a “mapping tool,” which is available on its website; many software vendors have mirrored this tool in the software programs used for skilled nursing facilities (SNF). Once the primary reason for skilled care is identified, it’s just as important that the Medicare team identifies all diagnoses that were active in the past seven days and continue to affect each patient’s current care needs. |
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ISDH-LTC Call Reminder:
Conference ID: 782 548 07#
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LeadingAge National Updates |
CMS Stakeholder Update Call held on 8/24 - focused on the roll out of the interim final rule/regulation (effective immediately) on nursing home staff testing and CLIA reporting, but covered a range of other related topics of interest to nursing home providers. Issues covered are summarized in this article.
- Effective immediately, nursing homes that fail to comply with requirements to report COVID-19 data to CDC through NHSN will be subject to
i. Citation at the scope of widespread and severity of no actual harm with potential for more than minimal harm that is not immediate jeopardy (level “F”).
ii. Enforcement of a CMP of $1,000 per noncompliance, and
iii. Increasing increments of $500 per CMP for up to 12 instances of noncompliance.
iv. As outlined previously in CMS guidance, nursing homes that fail to report on a weekly basis will receive a $1,000 CMP that increases incrementally by $500 for each subsequent missed week of reporting. This will cap at 12 weeks ($6,500) due to pre-existing statutory caps.
CMS Targeted COVID-19 Training for Frontline Nursing Home Staff and Management. Read the announcement here. This self-paced training is available immediately on the CMS Quality, Safety & Education portal and certificates of completion will be available for each course completed. Additionally, subject matter experts from CMS and CDC will be available through bi-weekly webinars beginning this Thursday, August 27 and running through January 7. Members can register for these webinars here.
PPE updates. The call included details about PPE distribution, especially N-95s.
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N95 distribution: Because of increased production of N95s, will be shipping 1.5 million n95s to nursing homes who need them (based on those who indicated need through NHSN reporting). Shipments will start this Thursday through next week.
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Additionally, 14 million masks will be diverted from the national stockpile, and sent to targeted markets. Will be sent to the commercial market place, hospitals, nursing homes, first responders, trying to provide additional commercial volume for those facilities to purchase.
- It was noted that “We are fundamentally in a different place than we were back in March or April.” The country now has 120,000 ventilators ready to deploy. States now have 30-60 day supply on hand of PPE.
POC Testing. Dr. Giroir reported on the call that 5,593 nursing homes had already received antigen testing machines. By the end of September all nursing homes with CLIA waivers (about 14,800) will have the machines. He added that over two million test kits had also been shipped, enough to test each staff members at least twice and that nursing homes would be able to order additional tests (no details provided on that).
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FDA recommendations for diagnostic tests for screening asymptomatic individuals for COVID-19. An FDA FAQ recommended that health care providers screening asymptomatic individuals should consider using a highly sensitive test, especially if rapid turnaround times are available. If highly sensitive tests aren’t available or turnaround times are slow, providers should use less sensitive point-of-care tests, even if they aren’t specifically authorized for this indication (commonly referred to as “off label”).
Provider Relief. HHS is still expected to explain how/when t will distribute the $5 billion in Provider Relief Funds … maybe by Friday. Seema Verma said there would be $2.5 billion for “testing in nursing homes”, and might hit nursing homes this Thursday. The formula will include a base payment per facility plus additional funds based on the number of beds.
SNF VBP Performance Period Changes for FY2022. The SNF Value-Based Payment program for FY2022 would normally be based upon readmission measure performance between October 1, 2019 and September 30, 2020. However, under the public health emergency, CMS granted an Extraordinary Circumstances Exceptions to reduce reporting burden for the SNF VBP reporting requirements for January 1 through June 30, 2020. Therefore, under the interim final rule, CMS is changing the performance period for the SNF VBP program for FY2022 to include data from April 1, 2019 – 12/31/2019 plus July 1 through September 30, 2020. This provides a full 12 months of data for the calculations. Keep in mind, the SNF VBP program uses claims data so there is nothing new for SNFs to report.
Katie’s meeting with Seema Verma. Here’s an article summarizing the wide ranging discussion. The Administrator used the time to preview several of the announcements that were made later in the afternoon and are reported on above.
Fall Advocacy Guide For Members. This article highlights our fall advocacy efforts for our members and we have created a new Conversations With Congress Fall Advocacy Guide to help plan both in-person and virtual meetings with congressional offices.
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- ISDH – COVID-19 Information Updates
- NHSN LTC, Public Health Investigator – Melissa Meador
- QSOG-20-03 NH/HHA/CLIA – Notice of Final Rule Adjusting Civil Monetary Penalties (CMPs) for Inflation
- QSO-20-35-ALL Enforcement Cases Held during the Prioritization Period and Revised Survey Prioritization
- CMS-CDC Fundamentals of COVID-19 Prevention for Nursing Home Management - Webinar Series
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Total positive cases: 88,421
Total deaths: 3023
Total tested: 1,010,981
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