COVID Update #242
HFAM Update, CMS Revises Visitation Guidance,
MDH Update on COVID-19 Revenue Supplemental Schedule
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HFAM Update
Friends:
Yesterday afternoon, the Centers for Medicare and Medicaid Services (CMS), working in alignment with the Centers for Disease Control and Prevention (CDC), issued new visitation guidance for skilled nursing and rehabilitation centers. This is good news and a critical advancement of policy guidance.
Below is AHCA/NCAL’s update on that topic from last night. Again, yesterday’s CMS move is great news. We have long written about the need for visitation in our sector, along with the tragic and understandable tension between government orders to protect people from COVID-19 and the need for residents and patients to have visits from loved ones.
Given the increasing vaccination rates, we have advised nursing home leaders to increase compassionate care visits while maintaining protocols. On February 11, 2021, in advance of new orders from Governor Hogan and MDH, we sought increased visitation and observation latitude in state orders given vaccination rates in our sector. In recent weeks we have been working on individual cases with specific centers (thank you all) to increase compassionate care visits. Over the last many months, we have written and advised on both the necessity of visitation and the need to protect people from the virus. The language from the February 11 MDH orders will aid in the implementation of the CMS guidance here in Maryland:
As of March 1, 2021, the following subsection applies to each individual nursing home:
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All nursing homes should follow the Centers for Medicare & Medicaid Services (CMS) guidance on nursing home visitation regarding COVID-19 (QSO-20-39-NH) or as updated by CMS. Either MDH or a local health department may direct a facility to a more restrictive set of conditions at any point.
That said, it will be important that Maryland (MDH) guidance is clear and consistent relative to this point in the CMS guidance (on page 3):
- Facilities should allow indoor visitation at all times and for all residents (regardless of vaccination status) of the resident or visitor, unless certain scenarios arise that would limit visitation due to a high risk of COVID-19 transmission, including:
- “Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated until they have met the criteria to discontinue transmission-based precautions”
The Bottom Line: Federal and state orders and guidelines over the last year rightfully limited visitation, nursing homes complied with those government orders, and lives were saved. The CMS guidance issued yesterday is excellent news. It will be important for skilled nursing and rehabilitation centers to allow indoor visitation and increase compassionate care visits.
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.
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CLICK HERE for the Dr. Katz Video, and please see the Donning and Doffing Checklist we have been sharing.
Be well,
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Joe DeMattos
President and CEO
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CMS Revises Memo on Nursing Home Visitors
On Wednesday, March 10th CMS released revisions to QSO memo on visitation (20-39-NH), incorporating vaccination status. The memo improves the ability for nursing home residents to receive visitors. CMS emphasizes the importance of maintaining infection prevention practices, given the continued risk of COVID-19 transmission. CMS's changes were based on new guidance from the Centers for Disease Control and Prevention (CDC).
Providers are strongly encouraged to review the QSO memo. While there are some differences between the new CDC guidance that was also released today, providers must follow CMS guidance and/or state and local guidance. AHCA will continue to review both set of guidance and seek clarity from CMS or CDC on any inconsistencies. We will provide updates as we have more information. If you are uncertain about whether visitation is allowed in a particular circumstance, contact your local/state health officials, and document any outreach you conduct. Click here to read more from ACHA/NCAL.
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Update from MDH: COVID-19 Revenue Supplemental Schedule
Per this Memo
"The COVID-19 supplemental schedule must be completed for cost report periods ending in calendar years 2020 and 2021. The due date for the supplemental schedule is:
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For cost report periods ending in calendar year 2020, the due date is June 30, 2021.
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For cost report periods ending in calendar year 2021, the due date is the same as the cost report due date. However, the earliest due date for any supplemental schedule is June 30, 2021."
March 3 Webinar
The Maryland Department of Health and its contractor, Myers and Stauffer LC, held a webinar on March 3, 2021 to review the COVID-19 Revenue Supplemental Schedule and take provider questions. The webinar was recorded and may be viewed by clicking this link.
If you have any questions that are not covered in the FAQ document, please send them to jdresslar@mslc.com.
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Other COVID-19 Webinars and Updates
CDC Modifies Quarantine and Visitation Guidance: As the basis for CMS' revisions to the visitation guidance for nursing homes, the CDC modified certain restrictions in long term care. Importantly, it suggests that fully vaccinated new admissions no longer need to quarantine upon admission to the facility. Read More
Today!
CMS National Nursing Home Stakeholder Call
Thursday, March 11, 2021
3:30 PM Eastern
Now Available!
Hosted by the Black Coalition Against COVID
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The 2021 HFAM Conference “Together We Re-Imagine” will be held in person 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.
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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.
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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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