HRSA Releases Additional Phase 4 and Rural Distribution Details: Portal Opens September 29
Yesterday, the Health Resources and Services Administration (HRSA) released additional details on the $25 billion September 10th announcement composed of the $17 billion Phase 4 distribution and the $8.5 billion rural distribution.
HRSA Updates and New Details
The Administration provided context for the size of the distribution and the parameters for award, eligibility, and use. HRSA noted the Provider Relief Fund (PRF) has approximately $39 billion. HRSA indicated the $39 billion will be reduced by the Phase 4 $17 billion to $22 billion. However, it is likely the $8.5 billion will also reduce the unobligated to $14 billion. The unobligated remaining amount of $22 billion or $14 billion is impacted by the ongoing availability of payments to providers who deliver care to the uninsured. Of note, HRSA also confirmed that virtually all skilled nursing facilities (SNFs) and assisted living communities (ALCs) (including private pay) are eligible for Phase 4.
Phase 4 Distribution
Based upon parameters in the Consolidated Appropriations Act , Phase 4 is modeled on Phase 3 and aimed at reimbursing providers for lost revenues and expenses related to COVID-19 based on Q3-4 of 2020 and Q1 of 2021. Phase 4 is open to all providers, including new providers – “any provider or supplier of health care, services, and support in a medical setting, at home, or in the community” is eligible to apply. Unlike the rural portion of funds, providers will not be excluded based on geography. To view a list of eligible providers, click here.
HRSA made clear that the new methodology implemented in this distribution is intended to support the Administration’s broader goals around health equity.
|
|
|
National Quality Award Intent to Apply Now Open
Sept. 16 - Nov.11, 2021
The 2022 National Quality Award intent to apply is now open! We encourage applicants who plan to apply for a Quality Award to submit an intent to apply by logging into the Quality Award Portal before the deadline on November 11, 2021. Applying for a National Quality Award provides a framework that can be used to prepare for and make critical improvements and serves as a team building activity to engage staff across all levels.
While not mandatory, applicants who submit an ITA will automatically save money on their overall application fee. No paperwork is needed.
|
|
|
|
Updated Infection Control Guidance
Late last week, CDC and CMS released updates to the Infection Control Guidance for Healthcare Settings. Primarily this document consolidates guidance for various settings, and lays out guidance that may be relevant for the duration of the response. Please read these new guidelines carefully.
Here is a short overview of the major changes:
- CDC continues to recommend source control for everyone in a healthcare setting, and has clarified recommendations for healthcare personnel, patients, and visitors, to better align with community guidance. This includes a few limited circumstances where fully vaccinated individuals in counties with low to moderate community transmission could choose not to wear source control.
- Quarantine is no longer recommended for fully vaccinated patients with exposure to SARS-CoV-2 or those patients who have had SARS-CoV-2 infection in the prior 90 days.
- The timing of SARS-CoV-2 testing after higher-risk exposure for healthcare personnel and close contact for patients has been clarified. "Test Immediately" means not earlier than 2 days after last exposure.
- Screening testing for unvaccinated healthcare personnel in nursing homes is now associated with community transmission level instead of test positivity. (High and substantial: twice a week testing, Moderate: once a week, and Low not recommended)
- During an outbreak response in nursing homes, options for more targeted contact tracing have been added. If contact tracing is possible, limited close contacts are identified, and there is no concern about transmission in the facility it may be possible to do a more targeted testing, instead of facility wide. Please discuss with your local health department.
-
Assisted Living should generally follow the guidance for Retirement Communities and Independent Living | CDC. However, in circumstances when healthcare is being delivered (e.g., by home health agency, staff providing care for a resident with SARS-CoV-2 infection), assisted living communities should follow the IPC recommendations in this healthcare guidance.
CMS Updates Testing Guidance
CMS also updated their previous requirements around testing. The CMS Memo updates the testing summary, including if the facility has the ability to identify close contacts of the individual with COVID-19; the facility can choose to conduct focused testing based on the known close contacts, as well as the levels of COVID-19 community transmission to now include four colors instead of the previous three.
Testing summary changes include:
- Symptomatic individual identified – staff and residents, vaccinated and unvaccinated, with signs or symptoms must be tested.
- Newly identified COVID-19 positive staff or resident in a facility that can identify close contacts – test all staff and residents, vaccinated and unvaccinated, that had high-risk exposure (staff) or close contact (residents) with a COVID-19 positive individual.
- Newly identified COVID-19 positive staff or resident in a facility that is unable to identify close contact – test all staff (assigned to a specific location where the new case occurred) and residents, vaccinated and unvaccinated, facility-wide or at a group level (e.g., unit, floor, or other specific area)
- Routine testing for residents is not generally recommended.
Routine testing intervals by county COVID-19 level of community transmission changes include:
- Low (blue) not recommended for testing of unvaccinated staff
- Moderate (yellow) once a week testing of unvaccinated staff*
- Substantial (orange) twice a week testing for unvaccinated staff*
- High (red) twice a week testing for unvaccinated staff*
- Vaccinated staff do not need to be routinely tested
* Frequency of testing presumes availability of Point of Care testing on-site at the nursing home or where off-site testing turnaround time is <48 hours.
|
|
HHS Distributes Phase 4 Provider Relief Fund
Last week, the U.S. Department of Health and Human Services (HHS) announced it will be releasing Phase 4 of the Provider Relief Fund (PRF). Phase 4 consists of $17 billion for providers who can document revenue loss and expenses associated with the pandemic. HHS has also created an option for reconsideration of Phase 3 awards and extended the due date for the first PRF Reports, formerly due on September 30, 2021, by 60 days. It is also possible rural SNFs and assisted living communities may be eligible for the $8.5 for rural providers.
Consistent with the requirements included in the Coronavirus Response and Relief Supplemental Appropriations Act of 2020, PRF Phase 4 payments will:
- Be based on providers’ lost revenues and coronavirus-related expenditures between July 1, 2020, and March 31, 2021.
- Reimburse smaller providers—who tend to operate on thin margins and often serve vulnerable or isolated communities—for their lost revenues and COVID-19 expenses at a higher rate compared to larger providers.
- Also include bonus payments for providers who serve Medicaid, CHIP and Medicare patients, who tend to be lower income and have greater and more complex medical needs.
- HRSA will price these bonus payments at the generally higher Medicare rates for Medicaid and CHIP patients to ensure equity for those serving low-income children, pregnant women, people with disabilities, and seniors.
Similarly, HRSA will make American Rescue Plan (ARP) rural payments to providers based on the amount of Medicaid, CHIP and Medicare services they provide to patients who live in rural areas as defined by the HHS Federal Office of Rural Health Policy. Accordingly, ARP rural payments will also generally be based on Medicare reimbursement rates.
|
|
Reminder: CMS Updates COVID-19 Billing Guidance
On September 8, 2021, the Centers for Medicare and Medicaid Services (CMS) Updated MLN Matters Article SE20011 titled Medicare FFS Response to the PHE on COVID-19. In the billing guidance CMS DID NOT change the longstanding blanket 3-day qualifying stay or spell-of-illness waivers for beneficiary eligibility for SNF Part A coverage.
In the CMS SE20011 guidance update, CMS added emphasis that all other coverage requirements including need for skilled level of care remain (page 13). This is consistent with prior CMS and AHCA guidance. Additionally, CMS now notes that contractors will be monitoring and auditing as needed to verify that the need and delivery of a skilled level of care was present.
|
|
|
We are thrilled to announce that you can now attend the 2021 HFAM conference in person OR virtually. The 2021 HFAM Conference “Together We Re-Imagine” will be held in person AND online from 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.
No matter how you attend, you will gain valuable knowledge and insight through exclusive, dynamic presentations and an innovative Solutions Lounge.
CEs awarded for in person and virtual attendance.
for more information and to register.
HFAM's safety protocol requires proof of vaccination
or a negative PCR test within 72 hours of attendance.
|
|
|
|
Thank you to our current sponsors!
|
|
Plus, Visit our Sponsors and Supporters in the
Brand New "Solutions Lounge"
|
|
Did you miss an update?
Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
|
|
|
|
|
|
|
|
|