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09/03/2020

Today's COVID-19 Report: Friday, September 4, 2020

Friday, September 4, 2020

Here are the latest need-to-know updates for Friday, September 4 regarding the COVID-19 pandemic.

Administration to pivot on nursing home testing

An alert sent this morning highlighted the conflicting guidance that Ohio nursing homes have been working under since QSO-20-38-NH took effect earlier this week. The memo proscribes three frequencies of testing, depending on the positivity level of COVID-19 in the surrounding county, which is in conflict with the Director’s Order which sets a goal of an every-14 day cadence of testing statewide.

This morning, LeadingAge Ohio met with the Administration as a follow-up to conversations earlier this week, and the Administration expressed their commitment to resolving the issues in a timely manner, including seeking alignment between state and federal requirements, and working with federal partners in areas where clarification is needed.

Providers should know that both the federal requirements and the state nursing home testing program remain in effect, and important guidance provided in the CCURT testing webinar yesterday should be followed, including reminders on specimen handling, labeling and packaging.

LeadingAge Ohio is hopeful that it will have a resolution to share with membership in the coming days. Until then, stay tuned to the COVID-19 Daily Report and send any concerns or questions to the COVID-19 mailbox at COVID19@leadingageohio.org.

Updated COVID-19 infection control survey tool and checklist

With the implementation of the new testing requirements, the Centers for Medicare & Medicaid Services (CMS) updated the COVID-19 Infection Control Focused Survey tool. LeadingAge has completed updates to its supplemental survey tool and checklist and placed it, along with the updated CMS tool, on the COVID-19 Nursing Homes page. You can access both documents here.

SNF infection control distribution incentive payments announced

This week, the Trump Administration announced a $2 billion provider relief fund that would offer incentive payments to nursing homes, based on two specific measures. The announcement included no detail on how the measures would be calculated. Essentially, to qualify a facility:

  • Must be a nursing home or skilled nursing facilities with active state certification
  • Must receive reimbursement from CMS (Medicare/Medicaid)
  • Must be in good standing (no revocation, terminations, expirations of certification or enrollment)
  • Must report to at least one of these three data sources: CASPER, Nursing Home Compare or Provider of Services (POS)

The two measures will be:

  • Ability to keep new COVID infection rates low among residents
  • Ability to keep COVID mortality low among residents. (we are told this measure will be more lightly weighted than the prior measure and will be risk adjusted).

There will be four monthly performance periods in September, October, November, December. $500 million per performance period/month will be distributed in the form of incentive payments to eligible nursing homes in October, November, December of 2020 and January 2021.

HHS will compare CDC county-level data related to total confirmed/suspected COVID 19 infections and test positivity rates to nursing home NHSN LTCF COVID-19 reported data on COVID infection and mortality rates.  No further details are available regarding the formulas or specific calculations to be used, but LeadingAge will provide updates as they become available.

Civil Immunity Bill Heads to Governor’s Desk for Signing

HB606, Ohio’s bill that would extend civil immunity to providers and employers acting during the coronavirus public health emergency, cleared the Senate on Wednesday and is now headed to Governor DeWine’s desk for signing. The bill applies to “acts, omissions, conduct, decisions, or compliance from the date of the Governor’s Executive Order 2020-01D, issued on March 9, 2020 declaring a state of emergency due to COVID-19 through September 30, 2021.”  The two chambers of the General Assembly worked together to iron out the differences that were needed to move the bill through each chamber. This passage was very welcome news for providers, who have been seeking this protection since the early days of the pandemic.

HUD announces Service Coordinator COVID-19 payments – Applications due to HUD by 9/11

On Wednesday, HUD announced that CARES Act awards for grant-funded Service Coordinators are now available. The supplemental payments will be approximately 9% of operating budgets, and applications for the payments are due to HUD by September 11. LeadingAge will host a call with HUD staff next week to answer member questions. More information about the call, and detailed instructions to apply for the payments, is available by clicking here.

  • Grant Awards: The supplemental awards will be equivalent to 9% of their SCMF/CHSP FY2020 program operating budget.
  • Eligible Period of Increased Costs: March 27 – December 31, 2020
  • Application Deadline:  9/11/2020
  • Acceptance of Notice of Award:  The authorizing official must access GrantSolutions and accept the award no later than 5 business days after receipt of notification.  GrantSolutions is sending notification emails to eligible grantees.
  • Spending Plan will be due:  Grantees must submit a spending plan via Grant Notes/Application to the assigned grant specialist within 20 days after acceptance of the award.
  • Availability of Funds:  Once the spending plan is approved by the grants specialist, the funds will be available within 3 business days.

Questions should be sent to the Grant Specialist, or to Juliana Bilowich at jbilowich@leadingage.org, Director of Housing Operations and Policy, who will send the questions to HUD staff.

Provider Relief Funds application process NOW open to both private pay assisted living and private pay nursing homes

As noted in Wednesday’s COVID-19 Daily Report, private pay AL providers can apply between now and September 13 through the Phase 2 General Distribution portal. LeadingAge has learned from HHS that private pay nursing homes can apply through this same process.  LeadingAge has outlined the details on the AL application process in an article posted  on the LeadingAge website. In the event a private pay nursing home member applies but is told their Tax Identification Number is not valid, please contact Nicole Fallon at nfallon@leadingage.org, Vice President of Health Policy and Integrated Services, with this information so that LeadingAge can continue its advocacy with HHS.

Hospice prescribing survey

The SUPPORT Act was enacted in 2018 to help combat the nation's opioid epidemic. Included among its provisions is a requirement that prescriptions for controlled substances covered under Medicare Part D drug plans be electronically transmitted by a health care practitioner in accordance with an electronic prescription drug program beginning January 1, 2021. The statute also allows CMS to identify circumstances under which it can waive the electronic prescribing requirement, including in instances where a controlled substance is covered by Part D and has been prescribed for a patient on hospice care for treatment of a condition that is not related to the terminal diagnosis or a condition related to the terminal illness. Recently CMS issued a Request for Information (RFI) seeking input on what exceptions to the SUPPORT Act's electronic prescribing requirement should be permitted.

It would be rare for a hospice practitioner to prescribe a controlled substance for a condition that is unrelated to the diagnoses and conditions that contribute to the six-month prognosis and therefore not covered by the Medicare hospice benefit. However, the National Association for Home Care & Hospice (NAHC) is seeking to understand the degree to which this could occur. For this reason, NAHC has developed a brief survey for hospice providers.

Please limit responses to one per hospice agency.

New “Care Compare” site

Yesterday the Centers for Medicare & Medicaid Services (CMS) released this announcement about the new CMS Care Compare site. The old compare sites (Nursing Home Compare, Home Health Compare, Hospice Compare) are all still live for the moment, with a banner at the top of each one encouraging consumers to try the new site. CMS has released no information about when the traditional sites will sunset. LeadingAge notes that true to previous communication about the new site, the information that is displayed on Care Compare has not changed from what was displayed on the previous compare sites. The information has simply been consolidated under one interface with an updated look. However, the press release (linked above) seems to indicate that additional information, like cost or new quality measures, may be included in the future.

Activity professionals discuss voting protocols and more on networking call

Activity professionals within the LeadingAge Ohio membership are continuing to come together to offer support, share ideas, and discuss resources in the midst of current COVID-19 restrictions.  On yesterday’s call, Susan Wallace, LeadingAge Ohio’s Director of Government Relations and Public Affairs, shared that while additional guidance is forthcoming from the administration on voting protocols for the upcoming November election, she encouraged members to focus efforts on moving forward with securing absentee ballot options for residents and to reach out to local county board of elections to discuss available options for member communities.  Additional voting resources are located on the Activity Professionals networking page on the COVID-19 Hub.   Several activity ideas were shared on the call including hosting a weekly “Room or Zoom” art class, drive-in movie theatre and preparing for a virtual Halloween costume contest for staff members' children to share with the residents.  Additional details regarding the next call scheduled for Thursday, September 17, at 12:30 can be found here.   

Please contact Jen Taylor at jtaylor@leadingageohio.org to ensure activities staff are receiving information on LeadingAge Ohio activities events. 

It’s okay to not be ok! 

In addition to the latest updates on Provider Relief Funds, nursing home testing, HUD CARES Act implementation, vaccine prioritization news, and home health/hospice/home care news, the next LeadingAge Coronavirus Update call on September 9 will host Natalie Dattilo, from Brigham Women’s Hospital.  Natalie has been featured in the media for cautioning against too much “forced positivity” during the pandemic.  She and other policy experts suggest that anxiety and depression have surged to historic levels in recent months and struggling to maintain that “everything is fine” doesn’t allow people to work through serious things they may be struggling with.  This is a serious aging services workforce issue and members on calls have talked about grief resources, including those offered by community hospice organizations.  Can policy makers and providers build staff supports that take the need for these services into account? Register here.

LeadingAge Need to Know: COVID-19 – September 4, 2020

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured the approaching deadline for CARES Act payments for Service Coordinators and a savings opportunity on the upcoming Collaborative Care Summit.

Check out the full report here.

                Linkage                         Buerger


Questions

Please send all questions to COVID19@leadingageohio.org. Additionally, members are encouraged to visit the LeadingAge Ohio COVID-19 Working Group facebook group to pose questions to peers and share best practices. LeadingAge is continuing its daily calls for all members.  To participate in these daily online updates, members should register here.  

LeadingAge Ohio is working to ensure that the information in our daily alerts, on our website, and all coronavirus-related communications is as accurate as possible. However, LeadingAge Ohio makes no guarantees about the accuracy of the information. 

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Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.