To: Mass Senior Care Members
From: Tara M. Gregorio, President
Re: COVID-19 Updates: June 1st CMS Memorandum; Register for Workforce Webinar; EOHHS Issues Administrative Bulletin on Baseline Testing Supplemental Payments; Updated Guidance on Proper Use of COVID-19 Waivers Claim Codes and Weekly DPH and CMS Call Reminders
Date: June 2, 2020
CMS Releases Memorandum on COVID-19 Survey Activities, CARES Act
Funding, Enhanced Enforcement for Infection Control deficiencies,
and Quality Improvement Activities in Nursing Homes
On June 1st, CMS released a memorandum addressing the following:
- Focused Infection Control Nursing Home Surveys and CARES Act Supplemental Funding – State Survey Agencies must complete focused infection control nursing home surveys on 100% of the nursing homes by July 31, 2020. State Survey Agencies will not receive the full CARES Act Supplemental Funding if these surveys are not completed by July 31, 2020.
- COVID-19 Survey Activities - CMS is also requiring States to implement the following COVID-19 survey activities:
- 1) Perform on-site surveys (within 30 days of this memo) of nursing homes with previous COVID-19 outbreaks, defined as:
-Cumulative confirmed cases/bed capacity at 10% or greater; or
-Cumulative confirmed plus suspected cases/bed capacity at 20% or greater; or
-Ten or more deaths reported due to COVID-19.
- 2) Perform on-site surveys (within three to five days of identification) of any nursing home with 3 or more new COVID-19 suspected and confirmed cases in the since the last National Healthcare Safety Network (NHSN) COVID-19 report, or 1 confirmed resident case in a facility that was previously COVID-free. State Survey Agencies are encouraged to communicate with their State Healthcare Associated Infection coordinators prior to initiating these surveys.
- 3) Starting in FY 2021, perform annual Focused Infection Control surveys of 20 percent of nursing homes based on State discretion or additional data that identifies facility and community risks.
- Expanded Survey Activities – Once a State has entered Phase 3 of the Nursing Homes Re-opening guidance States are authorized to expand beyond the current survey prioritization (Immediate Jeopardy, Focused Infection Control, and Initial Certification surveys).
- Enhanced Enforcement for Infection Control Deficiencies - CMS is expanding enforcement to improve accountability and sustained compliance with infection control practices. In addition to enhanced enforcement, CMS is also providing Directed Plans of Correction, including use of Root Cause Analysis, to facilitate lasting systemic changes within facilities to drive sustained compliance. Therefore, substantial non-compliance (D or above) with any deficiency associated with Infection Control requirements will lead to additional enforcement remedies.
- CDC-Collected Data and Nursing Home Compare - CMS will post the underlying CDC-collected data on a link on Nursing Home Compare later this week, so the public can view general information of how COVID-19 has impacted nursing homes in a user-friendly format. The data will be broken down by state, number of residents and number of staff. The data will be searchable by facility name and will be downloadable so researchers and other stakeholders can perform their own in-depth analysis. CMS will update the data weekly.
Register Now for Important Workforce Webinar:
Solution to Frontline Staffing Shortages: Resident Care Assistants (RCAs)
Please join Mass Senior Care and senior state officials for a webinar on Thursday, June 4th from 1:00 – 2:00 p.m., Solution to Frontline Staffing Shortages: Resident Care Assistants (RCAs). Nursing facilities were facing workforce shortages prior to the COVID-19 pandemic, and now more than ever members need innovative workforce solutions to provide additional staffing support in order to meet residents' needs. This webinar will highlight the newly recognized role of Resident Care Assistants (RCAs) which can support CNAs and nursing staff in skilled nursing facilities and create a training pipeline to critically needed CNAs. *This webinar will be recorded.*
- Jennifer James, Undersecretary, Executive Office of Labor and Workforce Development
- Patricia Yu, Senior Director of Healthcare Workforce Policy, Executive Office of Health & Human Services
- Adam Berman, President & CEO, Legacy Lifecare
- Tara Gregorio, President, Massachusetts Senior Care Association
EOHHS Issues Administrative Bulletin on Baseline Testing Supplemental Payments
Payment To Be Issued on or About June 22nd
EOHHS has issued Administrative Bulletin 20-55 providing billing guidance on supplemental payments to be paid to nursing facilities for completing baseline testing of both residents and staff by May 25th. Nursing facilities that used qualifying facility-organized testing between April 27, 2020, and May 25, 2020 are eligible to receive payment under this Bulletin. The supplemental payment for each eligible nursing facility will be equal to the number of completed qualifying COVID-19 baseline tests administered through a facility-organized testing method multiplied by $200. EOHHS will disburse supplemental payments to eligible nursing facility providers, calculated under this Bulletin on or about June 22, 2020.
CMS Updates Guidance on Proper Use of COVID-19 Waivers Claim Codes
AHCA has provided the following update regarding proper use of COVID-19 Waiver Claim Codes.
On June 1 CMS issued updated guidance clarifications for using the “DR” Condition Code and “CR” modifier on Medicare fee-for-service claims for services furnished under COVID-19 Section 1135 waivers such as the SNF-specific 3-day stay and spell-of-illness waivers. The full list of waivers and flexibilities can be found here.
CMS is clarifying which waivers the usage of modifier “CR” or condition code “DR” when submitting claims to Medicare. The chart in the updated guidance identifies those blanket waivers and flexibilities for which CMS requires the use of the modifier or condition code.
Please note that CMS will not deny claims due to the presence of the “CR” modifier or “DR” condition code for services/items related to a COVID-19 waiver that are not on this list, or for services/items that are not related to a COVID-19 waiver. There may be potential claims implications, such as claims denials, for claims that do not contain the modifier or condition code as required in the chart. However, providers do not need to resubmit or adjust previously processed claims to conform to the requirements below, unless claims payment was affected.
Massachusetts Department of Public Health (DPH) Weekly Call
for Nursing Homes and Rest Homes
The next DPH conference call for nursing homes and rest homes is scheduled for Wednesday, June 3, 2020 at 11:00 AM. This call will include members of DPH’s Bureau of Health Care Safety and Quality, Bureau of Infectious Disease and Laboratory Sciences, and Office of Preparedness and Emergency Management.
Phone Number: 888-390-5007
Participant Code: 3479679
CMS COVID-19 Stakeholder Engagement Call
CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.
Wednesday, June 3, 2020 at 4:30 – 5:00 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820
Access Passcode: 2672118
Audio Webcast Link: click here