MassHealth has issued a (1) COVID-19 Preparedness Program Payments Bulletin specifying the criteria for nursing facilities to qualify for a one-time quality improvement supplemental payment in February 2023 and (2) Request for Assistance for Applications (RFAs) regarding a new Nursing Facility Patient Transition Program to facilitate a smooth transition of patients in need of post-acute, short-term care from acute hospital settings. These 2 programs were authorized in the recently-enacted Rate Year 2023 Medicaid nursing facility rate regulation.
- COVID-19 Preparedness Payments Program – to be eligible for the one-time supplemental payment, nursing facilities must attest by January 15, 2023 to meeting the 4 criteria listed below. MassHealth will pay out the COVID-19 Preparedness Payments to eligible nursing facilities in February 2023 in the form of a lump sum. A total of $16.55 million will be split among eligible facilities and payments will be based on Medicaid days with amounts depending on the number of qualifying facilities. The four criteria are:
- Staffing – the facility has an average HPPD of 3.58 or higher for the calendar quarter ending December 31. 2022, or achieves a minimum 10% improvement in HPPD for the calendar quarter ending June 30, 2023, as compared to the calendar quarter ending December 31, 2022 (based on Payroll Based Journal Data); and
- Infection Control Deficiencies– the facility has no infection control deficiencies of an F-level or higher from Nov. 4, 2022 through June 30, 2023; and
- Staff Vaccination Rate– 90% staff have received the bivalent booster by January 1, 2023; and
- Continuous Compliance with Infection Prevention Strategies as detailed in the MassHealth Bulletin.
Any nursing facility that receives a COVID-19 Preparedness Payment is subject to compliance requirements by EOHHS. If a nursing facility is determined to be out of compliance with the criteria established in the Bulletin, MassHealth will recoup the paid COVID-19 Preparedness Payments as an overpayment. This compliance review is expected to be completed by EOHHS in the Summer of 2023.
- Nursing Facility Provider Transitions Program Request for Applications (RFA) - The purpose of the MassHealth RFA is to reduce the time spent in acute settings by patients who are medically ready for hospital discharge but require continued post-acute care in a Nursing Facility for what is expected to be a short-term basis. Participating nursing facilities are expected to promote transitions through increased staffing. To be eligible for funding consideration under this RFA, a facility must meet 7 conditions delineated in the RFA. The deadline for filing a Response to the RFA is November 23, 2022 at 5pm. EOHHS anticipates making a determination of awardees and the award amounts on December 7, 2022.