06/15/2020

Today's COVID-19 Report: Monday, June 15, 2020

Monday, June 15, 2020

Here are the latest need-to-know updates for Monday, June 15 regarding the COVID-19 pandemic.

New Hospice FAQs from CMS

On June 10, the Centers for Medicare & Medicaid Services (CMS) issued and answered some new frequently asked questions (FAQs) on Non-Long-Term Care Facilities and ICFs/IIDs. Among other topics, CMS addresses some hospice-related issues. LeadingAge provided an article describing the hospice-related provisions and has promised additional information on ICF/IID FAQs this week. 

CMS underscores in this FAQ that if hospice staff have appropriate PPE and do not meet the Centers for Medicare and Medicaid Services (CMS) criteria for restricted access, hospice staff should be let into nursing homes (unless there is a state or local ordinance that says otherwise). Hospice is mentioned multiple times through this FAQ as essential health care services.

Specifically, CMS states verbatim:

“Hospices serve an important role in providing essential healthcare services in a variety of community-based settings, including assisted and independent living facilities and should be granted access as long as their staff meet the CDC guidelines for healthcare workers. If hospice staff are wearing appropriate PPE and do not meet criteria for restricted access based on CDC guidance, they should be allowed to enter and provide services to the patient.”

CMS clarifies hospice access to patients in congregate care settings -- nursing homes, assisted living, and independent living -- which is an ongoing area of concern for hospice providers. Hospices have expanded their use of telehealth but have still run into issues accessing patients, even for a telehealth visit. CMS issued guidance on the role of hospice staff in nursing homes in March and April, and LeadingAge created a flowchart to help with decision-making.

The clarification of whether hospice comprehensive assessments can occur via telehealth is an important part of the FAQ (question #25); when questioned on this area, the answer from CMS has caused confusion. LeadingAge Ohio is seeking addition input directly from CMS and will provide an update ASAP.

Paycheck Protection Rules Updated

The Small Business Administration (SBA) issued an updated rule for Paycheck Protection Program (PPP) borrowers and prospects following the Flexibility Act’s passage.

The most important piece for providers is on the 60% payroll rule. There was concern that the law would create an all-or-nothing forgiveness scenario and no longer allow partial forgiveness. This rule allays those concerns and continues to allow partial forgiveness if people use less than 60% of dollars for payroll. 

LeadingAge provided an article on the rulemaking which explains in greater detail.

Economic Relief Funding: Expense-Tracking Tool Webinar from CliftonLarsonAllen 

The economic relief funding from Congress contains very specific rules for how the funds can be used by health care organizations. Tracking and monitoring is critical and can be very complicated, especially when funding is received from multiple sources (e.g. CARES Act and PPP Loans, to name a few).

LeadingAge Ohio partner CliftonLarsonAllen LLP (CLA) has created an expense-tracking tool that creates the foundation to organize and track expenditures in accordance with compliance and reporting initiatives.  LeadingAge has worked with CLA to provide and promote the use of this tool to assist members around the country. The tool continues to be updated to reflect the most recent funding and source requirements and reporting; CLA has just released version 6.0.

LeadingAge Ohio has arranged for CLA to introduce members to the tracking tool this Thursday, June 18 at 10:30AM. The 45-minute call will begin with background info on why CLA created this tool, including key information on the HHS Provider Relief Funds; this will be followed by a brief demo on how the expense-tracking tool actually works; the last portion of the call will include some frequently asked questions.

While the webinar is free, registration via Zoom is required to participate. Registrants will receive a confirmation email containing information about joining the webinar.

Tool to Assist Nursing Homes on NHSN Reporting Issues 

LeadingAge provided a quick tool to help nursing homes that are told by the Centers for Medicare & Medicaid Services (CMS) that they didn’t report to the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN), despite the nursing home believing it has done so correctly. 

The tool describes what might have gone wrong in easy bullet points and offers links for help correcting the errors, including instructions on how to export your NHSN data for comparison to the CMS data.

Links

Below is a handful of links to recent news stories featuring commentary by LeadingAge Ohio. LeadingAge Ohio is taking a proactive stance in terms of sharing information from providers with the media, and will continue to do so in the future, particularly as it relates to the narrative around cases/deaths in long-term care. 

• COVID-19 testing for long-term care still lacking (Dayton Daily News)

• 71% of coronavirus deaths in Ohio, 24% of cases linked to long-term care facilities (Columbus Dispatch)

• Which long-term care facilities around Cincinnati have COVID-19 cases? Here are 25 of them (Cincinnati Enquirer)

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 at here.