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November 2, 2020

Latest CMS Positivity Ratings for SNF Testing/Visitation. Today the Centers for Medicare and Medicaid Services (CMS) released a new table of county positivity ratings used to set SNF routine staff testing frequency. Like the Ohio Public Health Advisory System (OPHAS), the CMS ratings show the impact of the surge of COVID-19 cases in Ohio. Sixteen Ohio counties are now listed as red by CMS, meaning SNFs in those counties must test staff twice a week. Most of the rest are yellow, with only 12 still green. Under Ohio's SNF testing guidelines, however, there is no distinction between yellow and green, as both must test weekly. Only the CMS red counties, not the OPHAS red counties, count for the testing requirements, and there is no mandate to test all residents in a red-county SNF unless there is an outbreak.

CMS red county status is also relevant to SNF visitation, as we reported last week that the Health Department (ODH) interprets federal guidance as prohibiting indoor visitation at SNFs in red counties (or that have an outbreak). 

Assisted Living Test Result Reporting Reopens Today. The Department of Aging's tool for reporting residential care facility testing results reopened today and will stay open through 11:59 p.m. on Wednesday, November 4. This reporting period covers the state-mandated testing performed from October 12 through October 25. The reporting requirement applies whether or not the facility used state-supported (MAKO) testing to meet the biweekly mandate.

SNFs Receive HHS Quality Incentive Payments. We began to hear this morning that at least some SNFs in Ohio and elsewhere received their September Quality Incentive Program payments from the Department of Health and Human Services (HHS), along with an explanatory email. The email did not provide detail on how HHS calculated the incentive payments, leaving providers confused about why the payment amounts differed among similarly-sized facilities in different parts of the state. The payments also were disappointingly small. Some members reported not receiving their payments at all, which could be a timing issue, as 74% of Ohio SNFs qualified for a payment of some amount.

AHCA explained today that the total paid out in this distribution shrank from the original $500 million to $250 million because of various adjustments that HHS made. In addition, the amounts paid to centers in different states and communities varied depending on the amount of COVID-19 there. HHS has not disclosed how the extent of COVID-19 is determined (e.g., test positivity?) or how the prevalence metric affects the payment amount by state or community. According to this HHS table, the average payment to qualifying centers in the states ranged from $1,571 in Vermont to $49,515 in South Dakota. Ohio's average was toward the lower end of the range at $15,419, compared to the national average of $25,323. AHCA also said today that the current payments are based on COVID-19 cases, and a mortality-based payment totaling $83 million for September will be made later.

AHCA/NCAL Post-Election Analysis Member Call with Mark Parkinson This Friday. On Friday, November 6 at 2 PM Eastern, AHCA/NCAL CEO Mark Parkinson will provide an analysis of the impact of the recent election results on the long term care sector. All members are invited to participate.

Registration is limited, and the webinar will be recorded and available for playback within 24 hours.
How to Register: 

  • To avoid technical problems, use Google Chrome. 
  • Members will need to log in using their existing AHCA/NCAL username and password first. 
  • Once you are logged in to the website, you will be able to register by clicking the green register button at the top of the page. 
  • If you have forgotten your password, click here.
  • If you are new to the site, you can create an account here. Answer all fields on the create an account page - especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register for the webinar. 

Please email for additional assistance. 

Making Changes to Information on Visitation Dashboard. ODH's Rebecca Sandholdt of asked that we share the following announcement with SNF and assisted living members:

Facilities that need to make updates to their information in the visitation dashboard can now do so. For example if your license number is incorrect, the administrator has changed or the address is incorrect you now have the ability to make those changes for your facility. 

Your license number needs to be in the following format:

####N or ####R

Additionally, we asked for the Medicaid number; however, if you don’t put your license number please enter your Medicare number instead.