ODH transparency moves. During the daily press conference, Governor Mike DeWine and Health Director Dr. Amy Acton discussed a new order directing long-term care facilities to inform residents, families, and staff if there is a positive COVID-19 case in the facility and the Governor's decision to begin publishing information about cases in facilities. The order is not yet published, but a notice placed on the Enhanced Information Dissemination and Collection (EIDC) system before the press conference reads:
At today's COVID19 press conference, Gov. DeWine will announce an order to compel nursing home and long-term care facilities to notify families and caregivers of all residents when an employee or resident tests positive for COVID-19. This notification must be completed within 24 hours.
Additionally, the state will begin releasing the names and addresses of all long-term care facilities and nursing homes that have a minimum of one resident or employee case of COVID-19. We will not be reporting numbers of cases or deaths related to specific homes.
There are a number of unclear points in this statement that may be answered by the order itself, starting with the Governor's reversal of the last sentence when responding to a reporter's question and the definition of a long-term care facility.
CARES Act continued. Medicare providers last week began to receive payments from the Department of Health and Human Services (HHS) under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, amounting to $30 billion of the total $100 billion health care fund under the legislation. The payments amounted to approximately 6.2% of 2019 Medicare fee-for-service revenue. If you have a question or concern about the first tranche of payments, please use this mailbox to inquire: HOSPITALCOVID19@hhs.gov.
By the end of next week, we expect HHS to pay most of the remaining $70 billion to Medicaid providers. We believe all Medicaid providers will be covered, including ID/DD and other waiver providers. Medicare Advantage revenue also is to be considered.
NAHC issues home health, hospice waiver FAQs. NAHC completed sets of frequently asked questions and answers (FAQs) for both home health and hospice relating to flexibilities from various waivers the Centers for Medicare and Medicaid Services (CMS) issued in response to the COVID-19 pandemic:
- Home health
- Hospice
- Use of hospice technology-based visits.
- Physician services and telehealth.
- Hospice face-to-face requirements.
- Waivers applicable to the Conditions of Participation.
CMS offers SNF transfer guidance. CMS in late March granted a number of blanket 1135 waivers, some of which relaxed existing rules around SNFs' ability to transfer patients, allowing them to make certain capacity changes to respond to COVID-19. Today, CMS released a new Quality, Safety, and Oversight (QSO) letter 20-25-NH providing further explanation through a series of transfer scenarios. They include both transfers to certified and to non-certified areas.
DODD update. The Department of Developmental Disabilities revised their guidance for providers of waiver-funded services, clarifying that although providers may hire minors as direct support professionals, applicants under 18 years of age still must have a rule waiver approved by the department before they may be hired.
AHCA COVID-19 testing resources. AHCA/NCAL began to compile a list of companies they feel are reliable that can turn around COVID-19 test results quickly for long-term services and supports providers. There are only two laboratories on the list now, but AHCA will continue to update it. See also AHCA's memo explaining the differences between the nasopharyngeal swab-based and antibody test methodologies.