Week of 19 April 2020 - Academy of Senior Health Sciences

Information for LTC Providers

                         Week of 19 April 2020
Ohio News

Reopening plan being crafted as other states move forward
NHs can apply for CMP funds to pay for COVID-19 communication
equipment
CMS approves 1135 waiver; waiting on Appendix K
Ohio to increase C19 testing capacity
Local collaborative contact list
HOME Choice still active during COVID

National News

CMS QSO memo: Five star info, staff counts, FAQs
CMS suspends advance payment program
CDC adds to COVID symptoms
CMS MLN Connects

Reopening plan being crafted as other states move forward
Governor Mike DeWine is still working on his plan to restart Ohio's economy. The COVID
data has not shown the 14 day decline deemed by many experts to allow the economy to
return to normalcy. However, the accuracy of the data reflecting the virus in the
community is unknown with various studies indicating anywhere from 4 to 15% of the

population may already have been infected. In Ohio, it appears the healthcare system is
coping with the current levels of the virus. This situation - of unfilled hospitals and
unknown community spread, along with calls to reopen the economy sooner rather than
later, have Governor DeWine looking to start reopening Ohio on May 1. Other states, such
as Georgia, have already opened, or have detailed plans on opening, many businesses. How
the process is to work in Ohio is still being developed and not much as been released. Based
on tidbits shared in press conferences and what other states are doing, we can take a stab at
what to expect: hospitals will be able to perform elective surgeries; many small businesses
will be able to open with proper precautions; restaurants, theaters, gyms and other
congregate settings will be last to open and have restrictions in place that will gradually be
eased. As we approach May, how the state handles July events, especially 4th of July, will
be a significant indicator of where we are headed. We will keep you updated as more of
Gov. DeWine's plan to reopen Ohio's economy becomes available. (Back to top.)

NHs can apply for CMP funds to pay for COVID-19 communication
equipment
The Ohio Department of Health notified LTC providers on Friday that they can apply for a
CMP grant to cover the costs of communication equipment related to COVID-19. This
includes tablets and other devices for both telehealth and socialization of residents. Please
see the material below for more information:

    •   COVID-19 CMP FAQ
    •   COVID-19 CMP Approval Letter
    •   COVID-19 CMP Application Template

(Back to top.)

CMS approves 1135 waiver; waiting on Appendix K
CMS approved Ohio's 1135 waiver request. The waiver allows the state to "waive" certain
rules and regulations. The 1135 waiver covered the following areas: Medicaid FFS prior
authorizations, provider enrollment, services provided in alternative settings, and
continuation of HCBS. Please see the waiver approval letter by clicking here. ODM also
applied for "Appendix K" waivers, which is to waive rules and regulations related to HCBS.
That waiver request is still pending with CMS. (Back to top.)

Ohio to increase C19 testing capacity
The call for more COVID-19 (C19) testing capacity has been heard by the DeWine
administration. The Governor established a task force last week to address the issues that are

restricting the number of tests that can be performed. This corresponds with a recent change in
the priority for testing that included asymptotic exposed residents and staff at nursing homes
and other congregate settings. And an admission by the governor's staff that more testing will
allow them to make a more informed decision about reopening Ohio's economy. To date, the
task force has worked to increase the number of swabs available and the serum needed to store
the samples while being transported to the lab. This is expected to further increase Ohio's C19
testing capacity. Ideally, the state would like to begin random sample testing in the community
for both C19 and antigens to get a better feel for where the state is related to "herd immunity."
The more people that have been exposed to the virus, the quicker Ohio can get back to normal.
(Back to top.)

Local collaborative contact list
Over the past several weeks, including in several Weekly articles, the concept of the "three-
legged stool" involving collaboration between hospitals, local health districts, and providers
such as nursing homes has been discussed. The Academy has been communicating with the
Central Ohio EMA team to determine how best to link providers into the local
collaboratives. It was determined the best approach is to contact the regional leads. They
should be able to provide information on the local collaborations and connect you with the
hospital and local health department. Please click here for a map of each region along with
the contact information for each regional lead. (Back to top.)

HOME Choice still active during COVID
The Ohio Department of Medicaid wants to remind providers that HOME Choice is still
active during the COVID pandemic: "We continue to conduct transitions during this time
of lockdown and social distancing. In fact, we have transitioned over 35 individuals to
community settings in the last five weeks. Prior to happening, each of these transitions
were evaluated on a case-by-case basis and approved for moving forward after an
individualized health, safety and community sustainability plan was established. It is
important the HOME Choice Transition Coordinators work with individuals and nursing
facility staff to develop new and inventive ways of providing socially distant moving and
community linkage support. We are happy to report that in many cases this can be
accomplished. Home Choice is up to this creative challenge in order to accomplish essential
transitions to the community." Please click here for more information on the HOME
Choice program. (Back to top.)

CMS QSO memo: Five star info, staff counts, FAQs
The Centers for Medicare & Medicaid Services (CMS) provided information on how the NH
five-star rating system would be handled during COVID via the latest QSO memo (QSO-
20-28-NHs, click here to view). The memo also notes that CMS will be posting staffing
data. It also contains FAQs at the end of the document to clarify questions related to
previous memos or waivers. Below is the memo summary:

   •    CMS is committed to taking critical steps to ensure America’s nursing homes are
        prepared to respond to the threat of the COVID-19.
   •    Nursing Home Compare website & Nursing Home Five Star Quality Rating
        System: We are announcing that the inspection domain will be held constant
        temporarily due to the prioritization and suspension of certain surveys, to ensure
        the rating system reflects fair information for consumers.
   •    Posting of surveys: CMS will post a list of the surveys conducted after the
        prioritization of certain surveys, and their findings, through a link on the Nursing
        Home Compare website.
   •    Nursing Home Staff: CMS is publishing a list of the average number of nursing and
        total staff that work onsite in each nursing home, each day. This information can be
        used to help direct adequate personal protective equipment (PPE) and testing to
        nursing homes.
   •    Frequently Asked Questions (FAQ): We are releasing a list of FAQs to clarify
        certain actions we have taken related to visitation, surveys, waivers, and other
        guidance.

(Back to top.)

CMS suspends advance payment program
From CMS: "On April 26, the Centers for Medicare & Medicaid Services (CMS) announced
that it is reevaluating the amounts that will be paid under its Accelerated Payment Program
and suspending its Advance Payment Program to Part B suppliers effective immediately.
The agency made this announcement following the successful payment of over $100 billion
to health care providers and suppliers through these programs and in light of the $175
billion recently appropriated for health care provider relief payments. CMS had expanded
these temporary loan programs to ensure providers and suppliers had the resources
needed to combat the beginning stages of the 2019 Novel Coronavirus (COVID-19).

Funding will continue to be available to hospitals and other health care providers on the
front lines of the coronavirus response primarily from the Provider Relief Fund. The
Accelerated and Advance Payment (AAP) Programs are typically used to give providers
emergency funding and address cash flow issues for providers and suppliers when there is
disruption in claims submission or claims processing, including during a public health
emergency or Presidentially-declared disaster.

For more information on the CARES Act Provider Relief Fund and how to apply, visit:
hhs.gov/providerrelief.

For an updated fact sheet on the Accelerated and Advance Payment Programs, visit:
https://www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-
Sheet.pdf."
(Back to top.)

CDC adds to COVID symptoms
Several news outlets are reporting that the CDC has added to the symptoms for COVID-19.
Many of those working with symptomatic COVID individuals in the healthcare setting will
recognize these symptoms: chills, repeated shaking with chills, muscle pain, headache, sore
throat, and new loss of taste or smell. Please click here to view all of the CDC symptoms for
COVID-19. (Back to top.)

CMS MLN Connects
News

   •     Trump Administration Champions Reporting of COVID-19 Clinical Trial Data
         through Quality Payment Program, Announces New Clinical Trials Improvement
         Activity
   •     CMS Releases Additional Blanket Waivers for Long-Term Care Hospitals, Rural
         Health Clinics, Federally Qualified Health Centers and Intermediate Care Facilities
   •     IRF PPS FY 2021 Proposed Rule
   •     Bill Correctly for Inhalant Drugs

Events

   •     Ground Ambulance Organizations: Data Collection for Medicare Providers Call —
         May 7

MLN Matters® Articles

•    New and Expanded Flexibilities for Rural Health Clinics (RHCs) and Federally
        Qualified Health Centers (FQHCs) During the COVID-19 Public Health Emergency
        (PHE)
   •    New Waived Tests
   •    April 2020 Integrated Outpatient Code Editor (I/OCE) Specifications Version 21.1
        — Revised
   •    April 2020 Update of the Ambulatory Surgical Center (ASC) Payment System —
        Revised
   •    Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) -
        April 2020 Update — Revised
   •    Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code
        (CARC), Medicare Remit Easy Print (MREP) and PC Print Update — Revised
   •    Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code
        (CARC), Medicare Remit Easy Print (MREP) and PC Print Update — Revised

Publications

   •    Provider Compliance Tips for Nebulizers and Related Drugs Fact Sheet — Revised

Multimedia

   •    Medicare Home Health Benefit Web-Based Training Course — Revised

View this edition as PDF (PDF)

View this edition on the web.

(Back to top.)

ODDS AND ENDS                                                   NOTABLE DATES OR
                                                                EVENTS

REMINDER: Please submit PPE/Capacity/Staffing
daily survey                                                                                OANAC/ASHS Spring
                                                                                            Conference
Providers are reminded to submit their capacity survey to the
                                                                                            CANCELLED
state on a daily basis. The survey, which collects data on PPE,
ventilator and bed capacity, and staff is viewed by the state                               CGS: myCGS ATC
daily and is used to help determine where resources are                                     June 11, 2020
available and needed. Not all providers have responded and
this information is vital in helping the state respond to COVID-                            Click here to view CGS
19 "hot spots." Please click here to submit your survey and                                 Part A training events
bookmark/save the link so you can submit daily.
                                                                                            Click here to view CGS
                                                                                            Part B training events
CGS Webinars - COVID and Part A

COVID-19 Updates for Part A Institutional Providers

April 30, 2020
11:00 a.m. – 12:00 p.m. Eastern Time

Join the J15 Part A Provider Outreach and Education staff as
we provide an overview of the waivers and expansions in place
for Part A institutional providers during the Novel Coronavirus
2019 (COVID-19) public health emergency (PHE). Pre-
submitted questions are appreciated and may be submitted
upon registration or sent
to: J15_PartA_Education@cgsadmin.com.

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