Wednesday, April 29, 2020

New COVID-19 Resources & Important Reminders

Preparing for Widespread Testing 

The Centers for Medicare and Medicaid Services (CMS) has recently emphasized the importance of testing for COVID-19 in nursing facilities. In addition, a growing number of states are requiring testing of all residents and/or staff. When accessing testing, we recommend providers ensure that the tests are FDA approved PCR tests (versus Antibody/Serology tests) and that the lab will bill Medicare directly. Providers need to have a plan in place to isolate residents who test positive, and follow CDC guidance for staff that test positive. More information and guidance on preparing for widespread testing is available in here.

Continuing Restrictions on Visitors in LTC 

Even as states are beginning to lift their stay at home orders, nursing homes must continue to maintain current restrictions on visitors. As a reminder, CMS released guidance on March 13 that required all nursing homes to significantly restrict visitors and nonessential personnel, as well as restrict communal activities. The guidance indicates that individuals other than essential health care staff and visits for end-of-life situations, should no longer enter nursing homes until further notice.
Even though certain states may be lifting their individual stay-at-home orders, nursing homes must continue to follow this directive from CMS until new guidance is received. For help communicating these policies, please see our sample letter to families on restricting visitors.

Assisted living communities must follow any applicable state guidance. If no state guidance is issued, we recommend they follow AHCA/NCAL guidance and continue restricting the number of people entering the facility.

For all long term care communities, these restrictions remain critical safeguards to help protect against the spread of COVID-19.

Documentation & Asking for Help

Law firm Husch Blackwell lays out some general steps for documenting activities and response efforts to be prepared for surveys and potential litigation. AHCA/NCAL also recommends working with your legal counsel to develop practices. This resource is available to AHCA/NCAL members (log in required).

As a reminder, the association has developed brief guidance for facilities facing personal protective equipment and staffing shortages, as well as other challenges in receiving assistance. Most long term care providers do not have access to the adequate supplies or staff to provide the level of care needed to contain the virus. Documenting requests for assistance is a critical part of managing of the long term consequences of the lack of supplies and testing – and preparing for future surveys.

Unfortunately, also due to this crisis, many long term care providers are unable to fulfill requests for help made to regular contacts (e.g., suppliers, morgues, staffing agencies, etc.) and through traditional communication channels. Long term care providers need to regularly call for help and need to document these calls were made. Continue to reach out to these entities:

Be sure to check out the AHCA/NCAL guidance, which also has information on how to properly document calls for help and the importance of requesting a facility level waiver.

AHCA/NCAL Grant & Loan Management Resource Guide 

To aid members with managing the array of federal grants and loans, AHCA/NCAL has developed a basic primer (login required) for organizing oversight and day-to-day management of these emergency resources. The guidance includes federal cost reporting guidelines as well as recommended financial management approaches for members. This document is the Association’s first version; updates will be developed as the federal government and states release new or updated guidance.

COVID-19 Related Loss and Cost Calculator 

Also, available exclusively to AHCA/NCAL members is a COVID-Related Loss and Cost Calculator (login required). The purpose of this excel workbook is to offer a basic tool for members to assess allowable costs already reimbursed by pre-COVID payers, such as Medicare and Medicaid, and compare such reimbursement to shortfalls where grants and loans fill funding gaps. This tool will be particularly useful with reporting on and documenting use of the CARES Act Provider Relief Fund grants.

Scammers Posing as Government Officials 

AHCA/NCAL has developed a resource to warn providers about potential scammers posing as government officials. Learn more about how to screen callers claiming to be representing a state or federal agency or official or claiming to be from the IRS, Department of Commerce, or a Bank or other financial institution without first verifying the caller’s identity. This resource also includes ways to protect residents from scammers and some safety tips to confirm legitimate outreach calls from CMS or the CDC.

Separately, AHCA/NCAL had previously created a resource on how to beware of scams when working with vendors offering personal protective equipment.

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