Coronavirus Update #106
HFAM Update, CMS Announcement on NHSN Data, AHCA/NCAL Statement, COVID-19 Updates, Reminder on SNF COVID-19 Specimen Collection, CMS Calls this Week
HFAM Update

F riends,

A month ago we were in the thick of the COVID-19 surge in our sector. High percentages of your residents, patients, and staff were testing positive for COVID-19 and we were more than two months into the visitation ban put in place to save lives. In the middle of all of that, a family living hundreds of miles away was a nervous wreck thinking about their loved one in a Maryland skilled nursing and rehabilitation center. The family was able to call the center, talk with staff, and talk with their loved one; but due to the medical challenges of the resident, it was hard to really connect.

The family got in the car and made the trek from New York City to Maryland, of course when they arrived at the center they were told they could not come in and visit, and that it was in the best interest of their loved one and all in the center that they not come in. The family, exhausted by the pandemic and tired from their trek, wept in the driveway of the nursing home. It was then that Mary Ann, their loved one’s nurse came outside to console them. Mary Ann cried along with them, and reassured them that their loved on was doing well. And then Mary Ann surprised the travelers. She walked them on the lawn to a corner window that looked into a common room inside the center and told them “wait here.”

A few minutes later, Mary Ann wheeled the family member to the window from inside. The tears turned to those of joy, smiles beamed, and even through the window and with the medical limitations of the resident, the family connected. People were uplifted and a little community of staff, resident, and family was created. In that moment Mary Ann fulfilled an Rx for love and quality care more powerful than any other remedy.

Talking with family members, with staff in your centers, and with you, I know that Mary Ann is one of thousands of your care teams leading and caring in this way. Just as it was one small step for man, and one giant leap for mankind, Mary Ann is one of thousands of professional caregivers going above and beyond, and one in a million in her capacity to love and to care.

Thank you Mary Ann, and thank you all. 

Release of Nationwide Data:

  • We wanted to pass along this article from the Washington Post about the new nationwide stats on COVID deaths in nursing homes.  From a snapshot perspective in terms of Maryland the data is old and incomplete; but the data will catch up. At the bottom of the article, you’ll see they are asking nursing home staff members/residents/family members to submit their own stories to inform future coverage.

  • Below in this update is AHCA’s statement on the release of data. There is value and power in being part of the AHCA/NCAL family. 

  • Continue your focus on providing quality care and supporting your team.


  • In terms of continued staffing challenges, back-ups, and support, one resource is Steve Diamond – CLICK HERE.

  • In terms of staff training and recharging staff to fight burnout, an outstanding resource is Ryan McShane at ER Evolution, CLICK HERE.

As Always:

As we navigate COVID-19 together, we have been driven by the power of association, here at HFAM and at AHCA/NCAL. Our common purpose, the life threatening challenge of COVID-19, and the power of association have been and continue to be the driver of these universal messages we have sent time and time again:

  • Focus on providing quality care
  • Value your team
  • Over communicate with residents, patients, families and staff
  • Operate DRIVEN your infectious disease protocol
  • Take and document your action
  • Keep a timeline
  • Work with your hospital partners, and coordinate with local and state regulatory partners
  • Training - now is the time to be continuously training on PPE, Donning, Doffing and all things infectious disease protocol, workforce/workflow

Thank you for all you do! Potential power is realized with unity, focus, and consistent right action.

Be well,
Joe DeMattos
President & CEO
CMS Announcement on NHSN Data and Guidance on COVID-19-Related Survey Activity

On June 1, CMS released a memorandum ( QSO-20-31-ALL ) addressing NHSN data, COVID-19 survey activities, enhanced enforcement, and engagement of Quality Improvement Organizations (QIOs).
This guidance is effective immediately and will cease to be in effect when the Secretary determines there is no longer a Public Health Emergency due to COVID-19. At that time, CMS will send public notice that this guidance has ceased to be effective via its website.
AHCA/NCAL Statement in Response to CMS, CDC Data on Nursing Homes and COVID-Related Cases
Yesterday evening, The American Health Care Association and National Center for Assisted Living (AHCA/NCAL), released a statement in response to data released yesterday by the Centers for Disease Control and Prevention (CDC) on the number of nursing home residents who have contracted COVID-19 as well as an announcement from the Centers for Medicare and Medicaid Services (CMS) regarding additional penalties on nursing homes.
The following statement is attributable to Mark Parkinson, president and CEO of AHCA/NCAL:
“These numbers show what we have known for months, that COVID-19 disproportionately impacts the elderly with chronic diseases and the dedicated staff who care for them. Today’s report validates the need for the assistance that nursing homes have been calling for since the beginning of this pandemic. Especially as we continue to expand testing for residents and staff in long term care centers in June, we should anticipate the number of cases to rise as asymptomatic residents and staff will be identified. While an increase in these reported numbers may be startling, it will improve our ability to confront this threat and protect our residents.”
More COVID-19 Updates

Supporting Your Loved One in a Long Term Care Facility : CDC released a fact sheet on Supporting Loved Ones in a Long-Term Care Facility providers can share with residents’ families. The fact sheet includes ideas on how to keep in touch and ways providers are supporting communication between residents and their families.

SNF Therapy Telehealth Waivers and other Updated COVID-19 Billing FAQ Updates : CMS provided important updates to coverage and billing guidance impacting SNF related to COVID-19 1135 waivers. AHCA/NCAL has developed therapy telehealth waivers FAQs that address questions that SNF and AL members may have regarding applying these waivers to improve resident mobility care needs.

CMS Updates Guidance on Proper Use of COVID-19 Waivers Claim Codes : On June 1, CMS issued updated guidance clarifications for using the “DR” Condition Code and “CR” modifier on Medicare fee-for-service claims for services furnished under COVID-19 Section 1135 waivers such as the SNF-specific 3-day stay and spell-of-illness waivers.

Hilton’s Frontline Medical Professionals Room Program : Following on Hilton’s effort with American Express to donate up to a million rooms to frontline medical professionals, Hilton is offering healthcare heroes rooms at a significant discount through June 30th. They are bookable today via AHCA/NCAL’s dedicated booking platform (AHCA/NCAL member login required).
Payment Issue for 837 Institutional Claims

The following message has been relayed via the Maryland Department of Health from OET:

"There was an issue processing 837 Institutional files submitted for last week's payment cycle, 5/30/2020. All 837 Institutional files from last week have been processed for this week's payment cycle, 6/6/2020. The claim status for these claims can be checked on eMedicaid today, 6/2/2020."
Re: Nursing Homes COVID-19 Specimen Collection Due Date - 6/5/20

The Maryland Department of Health (MDH) last week released this letter from Secretary Neall regarding testing and lab submission.

Nursing homes are directed to use test kits delivered by the National Guard to complete the contemporaneous COVID-19 test specimen collection on 100% of nursing home residents and staff. It is essential that all nursing homes conduct specimen collection promptly. MDH requires specimens from 100% of residents and all available staff be collected and submitted to the designated laboratory for testing no later than June 5, 2020.

The Maryland National Guard will follow-up with a telephone survey of all 227 facilities to ensure all testing is completed and to address questions and concerns about universal testing. As previously noted, assistance with staff shortages due to temporary loss of asymptomatic positive staff is available through the Chesapeake Registry and from Bridge Teams as necessary.

Should you have any questions, please do not hesitate to contact your local health department or Col. Eric Allely at
CMS COVID-19 Stakeholder Engagement Calls – Week of 6/1/20

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts. 

Call details are below. Conference lines are limited so you are highly encouraged to join via audio webcast, either on your computer or smartphone web browser.

CMS COVID-19 Office Hours Calls (Tuesdays at 5:00 – 6:00 PM Eastern)

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:Increase Hospital Capacity – CMS Hospitals Without Walls; Rapidly Expand the Healthcare Workforce; Put Patients Over Paperwork; and Further Promote Telehealth in Medicare 

This week’s Office Hours:
Tuesday, June 2 at 5:00 – 6:00 PM Eastern
Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 4474407
Lessons from the Front Lines: COVID-19 (Fridays at 12:30 – 2:00 PM Eastern)

Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters.

This week’s Lessons from the Front Lines:
Friday, June 5 at 12:30 – 2:00 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Code: 6583696
Did you miss HFAM's previous alerts?

Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
Thank you.

We cannot thank you enough for the dedication and diligence in doing all that you can for the residents in your communities. HFAM continues to monitor the COVID-19 pandemic with our state and national partners and will do all we can to support you during this time.