Coronavirus Update #156
MDH Updates, CDC Interim Guidance on Rapid Antigen Tests, Webinar, Healthcare Heroes, Reminders about Survey Process, Medicaid Appeals, Admissions FAQ, DME Warehouse
Maryland Department of Health Updates: CARES Act Extension and Change of Payer Processing

  • Earlier this week, the Maryland Department of Health (MDH) shared this notice regarding the extension of the CARES Act.

CDC Interim Guidance on Rapid Antigen Tests

This week, the Centers for Disease Control and Prevention (CDC) released new interim guidance on rapid antigen testing for COVID-19. The key points that members should be aware of include:

  • The two rapid antigen tests on the market (BD Veritor and Quidel Sofia2, which are being sent to all nursing homes by CMS) are currently intended for use in diagnostic testing of symptomatic patients within five days of symptom onset. 
  • Through this new guidance, CDC expands use of these rapid antigen tests to include use as screening tool in congregate settings (such as a nursing home) for staff and residents.
  • All long term care facilities must defer to state or local guidance on their use. If no such guidance exists, you may consider following CDC guidance. 
  • Evaluating the test results must be done in context with the person’s symptoms and how likely COVID-19 is in the group of people getting the tests, which is usually similar to the community’s rate of COVID-19. 
  • Providers who are utilizing these antigen test devices must undergo proper training and be able to demonstrate competency and completion.

It’s very important that providers who are utilizing the point of care antigen test device understand this new CDC guidance. AHCA/NCAL has developed a more comprehensive summary here that members can utilize. 

AHCA/NCAL has also added information on how to access training for both antigen devices (BD Veritor and Quidel Sofia2) to its summary of important steps providers must take in preparing to use these testing devices. 

Additionally, CMS is expected to update the list of nursing homes receiving the point-of-care (POC) antigen tests later today (Thursday, August 20). CMS provides a zip file (an excel file) with the names of all the nursing homes to receive either the Quidel Sophia-2 or BD POC antigen tests. You can also find this list on under the paragraph “Supporting COVID-19 Testing.”
MDH Webinar Recap

Yesterday, the Maryland Department of Health held a webinar call to update the long-term care sector on COVID-19 developments and best practices. The call was recorded, in case you were unable to join or would like to review the topics discussed, which included:

  • Review current situation of COVID-19
  • Testing Taskforce Updates
  • Managing Admissions and Readmissions
  • Navigating the MDH Coronavirus Website
  • Q&A

You can also view the webinar's Powerpoint presentation here.

If you have any questions, please email
Essential Workers
Nominate a Healthcare Hero Today!
Deadline is August 24

When is the right time to honor heroes in the middle of a fight? Whenever and however you can! Since June, with the generosity of the Horizon Foundation we have provided 1485 meals, supported 23 centers and campuses, and provided direct aid to 30 frontline healthcare heroes in Howard County.

On Thursday, September 3, we plan to come together in-person in a socially distanced way and online to honor 15 frontline healthcare heroes. We appreciate all the sacrifices that healthcare teams have made and continue to make during this crisis. While every healthcare worker truly deserves praise and recognition, we want to celebrate a handful of our frontline heroes – this will be the start. 

See this flyer for more information and to nominate your healthcare hero today.
REMINDER: CMS to Return to Normal Survey Process

Centers for Medicare and Medicaid Services instructs states to return to normal survey process as soon as possible.

Centers for Medicare and Medicaid Services (CMS) issued a Quality, Safety & Oversight (QSO) memo to states yesterday instructing them to return to normal survey process as soon as resources in the state allow and in accordance with states' reopening plans. It also provides guidance on how to resolve pending enforcement actions suspended as a result of prior QSO memos on March 23, 2020 and June 1, 2020 that suspended some survey enforcement actions during the COVID-19 pandemic.

On March 23, 2020, CMS issued the QSO 20-20-All memorandum, which limited survey activity to focused infection control surveys. On June 1, 2020, CMS issued the QSO 20-31-All memorandum that provided survey re-prioritization guidance to transition to more routine oversight and survey activities. This latest memo instructs states to restart all normal surveys as possible.

CMS intends to resolve suspended enforcement cases and provide guidance for closing them out going forward starting yesterday. This process involves four components that are described in the QSO memo:

  1. Expanding the Desk Review policy for Plans of Corrections (POCs); 
  2. Processing enforcement cases that were started BEFORE March 23, 2020; 
  3. Processing enforcement cases that were started ON March 23, 2020, THROUGH May 31, 2020; and 
  4. Processing enforcement cases that were started ON OR AFTER June 1, 2020.

CMS is also issuing updated guidance for the re-prioritization of routine state survey agency (SA) Clinical Laboratory Improvement Amendments (CLIA) survey activities, subject to the SA’s discretion, in addition to lifting the restriction on processing CLIA enforcement actions, and issuing the Statement of Deficiencies and Plan of Correction (Form CMS-2567) for CLIA citations.

Providers with questions about past enforcement actions suspended during the pandemic should contact their state survey agency for guidance as there are many scenarios that may not be fully addressed by this memo.

Per CMS, questions about a specific enforcement cycle may be addressed with the specific CMS location.

REMINDER: Revision to Secretary Neall's Public Notice re. Provider Medicaid Timeframe to Request a Fair Hearing and File Provider Appeals Extension

Recently, the Maryland Department of Health (MDH) shared this notice regarding provider Medicaid timeframe to request a participant fair hearing and file provider appeals extension. Please share this notice with appropriate staff members in your organization.

On August 14, 2020, Secretary of Health Robert Neall issued an amendment to the Public Notice originally issued on March 24, 2020, regarding the timeframe for Participant Fair Hearing and File Provider Appeals Extensions.  This amendment impacts the timeframe within which providers must file an appeal of a Department action.

Under the original Public Notice, the Maryland Department of Health (“the Department”) extended the timeframe for requests by Medical Assistance providers to file appeals under COMAR until 30 days after the end of the Maryland state of emergency due to COVID-19. The extension previously granted is being discontinued effective September 1, 2020 in light of the Department’s determination that an indefinite extension for filing of appeals is no longer appropriate or necessary. The COVID-19 pandemic may continue for some time and providers have not experienced substantial challenges submitting claims.

Effective September 1, 2020, providers will have 30 days to file an appeal consistent with the requirements of COMAR

Any appeals that were not filed between March 12, 2020 and the date of the revised Public Notice issued on August 14, 2020, must be filed on or before September 18, 2020.
REMINDER: Updated FAQ on Admissions and Re-Admissions to Maryland Nursing Homes

This update clarifies the guidance regarding what to do when a facility does not have a single-person room available for readmission, review changes to FAQ # 3 in the guidance.  
Maryland State Durable Medical Equipment Warehouse

Please review this information on DME donations from the Secretary of the Maryland Department of Aging, Rona Kramer.
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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.