Coronavirus Update #99
Thank you, State Updates, Scorpion Protective Services, CARES Act Provider Relief Fund CHOW FAQs, Revised OSHA Policies , COVID-19 FAQs Updated: ACO Section , PPE Order Opportunity
Thank You, State Updates

Thank you and your teams for all you are doing. You are saving lives.  During times like these it is sometimes easy to lose discipline or to fallback on proactive communication. In talking with many of you recently, I know that is not the case with you and your teams. You and your teams continue to work hard and smart to save lives and to get people well – thank you.

We are seeing increases in National Guard testing, and the vast majority of reports are that interaction with Guard teams is very positive. State/Federal/Guard Bridge Teams (24 of them) are being deployed and that is going well; the only wish on that front is for more of those teams. I suspect more teams will be trained. 

Going forward:

  • As has been reported in national media, Guard across the nation will pull back in the next couple weeks to avoid the 90 day federal VA benefits threshold.

  • The absence of the Guard and the need to transition the Bridge Teams command and deployment structure could present challenges for our sector.

  • Maryland State and local governments will take more steps into the recovery mode; likely ahead of our sector’s complete recovery from our surge.

  • Healthcare in general and our sector in specific will need to remain vigilant and work with our hospital partners for summer waves of COVID-19 and future surges.

  • AHCA/NCAL and HFAM anticipate that SNF census will remain low in the coming weeks and months. AHCA’s leadership on CARES Act funding for our sector has been critical.

  • Testing, training and staffing will remain issues.

In terms of rates and the state budget:

At HFAM we are working hard and smart and day and night on your behalf. In terms of the state budget, the pandemic, and the economy, we are in unprecedented times—state government budget cuts will likely be significant. The first round of State of Maryland budget cuts came out yesterday and MDH was not included. Our four percent Medicaid rate increase remains in the budget and the budget reconciliation act and thus far has not been cut. That said, as always, we will have to work hard and smart to keep it. We will continue to advocate and it is critical that we work united. Together, we are navigating a new normal—these are REALLY tough times. 

On a related note, here is a piece of writing of mine that appeared in McKnight’s yesterday.
Our universal messages remain:

  • 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


Be well,
Joe DeMattos
President & CEO
Introducing Scorpion Protective Services

Scorpion Protective Services LLC is a full-service Security Protection Company that offers offers tailored Security Services intended to protect and defend the security of both Public and Corporate entities.

Scorpion Protectives Services LLC offers tailored Security Services including:

  • 24/7 Armed and Unarmed Guard Service

  • Executive Protection- Corporate and Personal

  • Executive Driving Services- Corporate and Personal

  • Corporate and Personal Security Surveys

  • Corporate Threat Assessment and Event Planning

  • Access to Improved Security and Surveillance Systems (through Trusted Business Partners)
CLICK HERE to s ee Scorpion Protective Services introduction letter. If you have questions or would like to learn more, please call (410) 698-5001 or email .
CARES Act Provider Relief Fund CHOW FAQs 

On May 19, the U.S. Department of Health and Human Services (HHS) posted four FAQs on Change of Ownership (CHOW) .  

The four CHOW FAQs are: 

  • Can an organization that sold its only practice or facility under a change in ownership in 2019 and is no longer providing services, accept payment and transfer it to the new owner? 

  • If the current TIN owner has not yet received any payment from the Provider Relief Fund, it may still receive funds in other distributions. Can a provider that purchased a TIN in 2019 accept a Provider Relief Fund payment from a previous owner and complete the attestation for the Terms and Conditions? 

  • If, as a result of the sale of a practice/hospital, the TIN that received a General Distribution payment is no longer providing health care services as of January 31, 2020, is it required to return the General Distribution payment? 

  • How does the organization account for these acquisitions when submitting revenue information in the Payment Portal? 

The UnitedHealth Group CARES Provider Hotline has given guidance that does not align with the FAQs. AHCA/NCAL has requested clarification on how to address action steps already taken related to CHOWs based on Hotline Guidance as well as a list of other questions to HHS.
Revised OSHA Policies 

The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has adopted revised policies  for enforcing OSHA’s COVID-19 requirements, which will become effective May 26, 2020. The previous memorandum will be rescinded. 

OSHA is increasing in-person inspections at all types of workplaces. In geographic areas with sustained elevated community transmission or a resurgence, OSHA will prioritize on-site inspections for high-risk workplaces, such as health care providers treating patients with COVID-19. 

OSHA is also revising its previous enforcement policy for recording cases of COVID-19. Under OSHA’s recordkeeping requirements, COVID-19 is a recordable illness. Employers are responsible for recording cases of COVID-19 if the case: 

  • Is confirmed as a COVID-19 illness 

Under the new policy issued, OSHA will enforce recordkeeping requirements for employee COVID-19 illnesses for all employers. OSHA acknowledges the difficulty in determining whether a COVID-19 illness is work-related, especially when an employee has experienced potential exposure both in and out of the workplace. OSHA’s guidance emphasizes that employers must make reasonable efforts, based on the evidence available to the employer, to determine whether it would be considered work-related. 
COVID-19 FAQs Updated: ACO Section 

On Friday, May 15, CMS updated its COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing . The ACO section included an updated question (pg. 40, question #6) around the length of time a Medicare Shared Savings Program (MSSP) ACO would be responsible for shared losses with the trigger of the Extreme and Uncontrollable Circumstances Policy. CMS’ response includes an example and explains that ACOS in performance-based risk tracks for 2020 would only be responsible for incurred losses for the time period prior to or after the COVID-10 Public Health Emergency (PHE). The rest of the FAQs are around the MIPS program and beneficiary notifications. With regards to beneficiary notifications CMS continues to allow notifications through email, secure portal or mail and has relaxed its timely notification policy as long as the beneficiary notification is completed by the end of the performance year. 
Reminder: Professional Liability Benchmark Report

Marsh & McLennan is conducting a long term care professional liability report for our sector. Through Marsh’s National Senior Care practice and Oliver Wyman’s Actuarial practice, Marsh & McLennan will now produce the Professional and General Liability Benchmark Report for Long Term Care Providers.
The information presented in this study is a critical component in various insurance industry initiatives and supports multiple state tort reform efforts. This benchmark study is also an important resource relied upon by insurance carriers, actuaries, and of course, long term care and senior living providers.
This year’s analysis is critical to establish a pre-COVID-19 baseline and we strongly encourage participation with a completion date of June 1.
The information Marsh & McLennan is collecting is listed below.

  1. Individual claim listings (excluding Protected Health Information) in Excel-readable format, containing all professional liability and general liability claims. This claim listing should provide claim level detail valued as 12/31/2019. If historical valuations are also available, please include claim listings valued as of 12/31/2018, 12/31/2017, 12/31/2016, and 12/31/2015.
  2. Occupied bed equivalent exposure information for the past 10 calendar years if available.

 This information should be provided separately for assisted living facilities and skilled nursing facilities.
Please contact Oliver Wyman regarding the data collection process or with any additional questions at .
CMS COVID-19 Stakeholder Engagement Calls

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.

Calls recordings and transcripts are posted on the CMS podcast page.
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, May 22nd at 12:30 – 2:00 PM Eastern
Toll Free Attendee Dial-In: 877-251-0301; 
Access Code: 6086125
Who are your healthcare heroes?

There are so many amazing stories of dedication, sacrifice, and compassion by long term care professionals who are going above and beyond to ensure the safety, health, and happiness of residents during this unprecedented time. These individuals are saving lives; they are heroes.

We want to hear your stories!

 Please email   to share a current story and picture of members of your team who are going above beyond to provide quality care during this unprecedented time. 
PPE Order
PPE is still flying out the door for LifeSpan, HFAM and LeadingAge MD. Running low where you are? We have limited quantities of masks, gloves, face shields and gowns available for pickup in Columbia.

All items are certified and FDA approved. Pricing is as follows, but subject to change: KN95 masks - $2.50 ea; Gowns - $7.50 ea; Disposable gloves $29/box of 50; Face shields - $4.00 ea. Send an email to  with desired items & quantities. 
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.