April 23, 2020
KHCA/KCAL is committed to providing our members with important updates. Below is a list of the most recent COVID-19 updates. Please visit our website for a list of complete updates.  www.khca.org
Governor Kelly's Executive Order No. 20-26
"Temporary relief from certain restrictions and requirements governing the provision of medical services."
Updated Guidance on Executive Order No. 20-23
Two weeks ago, we learned that skilled nursing would be included as part of the stimulus bill’s (aka the CARES Act) $100 billion Provider Relief Fund, when  HHS distributed the first $30 billion  from the fund and all skilled nursing facilities received 6.2% of their 2019 Part A and Part B Medicare payments.  Yesterday, HHS announced an additional $40 billion in distribution s , with checks going out as early as this Friday. Here is what we know so far. 

  1. SNFs are clearly part of a tranche of funds that HHS is using to pay providers based on their total revenue. It will distribute $20 billion of the $40 billion based on a percentage of providers total revenue, but will make some adjustment for Medicare revenue, that was recognized in the prior payment. We do not know the exact formula yet, but providers who have a high level of Medicaid and/or Medicare Advantage, will do proportionally better than those who do not. 
  2. HHS is also distributing $10 billion to those in COVID-19 hotspots. This may be for hospitals only. We are verifying that and if we are not part of these funds, we will seek reimbursement for SNF and AL COVID hotspots in future funding. 
  3. HHS is also distributing $10 billion to rural hospitals.  

The additional news is that today Congress will likely add $75 billion to this fund. That will replenish the fund to slightly over $100 billion. We will work to continue to receive the funding you deserve as you fight the daily battles in your buildings. As we learn more about the formula utilized to distribute the $20 billion, we will let you know.  
CDC Return to Work Guidance: Contingency & Crisis Strategies
Per CDC Return to Work Criteria guidance, health care facilities must be prepared for potential staffing shortages and have plans and processes in place to mitigate them, including considerations for permitting health care providers (HCP) to return to work without meeting all return to work criteria outlined.
 
CDC refers to the Strategies to Mitigate Healthcare Personnel Staffing Shortages document for information which provides both contingency and crisis strategies. Contingency strategies apply when staffing shortages are anticipated and crisis strategies apply when staffing shortages are happening.
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 . 
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). 
AHCA/NCAL’s  FAQs on the Provider Relief Fund  has been updated to include information on the additional funding to be released this week. We will continue to update the FAQ, as an increase of $75 billion is expected to pass the House and be signed by the President today. 
Kansas Health Care Association and the Kansas Center for Assisted Living
1100 SW Gage Blvd Topeka, KS 66604
PH: 785-267-6003 FAX: 785-267-0833