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Virtual Spring Conference Live Session Schedule:
May 21 @ 11:30 AM:
Wisconsin Assisted Living Regulatory Overview -- Survey Trends, Issues & Solutions with Bureau of Assisted Living Director Alfred Johnson
Watch the recorded webinar "A Panel Discussion of Cyber Security Issues Impacting Our Senior Communities" with Pat LeMire (M3 Insurance), Don Glidewell (ThinkAnew), Paul Johnson (Wipfli), and Peter Kujawa (Locknet - An EO Johnson Company). This Panel Discussion also talks about the cyber security issues that have risen during COVID-19.
A
LIVE
Q&A session will be held on May 28 at 10:00-11:00 a.m.
Don’t worry, if you are unable to attend a live session, it will be recorded and added as an on-demand session, that you may view in accordance with your own schedule.
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COVID-19 Updates: May 19, 2020
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This update includes:
- Temporary/Emergency Nurse Aide Training Program Update: Facilities Must Submit Waiver Requests to Continue/Create Programs; Waiver Request Form Templates Now Available
- DHS to Allocate DHS to Allocate $11.5 Million in Family Care Direct Care Workforce Funding due to Federal FMAP Increase
- Gov. Evers Announces $1 Billion Statewide Effort to support COVID-19 Testing, Contact Tracing, Operations, and Resources for Local Communities
- AHCA: Reopening Guidance by CMS Includes Aggressive Stance on Staff, Resident Testing
- Reimbursement and Legal Issues Related to COVID-19 Testing in Long Term Care
- Upcoming Webinar Next Week! The Advantages of PEAL/WCCEAL
- Infection Prevention Control Officer (IPCO) Version 2 Training Now Available with BONUS COVID-19 Content
- OSHA Alert on Nursing Home and Long Term Care Workers' Safety
- Updated CARES Act Provider Relief Fund FAQs
- Economic Impact Payments for Social Security and SSI Beneficiaries with Representative Payees
- Senator Tom Tiffany Sworn Into Congress, Resigns Senate Seat
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As of today, there are 12,885 confirmed cases of COVID-19 in the state of Wisconsin and 467 deaths caused by the virus. Click
HERE
to view the latest outbreak information from the Wisconsin Department of Health Services. Click
HERE
to view COVID-19 projections for Wisconsin and the United States.
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Temporary/Emergency Nurse Aide Training Program Update: Facilities Must Submit Waiver Requests to Continue/Create Programs
Waiver Request Form Templates Now Available
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As of May 11, 2020, the public health emergency ended and
Emergency Order #21
is no longer in effect; therefore, the Department of Health Services has established a waiver request process to allow entities and facilities to continue to hire and train caregivers through the Emergency Nurse Aide Training Programs.
The request should include the name of the facility and a request for a waiver of “all applicable regulations to allow for the continuation of the Emergency Nurse Aide Training Program.” It is not necessary to include specific regulatory references in your request.
DHS announced they are able to accept students via the survey who were hired and started training while the emergency order was in effect. Therefore, currently approved Emergency Nurse Aide Training Programs may continue to train students who began their training on or before May 18, 2020, without a waiver. Temporary nurse aides who have completed an Emergency Nurse Aide Training Program may also continue to work at this time.
The Division of Quality Assurance (DQA) will schedule a webinar to provide additional information as needed. The date and time of the webinar will be communicated via this listserv messaging. Thank you for your continued efforts to train much-needed nurse aides during this time.
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DHS to Allocate $11.5 Million in Family Care Direct Care Workforce Funding due to Federal FMAP Increase
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WHCA/WiCAL has learned that the Wisconsin Department of Health Services will allocate an $11.5 million increase in Family Care Direct Care Workforce Funding payments to providers in June. This increase results from an increase in federal matching funds allocated as a result of the federal stimulus legislation.
Per the structure of the Family Care Direct Care Workforce Funding program this funding will be made available for providers to distribute to frontline caregivers in assisted living facilities and other Family Care HCBS settings.
According to information WHCA/WiCAL has obtained from DHS, this funding was statutorily required to be paid in specified GPR amounts plus any matching FED to particular sources. The methodology for determining how this funding will be distributed will be presented to a provider stakeholder group on Friday. WHCA/WiCAL has representation on this committee, and the association will update members on any developments during the meeting in the WHCA/WiCAL COVID Update.
CMS has approved the ability of DHS to allow twice a year payments with the next payment for Family Care providers coming in June. This funding would be retroactive to January.
For more information on this development, stay tuned WHCA/WiCAL’s daily updates.
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Gov. Evers Announces $1 Billion Statewide Effort to support COVID-19 Testing, Contact Tracing, Operations, and Resources for Local Communities
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Gov. Tony Evers today announced a $1 billion statewide effort to support COVID-19 testing, contact tracing, acquisition of needed supplies, emergency operations, and resources for local communities throughout Wisconsin.
The effort is funded by $1.17 billion in federal Coronavirus Aid, Relief, and Economic Security (CARES) Act dollars.
The state has allocated approximately $260 million for testing efforts and $75 million for contact tracing.
The testing program includes:
- COVID-19 test kits: The state’s testing program will spend $202 million to provide COVID-19 test collection kits to Wisconsin hospitals, clinics, nursing homes, local public health departments, and others at no cost to ensure that everyone who needs a test receives a test.
- Local preparedness grants: These grants will provide $30,000 in funding to 96 local and tribal public health departments (for a total of approximately $3 million) to update preparedness plans to ensure Wisconsin communities, schools and businesses are prepared to support testing efforts into the fall.
- Local community and occupational testing pilots: These pilot programs will infuse $45 million in funding to local public health departments, occupational health providers, home health agencies, and health systems to conduct COVID19 testing in congregate, community and occupational settings. This program will incentivize testing by providing eligible providers $35 per COVID-19 test administered to a Wisconsin resident and will run through August 31, 2020.
- Public health testing coordinators: The testing program will provide $10 million in funding to local and tribal public health departments to coordinate local testing efforts.
See the governor's release on the program
here.
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AHCA: Reopening Guidance by CMS Includes Aggressive Stance on Staff, Resident Testing
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Amid the state-by-state reopening of the United States while the coronavirus (COVID-19) pandemic continues, the Centers for Medicare & Medicaid Services (CMS) on Monday
issued new guidance for state and local officials on "reopening" SNFs, including a focus on extreme caution and the call for aggressive testing for staff and residents.
CMS Administrator Seema Verma, in discussing the new recommendations in a press call Monday evening, said the impact of COVID-19 on SNFs has been “heartbreaking” given the unrelenting nature of the virus on the elderly and those with pre-existing chronic conditions. At the same time, she said families and residents have been separated for months since CMS in March declared nursing centers closed to everyone except essential staff and medical personnel.
“We did what was necessary to protect the elderly,” Verma said. Now, the time has come to prepare for what eventually will the allowance of visitors to return to facilities, with precautions like mandatory face coverings for all entering a building as well as coverings for residents and thorough screenings of all visitors.
“The vulnerable nature of the nursing home population requires aggressive efforts to limit COVID-19 exposure and to prevent the spread within facilities,” CMS said. “The recommendations issued today would allow states to make sure nursing homes are continuing to take the appropriate and necessary steps to ensure resident safety and are opening their doors when the time is right. This also serves to help states and nursing homes reunite families with their loved ones in a safe, phased manner.”
Because COVID-19 poses an elevated threat to vulnerable elderly SNF residents, CMS recommends additional criteria for nursing centers advancing through phases of reopening, to complement the Trump administration’s broader Opening Up America Again framework.
To that end, Verma said CMS is recommending to states and localities that nursing centers do not advance through any phases of reopening or relax any restrictions until all residents and staff have received results from a baseline test.
In addition, CMS recommends that state survey agencies inspect SNFs that experienced a significant COVID-19 outbreak prior to reopening. Lastly, CMS recommends that nursing centers remain in the current state of highest restriction even when a community begins to relax restrictions for other businesses and should be among the last to reopen within the community, to ensure safety of the residents.
Nursing centers may receive visitors during phase three, which is when there has been a sustained decrease in COVID-19 cases, the agency said. “A variety of factors must go into making this decision, including states not only relying on case count, but assessing the individual nursing home and other local factors. Visitors must be screened and wear a cloth face covering at all times,” CMS said.
During her press call, Verma also stressed that the CMS guidance is not a mandate to states, as states and localities will have to make the final decision on how and when facilities reopen. And, she said, it may even be the case that if individual facilities have a COVID-19 infection problem, that they would remain off-limits to reopening protocols until the situation is resolved.
“The guidance released today encourages state leaders to collaborate with the state survey agency and local health departments to decide how these criteria should be implemented,” CMS said. Given the critical importance in limiting COVID-19 exposure in nursing centers, CMS recommends that decisions on relaxing restrictions be made with careful review of the following facility-level, community, and state factors:
- Status of COVID-19 cases in the local community;
- Status of COVID-19 cases in nursing centers;
- Adequate staffing;
- Baseline test of all residents, weekly testing of all staff, practicing social distancing, and universal source control for residents and visitors (for example, face coverings);
- Access to adequate personal protective equipment; and
- Local hospital capacity
Verma also said by the end of the month new data culled from SHFs reporting COVID-19 infections, deaths, and other infection information will be made available and posted to the Nursing Home Compare website for public consumption. The new reporting requirements went into effect on May 18.
View the CMS FAQs here:
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Reimbursement and Legal Issues Related to COVID-19 Testing in Long Term Care
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AHCA/NCAL has received many questions from members on reimbursement and legal issues related to COVID-19 testing in LTC. Responses to common member questions are included below:
Reimbursement Issues
Medicare Coverage of Testing: Medicare fee for service and Medicare Advantage plans will cover the cost of COVID-19 diagnostic (PCR) tests. Tests range in cost from $115 to $500. Medicare Part B will only reimburse approximate $100 for the PCR and $35 for other tests. However, not all labs will bill Medicare directly. AHCA/NCAL strongly recommends that, wherever possible, providers use labs that will bill Medicare, as providers may not be able to bill for these services.
CARES Act Coverage: The CARES Act requires health plans to cover the cost of COVID-19 testing for beneficiaries at no cost to the beneficiary. CMS is requiring Medicare Advantage Plans to cover the costs of testing for MA plan beneficiaries. Typically, however, when a test is required by an employer for employment, then the employer is responsible for the cost of the test. If the state is mandating testing the employer may not be held accountable for the cost of the test but this has not yet been validated.
CARES Act Grant Funds: The CARES Act Grant Funds can be used to cover costs for resident tests that are not otherwise reimbursable. This does NOT include testing for residents under a Part A stay where it is included in consolidated billing.
Legal Issues
Resident Refusals: Residents that refuse to be tested for COVID-19 cannot be discharged involuntarily, unless the facility is otherwise incapable of caring for residents with a confirmed diagnosis of COVID-19.
Employee Refusals: Employers can make COVID-19 testing a condition of employment and terminate or not hire a person who refuses to obtain a COVID-19 test.
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Upcoming Webinar Next Week! The Advantages of PEAL/WCCEAL
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The WHCA/WiCAL Virtual Spring Conference will be holding a webinar on Wednesday, May 27 on the Advantages of PEAL/WCCEAL. We will be allowing WiCAL members who have not signed up for the virtual conference to attend this session. Pat Boyer, WHCA/WiCAL Director of Education and Quality Advancement, will be doing a Q&A session at the conclusion of the webinar.
WHEN: May 27, 2020
TIME: 12:30-1:30 p.m. CST
COST: Free
Webinar registration closes on Friday, May 22. If you are not already an attendee of the WHCA/WiCAL Virtual Spring Conference, click
HERE to register.
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Infection Prevention Control Officer (IPCO) Version 2 Training Now Available with BONUS COVID-19 Content
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The emergence of COVID-19 has compounded the need for centers to have an effective infection prevention and control program. AHCA/NCAL’s new and expanded version of its popular Infection Preventionist Specialized Training,
IPCO Version 2 is now available. The online training is recommended for individuals responsible for infection prevention and control in all long term care settings, including assisted living communities.
IPCO Version 2 is designed to train the Infection Preventionists to run a comprehensive infection prevention and control program. It is also now available for administrators to take to gain a deeper understanding of the infection prevention and control in the overall operation of a nursing facility. AHCA/NCAL recommends that each skilled nursing facility train at least two Infection Preventionists through
AHCA/NCAL’s IPCO training program should one Infection Preventionist leave the facility. The training is also highly recommended for assisted living communities because they care for a similar population and can face similar infection risks.
As an added feature to all participants registered for the IPCO Version 2 program, bonus content related to COVID-19 is included. The bonus content includes topics such as: Interim COVID-19 Guidance, courses on PPE, and N-95 mask use.
Members will need to login with their AHCA/NCAL usernames and passwords to register for
IPCO Version 2. For assistance obtaining AHCA/NCAL usernames and passwords, members should e-mail
[email protected] with their name and facility contact information.
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OSHA Alert on Nursing Home and Long Term Care Workers' Safet
y
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The US Department of Labor’s Occupational Safety and Health Administration released
guidance aimed at protecting nursing homes and long term care facilities workers from exposure to COVID-19. Many of the recommendations are based on CDC guidance including optimizing PPE, screening workers and sending sick workers home. The guidance includes encouraging staff to report any safety or health concerns and staggering breaks to avoid overcrowding in the break from.
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Updated CARES Act Provider Relief Fund FAQs
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The U.S. Department of Health and Human Services has posted a reorganized and updated set of
Provider Relief Fund FAQs. Structurally, the document now is broken out by Allocation type: Targeted, General, Uninsured, Rural and Indian Health Services. FAQs of interest to AHCA/NCAL members that have received grants, specifically SNFs, include:
- Additional detail on Attestation – DHHS provides information on accepting funds, rejecting funds, as well as how to accept one award but reject another.
- Publication of Payment Data – Through a CDC data portal, DHHS now is displaying award data by provider name and award amount. Tax Identification Numbers (TIN) and provider type are not included in the database available here. DHHS notes in the FAQs is does not intend to add data elements such as NPIs, TINs, or other provider identification details.
- Tranche 2 General Allocation Formula – DHHS show the formula and discusses why a provider that received a Tranche 1 allocation might not have received a Tranche 2 allocation.
- Payment Portal – DHHS offers guidance on how providers without a TIN, such as county owned providers may attest and/or apply for funding.
- Additional Payments – Additional detail is provided on requesting additional funds in the context of the 2% limit.
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Economic Impact Payments for Social Security and SSI Beneficiaries with Representative Payees
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The Social Security Administration recently issued an update that beneficiaries who have their regular monthly payments managed for them by another person, called a representative payee, will begin receiving their economic impact payments (EIPs) from the IRS in late May.
It is important to note that under Medicaid rules, a stimulus payment is not counted as income. Therefore, receiving a stimulus payment does not change a resident’s monthly payment (often called a ‘patient pay amount’ or ‘share of cost’). The resident pays the same monthly amount to the nursing facility and keeps the stimulus payment for their own use. In addition, the stimulus payment does not count as a Medicaid resource for 12 months. In other words, for the first year, the payment cannot cause you to have ‘too much’ savings.
More details on these payments can be found in this
SSA press release. You may also find information about the eligibility requirements and other information about the Economic Impact Payments
here. In addition, please continue to visit the IRS at
www.irs.gov/coronavirus for the latest information. Social Security will continue to update the agency’s
COVID-19 web page with additional information.
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H.R. 6800, The HEROES Act Passes the House
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On Friday, May 15th, the United States House of Representatives passed H.R. 6800, The HEROES Act, another piece of legislation aimed at addressing the effects of the COVID-19 pandemic. This bill was passed largely along party lines with most Democrats voting for it and Republicans voting against the package. Leader McConnell has stated that he will not bring up this legislation in the Senate. The Senate is likely to craft its own bill. We will continue to work with both chambers and advocate for our priorities during this challenging time
Of particular note to our sector, below are the provisions found in the bill:
- Ensures an additional $100 billion for the provider fund.
- Improves the Accelerated and Advance Payment Program that has been critical to keeping providers afloat including lowering interest rates for repayment.
- Allows facilities with the most losses from this pandemic to be compensated fairly.
- Increases the Federal Matching Assistance Percentage (FMAP) by 14 percentage points through June 30, 2021. At a time of financial instability, this would ensure State governments have the resources they need to continue providing critical services.
- Delays the implementation of the Medicaid Financial Accountability Rule (MFAR) until the end of the emergency period.
- Requires Medicare’s Quality Improvement Organizations to provide infection control support to nursing homes struggling with COVID-19 outbreaks.
- Ensures skilled nursing facilities have a means for residents to conduct “televisitation” with loved ones while in-person visits are not possible during the COVID-19 emergency.
- Requires public reporting of positive cases in nursing facilities.
- Provides $150 million to states to create strike teams if three or more residents or staff are diagnosed with COVID-19 in a 72-hour time period.
- Provides a 20 percent per diem increase for facilities with COVID-19 only units.
- Provides a $13.00 increase in wages for essential workers up to $10,000.
As the Senate begins to consider this bill, AHCA/NCAL will keep you updated as to what the final outcome will be.
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Senator Tom Tiffany Sworn Into Congress, Resigns Senate Seat
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State Senator Tom Tiffany (R-Minocqua) announced yesterday that he resigned from the Wisconsin State Senate.
“Later today I will resign from the Wisconsin State Senate. I want to thank the people of the 12th Senate District for putting their faith in me to represent their voices in Madison. It has been an honor to work for them, and I am grateful for having the opportunity to serve in the Wisconsin Legislature," said Tiffany in a statement yesterday.
Today, Tom Tiffany was sworn into the U.S. House of Representatives following his victory in a special election held on May 12 against Democrat Tricia Zunker.
Tiffany will serve the remainder of former Congressman Sean Duffy's term after Duffy resigned for family reasons last fall. Tiffany has begun collecting signatures to run again in November to serve a full two-year term. He will again face Tricia Zunker.
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Jim Stoa, J.D.
| Director of Regulatory Affairs and Government Relations |
[email protected]
Pat Boyer, MSM, RN, NHA
| Director of Quality Advancement and Education |
[email protected]
Allison Cramer
| Communications and Government Relations Specialist |
[email protected]
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Business Partner Spotlight
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Energy Performance Lighting (EPL) is a commercial lighting contractor, located in Cottage Grove, WI, specializing in high-performance, energy-efficient lighting solutions since 2003. We provide turnkey lighting upgrades; audit, design, and installation, all with our
in-house lighting experts, electricians, and technicians. We incorporate how light spectrum affects human performance. We know we can improve reading speed, comprehension, and alertness with specific spectrums of light. Schools, medical, offices, industrial and government facilities have all benefited from our
knowledge of lighting science. The best part of it is we do not cost any more than a “light bulb changer” and the energy savings pays for everything.
CONTACT:
Rodney Heller LC, CLEP
608-661-5555 X205
For the complete listing of WHCA/WiCAL Gold Business Partners, click
HERE
!
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