HFAM Update: Sine Die
Plus Important Updates from CMS, AHCA
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Friends:
As you know, midnight last night was Sine Die of the 2022 Maryland General Assembly Legislative Session. Together, we accomplished much to protect quality care for Marylanders in need, support our care workforce, and improve our sector’s financial stability. The extended HFAM team reviewed hundreds of pieces of legislation spanning multiple issues.
Let me just say at the onset that you get these updates from me and I am often testifying, lobbying, or speaking with media and influencers on the key issues of our sector. That said, our success in terms of public affairs and government relations would not be possible without the extended HFAM team: Hope Morris, Jane Neumaier, Patty DeGrasse, Ashlie Bagwell, Howard Sollins, Brian Klausmeyer, Paul Tiburzi, and Carville Collins. This year I want to especially thank Ashlie Bagwell. Our success would simply NOT have been possible without her hard and diligent work, right down to the wire. Thank you, Ashlie.
In total, 66 pieces of legislation were actively tracked after initial review. Of those bills, 40 were priorities that HFAM took a position on and 26 bills were monitored. In total, HFAM submitted 40 pieces of testimony.
One of the biggest accomplishments this session was regarding the Medicaid budget. The FY23 budget includes the 4% Medicaid rate increase that was previously enacted as part of the minimum wage legislation. In addition, our legislative efforts resulted in securing an additional 4% Medicaid rate increase, as well as a one-time several million-dollar bonus payment for nursing homes (and other Medicaid providers).
NOTE: Please stay tuned for a more detailed recap of passed legislation that that impacts the long-term care sector, our members, employees, as well as residents, patients, and their families.
In terms of COVID, we do expect a coming spike. Now is a time to take a breath and to redouble our diligence.
As Always:
- Focus on what is in your control and not what is out of your control.
- Let’s get those boosters and the flu vaccine in the arms of people.
- Overcommunicate – with residents, patients, families, staff, and government partners.
- Adapt and innovate.
- Rely on your partnerships.
- Speak up when you need help.
- Double efforts on infectious disease protocols, training, and operations.
- Take and document your action; keep a timeline.
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Joe DeMattos
President and CEO
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CMS Issues FY 2023 SNF Proposed Payment Rule
The Centers for Medicare & Medicaid Services (CMS) recently issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2023 update. Highlights include:
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The proposed rule provides for a net market basket increase for SNFs of 3.9 percent beginning October 1, 2022, but for a proposed parity adjustment of 4.6 percent.
- The 3.9 percent market basket update reflects an unadjusted market basket increase of 2.8 percent increased by 1.5 percent forecast error adjustment, as well as a reduction of 0.4 percentage points, in accordance with the multifactor productivity adjustment required by Section 3401(b) of the Affordable Care Act.
- However, due to the proposed parity adjustment, CMS estimates that the net market basket update would decrease Medicare SNF payments by approximately $320 million in FY 2023.
- While CMS questions the need for a second delay, it solicits comments on a possible delay or phase of the proposed parity adjustment.
AHCA/NCAL has developed a summary of the payment rule and the greatest impacts on members.
Additionally, the Association will host a member-only webinar on Thursday, April 14 at 4 PM Eastern. AHCA/NCAL President and CEO Mark Parkinson will provide an overview of the proposed rule and brief the membership on submitting comments to CMS. The webinar will be recorded, and all registrants will receive an email when the recording is ready. If you have questions or need assistance registering, please email educate@ahca.org.
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Next Steps for Facilities Using 1135 Waiver for Nurse Aid Training and Certification
The release of CMS QSO-22-15-NH & NLTC & LSC (see below section in this update) has caused concern and confusion as to what it means for the ability of nursing homes to employ Temporary Nurse Aides (TNAs). AHCA understands members concerns and challenges, as the TNA role has been invaluable to the care of residents throughout the pandemic and TNAs serve as key support to the other staff in nursing homes.
AHCA is seeking some clarifications from CMS, and in the meantime, has outlined key takeaways and next steps facilities can take to prepare for the upcoming end of the 1135 waiver.
Please note: The previous announcement about waiver end dates does not impact the 3-Day Stay or the Spell of Illness waivers. Those waivers remain in force nationwide for all hospitals, communities, and SNFs.
We will continue to advocate for innovative approaches to resident care and services and seek new ways for enhancing the workforce to support members in providing quality care to residents. Please email COVID19@ahca.org with any questions.
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REMINDER: Update to COVID-19 Emergency Declaration Blanket Waivers for Specific Providers
CMS has issued QSO-22-15-NH & NLTC & LSC, which provides an update to COVID-19 emergency declaration blanket waivers for specific providers.
CMS will end specified waivers in two groups:
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60 days from issuance of this memorandum - Monday, June 6, 2022
- Physical Environment
- Life Safety Code (LSC) and Health Care Facilities Code (HCFC) ITM
- Outside Windows and Doors
- Life Safety Code-Fire Drills & Temporary Construction
- Paid Feeding Assistants for LTC facilities
- In-Service Training for LTC facilities
- Training and Certification of Nurse Aides for SNF/NFs
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30 days from issuance of this memorandum - Saturday, May 7, 2022
- Resident Groups
- Physician Delegation of Tasks in SNFs
- Physician Visits
- Physician Visits in Skilled Nursing Facilities/Nursing Facilities
- Quality Assurance and Performance Improvement (QAPI)
- Detailed Information Sharing for Discharge Planning for Long-Term Care (LTC) Facilities
- Clinical Records
Please refer to the memo for specific details around each of the waiver categories. And, click here for the CMS press release.
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HRSA Offers New PRF Reporting Flexibilities
HRSA has announced information on the opportunity to request the submission of a late Provider Relief Fund (PRF) report based on extenuating circumstances for payments received between April 10 to June 30, 2020. Detailed information is available on the HRSA PRF website.
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REMINDER: CMS Releases Revised Guidance on Vaccine Mandate IFR
The revisions were made to clarify the expectations for assessing compliance with the requirement to ensure all staff are vaccinated. AHCA/NCAL has highlighted key revisions, but providers are encouraged to review the Long-Term Care and Skilled Nursing Facility Attachment A-Revised, as well as the applicable memo listed above, for detailed changes.
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Want to see previous HFAM updates?
Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
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