COVID-19 UPDATE #104
November 20, 2020
DOH AND RCS TO HOST WEBINAR ON UPDATES TO LTC SAFE START AND VISITATION ON NOVEMBER 24
REGISTER TODAY
The Department of Health (DOH) and the Aging and Long Term Support Administration Residential Care Services (RCS) will be hosting a webinar on November 24, 2020, at 8 AM. The subject of this webinar is the LTC Safe Start documents, updated guidance, and visitation changes to LTC facilities. Please register here for the Safe Start and Visitation Update on November 24, 2020, at 8:00 AM.
DEAR ADMINISTRATOR LETTER REMINDS PROVIDERS TO ALLOW HEALTH CARE VISITS
In a Dear Administrator letter dated November 18, 2020, all providers are reminded to allow health care provider visits. The letter indicates that under the Governor’s proclamations, including proclamation 20- 25.8, visits from health care providers are not restricted. Facilities and homes must allow visits from health care providers, including, but not limited to the following health care services:
  • Home health
  • Hospice
  • Mental health
  • Behavioral health services
  • DME
  • Oxygen vendors
  • Emergency responders

All health care providers must pass a health screening and wear a mask and all other appropriate PPE to enter a facility or home.
NEW INCENTIVE PROGRAM TARGETING DUAL ELIGIBLES DISCHARGING FROM HOSPITALS TO SNFs
On November 13, 2020, the state of Washington, Department of Social and Health Services (DSHS) released a notice that nursing facilities would be eligible for a $6,000 incentive payment for certain admissions. The program was set up to move patients out of the acute care setting to make room for individuals that need inpatient services for COVID-19.

Consolidated Billing Services Inc. (CBSI) has taken the time to review the notice and followed up with the Department on some technical questions on program requirements. We want to thank CBSI and Bill Ulrich for their work. Here is CBSI’s understanding of the program.

Eligible Admissions
  • The incentive is in effect for admissions from an acute care hospital occurring November 13, 2020, through December 31, 2020.
  • Payments will be made for patients with Medicare AND Medicaid eligibility only.
  • Readmissions are not eligible for the incentive. If a patient has been in your SNF and was transferred to the hospital, and then returned from the hospital, that patient would be considered a readmission and not eligible for the admission incentive. Also, if a patient had been in a SNF and was transferred to the hospital, and was then transferred from the hospital to another SNF, that patient would also be considered a readmission and not eligible.
  • The incentive is not based on an expected SNF length of stay.

Documentation
  • A Nursing Facility Notice of Action form must be completed.   An email can be sent to Julie Cope at julie.cope@dshs.wa.gov with the specific client name and ID and she will confirm eligibility and issue an incentive letter. 
  • These requests may occur prior to the admission from the hospital. Generally, the client-specific incentive approval letter will be made the day of request.

Payment
  • The Department will review the Notice of Action form to confirm the admission prior to payment authorization.
  • Payment will be generated through Home and Community Services submitting an A-19 Invoice confirming the eligible admission.
  • Payment will be made to the nursing facility within 30 days of receipt of the Notice of Action. This payment will be processed in the same manner as the COVID testing funding.

If you have any questions regarding this incentive program, please contact: Bill Hartung at bill.hartung@billing-services.com, or (509) 448-2067, extension 210 or Bill Ulrich at bill.ulrich@billing-services.com, or (509) 448-2067, extension 202.
DEAR ADMINISTRATOR LETTER TO SNFs EMPHASIZES CALL TO ACTION TO COMPLETE CMS TRAINING
In a Dear Administrator letter dated November 19, 2020, Residential Care Services (RCS) reminds skilled nursing providers about the CMS Nursing Home COVID-19 training. The letter reviews the modules and provides insight on how many skilled nursing professionals have completed the training across the country. All Washington skilled nursing centers are urged to utilize the training.

If a nursing home’s staff is unsure which training module best meets their needs, CMS is offering an online self-assessment tool here to help them identify their needs and suggest the appropriate training modules that best reflect those needs. A certificate of completion is offered for each completed training course. For anyone interested, the training is free to access on a public CMS website; instructions on how to create an account and take the training are available here. The list of nursing homes at which 50% or more of staff have completed CMS COVID-19 training is here.

If you have questions, please contact Lisa Herke, Nursing Home Program Policy Manager at (509) 209-3088 or lisa.herke@dshs.wa.gov.
SNFs RECEIVE CALLS FROM CMS INQUIRING ABOUT TESTING
We have heard from CMS that, using NHSN data, they have identified SNFs reporting cases of COVID-19, but not reporting any testing results. CMS has also identified facilities in “yellow” or “red” counties that are not reporting testing. Staff from the Office of Program Operations and Local Engagement and QIOs will call facilities to inquire about these discrepancies. CMS has told us these are primarily aimed at understanding and they are not calling from a survey perspective. CMS reports that these calls are intended to be helpful.  
ADDITIONAL RESOURCES
WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.