COVID-19 UPDATE #22
April 17, 2020
EVERY PAYROLL PROTECTION PROGRAM BORROWER SHOULD CARE ABOUT FORGIVENESS
Expansion of the Payroll Protection Program (PPP) loans has emerged as a key form of relief provided by the CARES Act, but amid the euphoria and confusion of rolling out a brand new program in the midst of a crisis, some large questions linger, not the least of which is how the forgiveness will rules apply once you get the funds. As lenders start to disburse funds, and more money may be on the way from Congress, the forgiveness rules are still a work in progress that require careful navigation with only a limited map to help. Read more . Many thanks to Lane Powell for providing this article.
UPDATES TO PROVIDER RELIEF FUND WEBSITE
The federal government has added an attestation portal to the CARES Act Provider Relief Fund website . Providers who have been allocated a payment from the initial $30 billion general distribution must sign an attestation confirming receipt of the funds and agree to the terms and conditions within 30 days of payment.

Additionally, the federal government has clarified that relief funds are available to all providers regardless of whether they have specifically treated COVID-19, noting that the government “broadly views every patient as a possible case of COVID-19.”

AHCA/NCAL has updated its FAQs on the Provider Relief Fund as a result of this new development.
SUSPENSION OF STANDARD SURVEYS CONTINUES
CMS announced on its national call on April 15 that the suspension of standard surveys will continue until further notice. This means CMS guidance released on March 23 has been extended until CMS states otherwise. CMS will continue to conduct surveys for immediate jeopardy situations and additional infection control focused survey using this tool .

Surveyors entering the building should bring their own personal protective equipment (PPE); be sure to screen surveyors as you would any visitor entering the building, which now includes temperature checks. Surveyors should spend as little time onsite as possible for these surveys and are instructed not to investigate routine issues.
RCS ISSUES DEAR ADMINISTRATOR LETTERS FOR ASSISTED LIVING AND SKILLED NURSING FACILITIES
In an April 16, 2020, Dear Administrator letter to skilled nursing providers, the Department of Social and Health Services (DSHS) filed emergency rules (WSR 20-09-074) effective April 13, 2020, related to Preadmission Screening and Resident Review (PASRR), resident assessments, care planning, resident groups, and discharge/transfer rules. The following rules are amended, suspended, or temporarily repealed:
  • Transfer and discharge rules: Amendment of WAC 388-97-0120 suspends the requirement to provide a bed-hold notice to a resident who leaves the facility.
  • Resident assessment: Amendment of WAC 388-97-1000 removes the timeline requirements from the required resident assessment.
  • Care planning: Amendment of WAC 388-97-1020 removes the requirement to develop a care plan within seven days of completion of the resident assessment.
  • PASRR: WACs 388-97-1915 and 388-97-1975 were amended to permit the Level I screening, and if needed, the Level II evaluation to occur up to 30 days after admission.
  • Resident groups: WAC 388-97-0920 ensures residents can participate in resident and family groups. The WAC was temporarily repealed.

A second Dear Administrator letter dated April 16, 2020, to skilled nursing providers addresses a number of issues related to CMS and CDC Guidance, Blanket Waivers, and Transfer/Discharge information.

A third Dear Administrator letter dated April 16, 2020, to both assisted living and skilled nursing providers was released on April 16, 2020, regarding the need to have an emergency plan related to staffing/support if an administrator becomes ill due to COVID-19.
2020 CENSUS OPERATIONAL ADJUSTMENTS DUE TO COVID-19
To protect the health and safety of staff and the public and ensure a complete and accurate count of all communities, the Census Bureau is adapting or delaying some of their operations. Residential Care Services (RCS) has issued a Dear Administrator letter regarding skilled nursing facility Census 2020 and how COVID-19 affects response deadlines.
 
Click here for additional information and most current schedules including, but not limited to, extending the group quarters (including nursing homes) response deadline to June 19 and extending the online and the self-response deadline to August 14.
SEATTLE-KING COUNTY PUBLIC HEALTH LTC RESPONSE UPDATES
The Seattle-King County Public Health Department is providing updated information for facilities in their region. Please note the following for Seattle-King County facilities and individuals.
 
Facilities in King County can request an infection control assessment. So far this week, Public Health has completed infection control visits to skilled and assisted living facilities in King County. To request an infection control assessment, facilities can call the Public Health Call Center at (206) 477-3977. They will receive a call back from a disease investigator, typically within 24 hours.
 
Drive-by testing for symptomatic health care workers available now. Health care workers who are currently experiencing symptoms of COVID-19 and who cannot access testing through their health care provider can now access a new resource to sign up for drive-by testing . Nursing home workers, workers in assisted living and adult family homes, and home care workers who cannot otherwise access testing are encouraged to use this resource.
 
There is support for families who choose to bring loved ones home. In response to COVID-19 outbreaks, some families are choosing to bring their loved ones home from facilities where they currently receive care. Aging and Disability Services, the Area agency on Aging for Seattle and King County provides support and information for family caregivers .  
 
Testing Partners take LTC facility assignments. Health system partners and Seattle Fire Department took on more assignments this week to test residents and staff of skilled nursing facilities in their networks/jurisdictions. Public health is contacting these facilities, confirming that standing orders are in place, and coordinating to determine which labs the tests will be sent to. As much as possible, these tests will include all residents and all workers.
NEXTSTEP EXTENDS TRAINING OPPORTUNITY FOR JUST $5 PER PERSON
In response to the immediate need to provide information regarding COVID-19 to caregivers, NextStep will offer a discount for the COVID-Ready CE for another week. While it will no longer be free, the cost is only $5 per person (rather than $39). Use promo code WACOVIDCERT to receive the discount.

You do not need to apply to use it nor have an approval letter for this program. Please email David Chappell with any questions regarding certificates. Click here to enroll. If you have difficulty accessing or navigating the course, please contact NextStep directly at covidsupport@nextstep.careers .
WHCA UPDATES COVID-19 FAQ DOCUMENTS FOR ASSISTED LIVING AND SKILLED NURSING
Since providers began responding to the public health emergency that is COVID-19, WHCA staff has been working to provide information, answers, and resources to assist. We have compiled a list of Frequently Asked Questions (FAQs) for assisted living and for skilled nursing providers. If you and your team are looking for answers to questions you have, you may find information to help in these documents. We continue to update them as we continue to answer questions for our members.
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.