COVID-19 UPDATE #49
June 29, 2020
DEAR ADMINISTRATOR LETTER ADDRESSES FIRE DRILLS AND TRAINING IN SKILLED NURSING CENTERS
In Dear Administrator letter NH 2020-042 , providers are notified that the Department of Social and Health Services (DSHS) filed an emergency rule ( WSR 20-14-026 ) effective June 23, 2020, related to fire drills, windows in resident rooms, and quality assurance requirements. This rule making is necessary to respond to the significant threat of COVID-19 to our most vulnerable populations, especially for those receiving care in nursing homes.

Some of the highlights of the letter include:
  • Current nursing home rules require periodic fire drills, as well as staff training about how to respond to a fire. WAC 388-97-1740 was amended to remove the requirement for periodic fire drills. Training on responding to a fire is still required.
  • Amendment of WAC 388-97-1760 reduced the scope of quality assurance activities. Facilities must continue to review adverse events and infection control.
  • Current nursing home rules require a transparent glass window in each resident room. Amendment of WAC 388-97-2400 waives the requirement for a transparent glass window. This will increase the ability for facilities to increase capacity temporarily by utilizing windowless space for resident rooms.
CLAIMS PROCESSING GUIDANCE FOR 3-DAY STAY AND SPELL-OF-ILLNESS WAIVERS
On June 26, the Centers for Medicare and Medicaid Services (CMS) updated SNF billing guidance related to Medicare beneficiaries receiving care when a SNF utilizes the COVID-19 public health emergency (PHE) 3-day stay and spell-of-illness waivers. The new guidance was posted in a revised MLN Matters article SE20011  under the heading “Skilled Nursing Facility (SNF) Benefit Period Waiver - Provider Information” (pages 9-13).
This section includes a summary of the waivers, examples of how beneficiaries could qualify for the qualifying hospital stay (QHS) 3-day stay waiver as well as the spell-of-illness benefit period waiver. Most importantly, CMS included detailed guidance for documentation, completing MDS assessments, and entering claims data needed in order to permit processing of claims using the waivers. CMS notes that the MACs will be required to manually process waiver claims but must “make every effort to ensure timely payment” within the 14-day payment floor. Finally, CMS provided guidance related to handling claims previously submitted that need to be addressed to bypass existing edits.
AHCA/NCAL highly recommends that providers review the guidance and share with clinical and billing staff. CMS is expected to post frequently asked questions (FAQs) soon associated with this updated billing guidance. AHCA/NCAL will notify members when the FAQs are posted.
CMS ANNOUNCES PLANS TO END THE BLANKET WAIVER REQUIRING NURSING HOMES TO SUBMIT STAFFING DATA
On June 25, the Centers for Medicare and Medicaid Services (CMS) announced plans to end the emergency blanket waiver requiring all nursing homes to resume submitting staffing data through the Payroll-Based Journal (PBJ) system by August 14, 2020. The PBJ system allows CMS to collect nursing home staffing information that impacts the quality of care residents receive. The blanket waiver was intended to temporarily allow the agency to concentrate efforts on combating COVID-19 and reduce administrative burden on nursing homes so they could focus on patient health and safety during this public health emergency.

The memorandum released also provides updates related to staffing and quality measures used on the Nursing Home Compare website and the Five Star Rating System.
PHASED REOPENING OF LICENSED AND CERTIFIED LTC FACILITIES AND AGENCIES WEBINARS OFFERED FOR AL AND SNF
Residential Care Services (RCS), in coordination with Department of Health (DOH) and stakeholders, has prepared plans for a phased reopening of long term care facilities in Washington State. These plans are currently being reviewed by the Governor’s office and are anticipated for release in the near future. In preparation for this release, RCS has prepared a presentation for assisted living and a presentation for skilled nursing providers regarding the plan for each setting. These presentations will include a Q&A session. If you are interested in learning more about the phased reopening, please register for the presentation appropriate for your facility below. If you subscribe to GovDelivery for more than one provider type, please keep in mind there are different presentations based on different programs. Be sure you are signing up for the presentation with your program type in the title. Registration is required and once you register, you will receive a confirmation email with instructions to join the webinar.

July 1, 2020 | 1:00 PM PST

July 2, 2020 | 1:00 PM PST
DOH WEEKLY WEBINAR TO ADDRESS SKILLED NURSING ISSUES
The Department of Health (DOH) has been hosting weekly webinars for long term care providers to answer questions and provide information specific to long term care. On Thursday, July 2, the DOH call will address issues surrounding the NHSN upload process, DSHS survey, and aggregate nursing home data from NHSN.

Please register for DSHS Survey and DOH NHSN Upload for Nursing Homes webinar to be held on July 2, 2020, at 11 AM PST. After registering, you will receive a confirmation email containing information about joining the webinar.
RURAL SOCIAL ISOLATION AND LONELINESS WEBINAR SERIES IS OFFERED FREE OF CHARGE
In this series, participants will learn about loneliness and social isolation among older adults in rural and urban areas. Trainers will discuss what has changed as a result of the current health pandemic, how we can prepare rural providers to ask questions to determine isolation/loneliness, and what we can do for rural people who are experiencing isolation/loneliness. Session two will provide examples of programs that have been addressing rural isolation among older adults, and how they have adapted during the health pandemic. Finally, the third session will focus on grief and loss, as well as supports available in rural areas. Click on the title links below for additional information and registration.
 
Date: July 14, 2020
Time: 11:00 - 12:00 PST
 
Date: July 22, 2020
Time: 7:00 - 8:30 a.m. PST
 
Date: July 28, 2020
Time: 10:00 - 11:00 a.m. PST
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.