COVID-19 UPDATE #64
August 6, 2020
GOVERNOR TO ADDRESS PUBLIC TODAY REGARDING LONG TERM CARE COVID-19 RESPONSE STRATEGIES
Governor Inslee will address the public today at 2:30 PM to discuss long term care and response to COVID-19. We encourage providers to watch his press conference at 2:30 PM today on TVW or a local news network. 
DEAR ADMINISTRATOR LETTERS FOR SKILLED NURSING PROVIDERS
A Dear Administrator letter dated August 3, 2020, informs skilled nursing providers of the Health and Human Services (HHS) notices regarding the following press releases:
  • On July 14, 2020, a press release announced an initiative to increase testing in nursing homes. Through the initiative, HHS will send rapid point-of-care testing instruments and tests to nursing homes.
  • On July 22, 2020, a press release announced mandatory weekly testing for nursing home residents and staff under certain conditions.

More information regarding the status of these issues can be found in the letter.

A second Dear Administrator letter dated August 3, 2020, is regarding the CMS Update on RUG-IV and PDPM Codes. On May 13, 2020, the Centers for Medicare and Medicaid Services (CMS) released a memo that included vital information about their update to the Minimum Data Set (MDS) 3.0 (a resident assessment) item sets effective October 1, 2020. CMS is allowing states to collect data from Resource Utilization Group-IV (RUG-IV) and the Patient Driven Payment Model (PDPM) codes on the Omnibus Budget Reconciliation Act (OBRA) resident assessments simultaneously. In the memo, CMS requested states notify them by June 30, 2020, if the state wanted to collect codes from PDPM and RUG-IV concurrently. Washington State accepted CMS’s offer of collecting PDPM and RUG-IV codes simultaneously. The letter goes on to state, “Please be sure that your MDS 3.0 software vendor is aware of this choice by Washington State.” For more information, the letter is available here.

A third Dear Administrator letter dated August 3, 2020, is regarding Off-Hour Surveys. Effective June 11, 2020, Engrossed Second Substitute Senate Bill 6515 amended RCW 18.51.230 and changed the state standard for off-hour surveys. The state standard now aligns with the federal off-hour standard. Detailed information regarding the CMS definition of an off-hour standard and CMS guidance can be found in the letter.

A Dear Administrator letter dated August 4, 2020, informs skilled nursing providers of a Pilot Modified Off-Site Case Mix Accuracy Review (CMAR) process the Department will be commencing soon. The pilot is voluntary and outlined in the letter. The pilot project also includes the use of QAN (Quality Assurance Nurse) protocols and is for consultation only. The Department is seeking volunteer facilities to be part of this pilot process. Details regarding this project can be found in the letter. If you are not familiar with the QAN program and the historical use of QAN protocols, please email Elena Madrid with questions.
DEAR ADMINISTRATOR LETTERS ADDRESS ASSISTED LIVING AND SKILLED NURSING PROVIDERS
Two Dear Administrator Letters were released for both assisted living and skilled nursing providers on August 4, 2020. The first letter addresses the issues of N95 Fit Testing and the DSHS Facility Online Survey. The letter reminds facilities to ensure that staff are fit tested for respirator masks (N95) as soon as possible. While the letter gives some “options” to assist with fit testing, WHCA members have found that this is not an easy or as readily available process as some might think. WHCA has compiled a number of resources to assist with fit testing on our COVID-19 resource page. WHCA recently hosted a webinar on fit testing as well. The letter also reminds both assisted living and skilled nursing facility providers to complete the Department’s online COVID-19 Facility Survey twice weekly on Mondays and Thursdays.

The second letter informs long term care settings including assisted living and skilled nursing facilities that the COVID-19 proclamations addressing such issues as healthcare worker licensing, nursing assistant waiver, resident rights, visitation, and fingerprint background checks have been extended to September 1, 2020. Details regarding these proclamations can be found here.
COVID TESTING IN ASSISTED LIVING: DSHS/DOH WEBINAR SCHEDULED
The Department of Social and Health Services (DSHS) is partnering with the Department of Health (DOH) on implementation of point prevalence testing for COVID-19 in assisted living facilities. A webinar hosted by DOH is scheduled on Tuesday, August 11, from 1 – 2:30 PM to review test supply and PPE logistics, testing process, sample collection and shipping. Registration in advance is required; to register, click here.

After you register you will receive a confirmation email from GoToWebinar containing the link to join the webinar. A provider letter to assisted living facilities will be issued soon with additional information regarding this testing. We will keep you apprised as we learn more about the Department’s plan.
CMS REQUIRED TRAINING COMING FOR SKILLED NURSING FACILITIES SEEKING ADDITIONAL PROVIDER RELIEF FUNDS
A White House announcement last week referred to a COVID-19 training that nursing homes must participate in to qualify and receive additional funding from the Provider Relief Fund. In a CMS press release, they shared that, “CMS, in partnership with the CDC, is rolling out an online, self-paced, on-demand Nursing Home COVID-19 Training focused on infection control and best practices. The training being offered has 23 educational modules and a scenario-based learning modules that include materials on cohorting strategies and using telehealth in nursing homes to assist facilities as they continue to work to mitigate the virus spread in their facilities.”

The American Health Care Association has confirmed with CMS that this new training has not yet been launched. CMS has targeted September 2020 for launching the program. We will keep members informed of the program and how to access it as we receive updated information. Read more.
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.