COVID-19 UPDATE #83
September 25, 2020
OCTOBER 2020 NURSING FACILITY MEDICAID RATES
October 2020 rates have been transmitted to the Health Care Authority (HCA) and will be loaded with an effective date of October 1, 2020. The October 1 rate has been calculated using the August 1, 2020, rate, but the COVID-19 add-on will raise to $7.50 from $5.00. The October rates will be emailed to the appropriate parties by September 30, and they are available on the DSHS website here.
CMS VISITATION GUIDANCE FOR SKILLED NURSING - MORE TO COME
Discussions continue with regulatory bodies including DSHS, DOH, and CMS regarding the need for clarification related to CMS’s release of QSO 20-39 and the conflicts with our Safe Start for LTC Plan (nursing homes and facilities for individuals with intellectual disabilities). Most other states have similar conflicts and AHCA continues to address the concerns with CMS on our behalf. As more information becomes available, WHCA will ensure you are made aware.

Visitor Testing
In the guidance, CMS states that at this time visitor testing is NOT required. However, they go on to encourage facilities in medium or high-positivity counties to test visitors, if feasible. If so, facilities should prioritize visitors that visit regularly (e.g., weekly), although any visitor can be tested. Facilities may also encourage visitors to be tested on their own prior to coming to the facility (e.g., within 2–3 days) with proof of negative test results and date of test.

This guidance is limited and poses additional questions regarding the feasibility of testing visitors for COVID. Keep in mind that all tests performed in the facility with point-of-care antigen devices require a MD/practitioner’s order and facility reporting.

Communal Dining and Activities
Another area where there is discrepancy between the CMS guidance and the more stringent WA LTC Reopening plan is communal dining and activities. The CMS guidance states that while adhering to the core principles of COVID-19 infection prevention, communal activities and dining may occur.

Residents may eat in the same room with social distancing (e.g., limited number of people at each table and with at least six feet between each person) and that facilities should consider additional limitations based on status of COVID-19 infections in the facility.

CMS also states that group activities may be facilitated (for residents who have fully recovered from COVID-19, and for those not in isolation for observation, or with suspected or confirmed COVID-19 status) with social distancing among residents, appropriate hand hygiene, and use of a face covering. Facilities may be able to offer a variety of activities while also taking necessary precautions with alterations to adhere to the guidelines for preventing transmission.

Please keep in mind, RCS and CMS Seattle have agreed that providers and regulators need additional time to digest the implications of CMS’s revision. Accordingly, because portions of Washington’s phased reopening/visitation plan are more stringent than CMS’s revisions, Washington SNF providers will continue to follow Washington’s phased reopening/visitation plan until RCS is able to provide further guidance.

We encourage all impacted providers to carefully review the CMS-issued revised guidance. As additional information is made available, we will continue to keep you informed. If you have questions, please email Robin Dale or Elena Madrid.
VISITATION SUPPORT GRANT REQUESTS FOR SKILLED NURSING
In a Dear Administrator letter dated September 23, 2020, the Department of Social and Health Services (DSHS) provides information on grant requests for communicative technology to assist residents in communicating with their families during this challenging time of COVID-19. To date, approximately 150 skilled nursing centers have been approved; more than $400,000 has been disbursed. If a skilled nursing center has not yet applied, there is still time to do so. If you have questions about these grants or how to apply, please email Melissa Lawton, CMP Grant Program Specialist for DSHS.
WHCA UPDATES ASSISTED LIVING FAQ DOCUMENT
The Assisted Living Frequently Asked Questions (FAQ) document has been updated by WHCA staff to reflect questions and new information available as we continue to move forward in our response to the COVID-19 pandemic. With new information on testing, visitation, and the Safe Start Plan for LTC, we have added additional questions and provided feedback and resources to help providers navigate the changes. Click here to review the document.
RENEW YOUR CREDENTIAL BY SEPTEMBER 30 IF YOU DELAYED PAYMENT
Time is growing short for Washington health care professionals who took advantage of this year’s license expiration extension. With providers focusing on patient care during the COVID-19 pandemic, the secretary of health extended expiration dates for licenses due for renewal between April 1 and September 30, 2020. The extension included a waiver of late fees.

As the end of September rapidly approaches, the extension is about to expire. That means providers who took advantage of the extension must renew their licenses no later than September 30 for their licenses to remain active and to keep from having to pay late fees.

Providers who delayed renewal, and whose normal expiration date has passed, may:
  • Renew through the online licensing system, if their profession is able to (credit card, debit card or E-check accepted), or
  • Return the renewal notice with payment by mail (check or money order accepted.)
 
Providers in some professions cannot renew late online. A list of professions able to renew online after their normal expiration date is on our License Expiration Extension Frequently Asked Questions page. No late fees will be due, as long as the payment is received online before 11:59 PM on September 30 or if it is postmarked no later than September 30. The Department of Health will need three to five business days to update license status after they receive mailed-in payments. If you have questions, please contact the call center at (360) 236-4700.
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.