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*Updates are listed by date with the most recent listed first.

10/28/20: Provider Relief Incentive Payments for September: Today HHS announced today that the first monthly Nursing Home Infection Control Incentive Payment will be sending out $333M to 10,501 nursing homes (76% of eligible nursing homes) who qualified for the incentive payment. These payments should arrive on Monday, Nov. 2.  To be eligible for an Infection Control Incentive Payment, providers must first meet two "gateway" criteria: 1) the nursing home's infection rate must be lower than that of the infection rate in their county; AND 2) the nursing home's mortality rate must be less than 10% for all residents in their facility that contracted COVID-19 (includes both in-facility acquired infections as well as COVID admissions). The incentive payments are based off performance for August 31 - September 27.  There will be a range of payments. HHS also shared how many facilities in each state received payments and the aggregate amount of those payments by state. LeadingAge national will be providing an article on this in the next few days. 

10/28/20: Requirements for Swabbing and Self-Swabbing for POC and BinaxNow Tests: During last week's member call with Nebraska DHHS it was indicated by representatives from Nebraska DHHS that a licensed healthcare provider must do the swabbing for POC and BinaxNow tests and that self-swabbing was not allowed. This was a significant concern for LTC providers based on the workforce shortage and the many additional staff requirements related to COVID-19. On the call with DHHS today, after much conversation, it was agreed that swabbing for these tests (nasal swabbing) can be completed by a trained, but unlicensed, health care provider. This means that a CNA or Med Aide or another team member who can demonstrate competency by completing necessary training modules and demonstrating competency CAN do the swabbing. Self-swabbing is also allowed if observed by someone who is trained to do the swabbing. It is strongly recommended that documentation of training are maintained for team members doing this work.

10/28/20: Phase 2 AL Provider Relief Funds: Assisted Living's that applied under Phase 2 by last Tuesday will receive a payment this Friday. LeadingAge would like to hear if we have AL members who do NOT receive payments or who are still waiting for their TINs to be validated. Please contact your state association representative (Jenifer at jenifer.acierno@leadingagene.org) if you applied but do not receive a payment or are awaiting TIN validation.

10/28/20: Phase 3 Applications Are Low: HHS shared with LeadingAge national today that only 35,000 of a potential 1 million providers have applied for Phase 3 funding. This round of funding is opened up to any provider of health care services, and supports, including Medicare, Medicaid and private pay. The payments first ensure that providers get their 2% and then any remaining funds will be distributed as add-on payments (over and above the 2%) to providers who demonstrate more need for funds to cover coronavirus expenses and lost revenues. If fewer providers apply, the pot of funds for add-on could be a significant portion of the $20B set aside for this Phase.

10/28/20: Affordable Housing and Pharmacy Partnership: Here is a Q and A for affordable senior housing providers on the pharmacy partnership program, why affordable housing providers should fill out the REDCap form, and what this partnership might, and might not, mean for them.

10/28/20: CDC NHSN POC Test Reporting Tool Training Rescheduled: CDC has rescheduled training on the new NHSN Point of Care Test Reporting Tool. These trainings will now be held this Friday, October 30 at 1pm CT and Monday, November 2 at 11:30pm CT. The NHSN website has not been updated yet with these new dates, but once updated you will access the registration for these webinars here under "Training". 

While enforcement discretion will be exercised until November 20 on this reporting requirement, it appears that discretion will only apply to those who have been unable to report through NHSN due to a lack of Level 3 access and who have initiated the process to upgrade. Reporting does not stop during the upgrade process. Providers must continue reporting to the state/local health department as previously required until they are able to report through NHSN.

10/28/20: CDC Pharmacy Partnership Program for LTC: The deadline to opt in to the Pharmacy Partnership Program for LTC has been extended to November 6. Nursing homes (including those who are part of a Life Plan Community) register through NHSN. Other providers (including the other sections of a Life Plan Community) register through the REDCap form. You received a direct email today from LeadingAge Nebraska if you were not on the list of registered facilities.

Here are some Q&As that might assist you as you determine your next steps.  LeadingAge national is recommending that all providers register.

  • Q: Are ICF/IDD residents going to be immunized under CVS/Walgreens partnership?
  • A: No. The first phase includes people in nursing homes/AL/CCRCs over age 65.
  • Q: If a nursing home plans to work with its local or LTC pharmacy, does it do any harm for them to fill out the CVS/Walgreens application before 11/6?
  • A: We recommend that they fill our the form, indicate their LTC pharmacy, and then indicate CVS/Walgreens as a back-up (a back-up is required to complete the form. This way they can be linked to their LTC pharmacy, BUT if their LTC Pharmacy is not able to support them, they will still be able to be linked to vaccine.
  • Q: Is there any guarantee that the state will allow local/LTC pharmacies to administer the vaccine? Specifically the question from members has been that they want to use their LTC pharmacy or local pharmacy. Is there a guarantee that the residents will have the same access to vaccines as if they had used the CVS/Walgreens partnership?
  • A: It will vary state-to-state. Some states are backed up on-boarding providers and are prioritizing larger hospital systems. Indicate a preferred option and back-up on your form. If your LTC pharmacy is able to get vaccine through the state, then you can go that route, but many smaller LTC pharmacies have indicated that the -80 storage with a minimum order of 1000 doses may be difficult to handle and distribute.
  • Q: There is no CVS or Walgreens within 75 miles of my nursing home.  Should I fill out the NHSN form?
  • A: Yes. Mapping and work is being done with a couple of smaller regional chains and state health departments to ensure coverage.  Just pick whichever location is closer. You can indicate this as your back-up plan.

10/28/20: Distribution Update on HHS BinaxNOW Test Cards AND POC Testing Equipment: Abbott BinaxNOW test cards are being distributed from federal HHS to nursing homes in red and yellow positivity counties in quantities meant to enable them to complete routine testing of all staff (twice per week, once per week). Positivity rates are re-evaluated bi-weekly.  Based on our Nebraska member call with DHHS today, the state distribution is focused on Nursing Facilities first and then Assisted Livings with outbreaks. Angela Ling with DHHS indicated that she is receiving outbreak information from the ICAP team.  She also indicated that if an AL is in need of tests (for instance in a red county for positivity and without testing supplies) that you can reach out to her directly at angela.ling@nebraska.gov so that she can consider distribution.  When you email her please include your CLIA # and the number of staff and residents at your location. She also indicated that if you do not hear back from her after 24 hours to please follow up with her. 

The distribution of the Quidel and BD point-of-care testing devices is nearly complete (one more week). Questions have been received about eligibility of providers who did not have CLIA waivers when this initiative began but have since applied. HHS indicated on their call today that providers who were unable to obtain a CLIA certificate/waiver prior to September 30 "are welcome to purchase these devices from the manufacturer." So unfortunately, if a provider was not able to secure a waiver prior to September 30, they are not included in these allocations.

10/28/20: The State of Nebraska and the Department of Health & Human Services has Announced Round 2 of Community CARES Grants: Round 2 of Community CARES Grants opened last week. Organizations that received a Stabilization Grant in Round 1 (awarded in July 2020) are not eligible for Round 2 funding. The only exception to this rule is Assisted Living Facilities and Long-Term Care Facilities. These two types of facilities are eligible to apply for Stabilization Round 2 funding, regardless of whether they applied for Round 1 funding. If you are a provider of long-term care services and received assistance under Round 1 of these DHHS grants, you ARE eligible to apply again under Round 2.

Starting October 21, charities -including non-profit 501(c)(3),  providers and centers of worship may apply by visiting the Coronavirus Relief Fund website. Please see tabs for each grant for eligibility, use of funds. For more information about the Coronavirus Relief Fund program visit:

https://home.treasury.gov/system/files/136/Coronavirus-Relief-Fund-Frequently-Asked-Questions.pdf.

On the state website, you can learn to apply for two grants overseen by DHHS - 1) the Stabilization Grant for Charitable Organizations & Licensed Providers and 2) the Healthy Places Grant for Centers of worship - and seven administered by the Department of Economic Development, which focus on assistance for businesses.

Link directly to the application portal: https://mcrcares.servicenowservices.com/nebraska.

Application deadline is November 13.

10/26/20: Visitation Guidance from the State Fire Marshal: With the weather becoming colder and the positivity rate in many Nebraska counties being on the increase, please see the information provided by Doug Hohbein of the State Fire Marshal's office regarding options to help facilitate visitation.  The documents reference the CMP Funding that was to be made available for this purpose. As an update, we are still waiting to hear from Medicaid regarding the availability of that funding yet this week.

Visitation Tent Requirement | Outdoor Visitation Requirement

10/26/20: Nebraska State Vaccination Plan: DHHS announced the Nebraska COVID-19 Vaccination Plan this morning.  Health care workers and long-term care residents are prioritized as a part of this plan.  

As was shared last week, NF and AL providers (and others that share the same location, such as IL) are eligible to sign up for the Pharmacy Partnership for Long Term Care program.  If you are located within 75 miles of a CVS or Walgreens For assisted living and other providers who do not have access to NHSN, you may opt in to the Pharmacy Partnership for LTC Program by completing the RedCap form here: https://airc.cdc.gov/surveys/?s=R3TYTJDAW4.  LeadingAge has also provided an article about the HHS & CDC Pharmacy Partnership Program and FAQ. Responses are being requested by 11:59pm EDT on October 29, 2020.  

10/26/20: LeadingAge National Coronavirus on Wednesday Features Our Very Own Member, Jerry Nevins, of Rose Blumkin Jewish Home: Wednesday's call will feature insights from a former surveyor-turned-provider. Working with Long Term Care state surveyors can be challenging in normal times and when you add a pandemic it can be even more vexing to providers. What if you could hear from a former state surveyor and hear his thoughts on how his community is handling the challenges of COVID-19 and how to work with your surveyors during this chaotic time? Jerry Nevins from Rose Blumkin Jewish Home in Omaha will give you his ideas for what surveyors might be looking for and how you can work as a team. He will also provide ideas for how you can work with local coalitions to find needed supplies and resources like PPE. If you haven't joined us for our Coronavirus update calls, you can register here.

10/26/20: Provider Relief Updates: HHS Eliminates Prior Limits on Lost Revenues Established in Sept. Reporting Requirements: The long anticipated and hoped for revisions to the September 19 PRF Reporting Requirements arrived today and came with an explanation that the revisions were a direct result of pressure from stakeholders and Congress with the conclusion, "There is consensus among stakeholders and Members of Congress who have reached out to HHS that the PRF should allow a provider to apply PRF payments against all lost revenues without limitation." The result is that providers will no longer report on operating income changes year over year but actual change in patient care revenues from 2019 to 2020. In addition, the revised document eliminates the prior limits on the use of PRF dollars to cover lost revenues. This is an advocacy victory as we raised concerns about these provisions with HHS on numerous occasions. LeadingAge anticipates an update to the HHS FAQs in the next couple of days to reflect these changes. LeadingAge national has provided an article with a few more details.

  • Eligible Providers for Phase 3 Application Expanded: HHS also announced that the Phase 3 application is now open to residential treatment centers, chiropractors and eye/vision providers. They also confirmed the following providers are eligible even if private pay:  nursing service and related providers, hospice providers, respiratory, developmental, rehabilitative and restorative service providers, nursing and custodial care facilities, among other providers. The website and FAQs have not been fully updated to reflect these changes yet.
  • Phase 2 Funds continue to go out: $90 million in PRF funds went out to 661 AL providers on Monday. This was the third wave of disbursements from the Phase 2 General Distribution process.
  • Bankruptcies may disqualify nursing homes from Infection Control Payments: LeadingAge has heard from some nursing home members who did not receive Infection Control Distribution dollars in late August. Upon inquiry to HHS, they were informed that providers were denied as they were on the CMS bankruptcy exclusion list.  LeadingAge is continuing to advocate for these organizations to get dedicated Infection Control funds. This is one of the criteria that HHS/CMS is using to determine which providers receive funds.

10/26/20: NHSN Reporting of POC Testing: Nursing homes are now required to report point-of-care testing through NHSN, which requires SAMS level 3 access. If you are a LeadingAge Nebraska member that needs to upgrade to Level 3, you will be receiving a separate email tomorrow.  CDC/NHSN have been reaching out to providers via email over the past several weeks to initiate the upgrade process. If you are not currently in the process of upgrading to Level 3, you should reach out to NHSN immediately by emailing nhsn@cdc.gov and include "POC test reporting" in the subject line.

10/26/20: Online Training Available for Community Emergency Preparedness for Older Adults and Disasters: The U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR) are offering a new web-based training that is designed to improve public health and emergency medical responder capability to address the access and functional needs of community-dwelling older adults in disasters. This new training complements ASPR's previously-released Access and Functional Needs (AFN) web-based training defines the concept and requirements for addressing the AFN of at-risk individuals, and provides tools and resources to help you address the AFN of at-risk individuals in your community during disaster preparedness, response, and recovery activities. The trainings are at-your-own-pace and free, although participants will need to create an account in the TRAIN system to access training. Additional information regarding the training is available here.

10/26/20: States Begin Detailing Specific Use of 150 Million BinaxNOW COVID-19 Tests: Four weeks after HHS announced the nation-wide deployment of 150 million state-of-the-art Abbott BinaxNOW rapid point-of-care tests to assist Governors' reopening efforts, states have begun to report where they are distributing these tests. To view the allocation of tests to each state and territories click here.

10/26/20: Considerations for Use of SARS-CoV-2 Antigen Testing in Nursing Homes: This document provides a summary of considerations for use of SARS-CoV-2 (the virus that causes COVID-19) antigen testing in nursing homes and is intended for nursing home providers and state and local public health departments.

10/26/20: Senate Finance Committee Chairs Letter to HHS Regarding Alzheimer's Project Goal for Cure by 2025: The end of last week Senators Toomey (R-PA) and Stabenow (D-MI), Chair and Ranking Member of the Health Subcommittee of the Senate Finance Committee, released a letter to HHS Secretary Azar with recommendations to "promote care coordination for Alzheimer's disease patients enrolled in federal health programs, improve disease detection, enhance the affordability and accessibility of long-term care, strengthen protections for vulnerable individuals, and incentivize the development of cures." These recommendations were based on comments received by over 30 experts and stakeholders, including LeadingAge national.  A number of LeadingAge recommendations were adopted, in whole or in part, including directing CMMI to develop an alternative payment model for managing care for persons with AD/RD, improving and expanding access to the PACE program, encouraging use of the care planning code available for AD/RD. Other recommendations include increasing care coordination, improving access to palliative care, developing quality indicators for dementia care services, increasing availability of telehealth services for dementia care in nursing homes, and a number of recommendations around improving research and innovation in care and services. 

10/26/20: The State of Nebraska and the Department of Health & Human Services has Announced Round 2 of Community CARES Grants: Round 2 of Community CARES Grants opened last week. Organizations that received a Stabilization Grant in Round 1 (awarded in July 2020) are not eligible for Round 2 funding. The only exception to this rule is Assisted Living Facilities and Long-Term Care Facilities. These two types of facilities are eligible to apply for Stabilization Round 2 funding, regardless of whether they applied for Round 1 funding. If you are a provider of long-term care services and received assistance under Round 1 of these DHHS grants, you ARE eligible to apply again under Round 2.

Starting October 21, charities -including non-profit 501(c)(3), providers and centers of worship may apply by visiting the Coronavirus Relief Fund website. Please see tabs for each grant for eligibility, use of funds. For more information about the Coronavirus Relief Fund program visit: https://home.treasury.gov/system/files/136/Coronavirus-Relief-Fund-Frequently-Asked-Questions.pdf.

On the state website, you can learn to apply for two grants overseen by DHHS - 1) the Stabilization Grant for Charitable Organizations & Licensed Providers and 2) the Healthy Places Grant for Centers of worship - and seven administered by the Department of Economic Development, which focus on assistance for businesses.

Link directly to the application portal: https://mcrcares.servicenowservices.com/nebraska.

Application deadline is November 13.

10/21/20: *If you missed today's member call with DHHS, here are a few of the items that were updated. 

  • It was indicated that at this point in time only licensed health care professionals can administer and run the POC testing. More to come with clarification on who this includes.  
  • DHHS does not support the process of self-swabbing for testing but will continue to seek additional information on this.  
  • Surveyor testing plans are still being implemented.
  • There is still NOT an AL Infection Control template approved/ready for distribution.
  • No update on whether NHSN reporting for POC will be sufficient to replace the duplicate state reporting yet.

DHMs for Phase 3.1 Go Into Effect for All Nebraska Counties TODAY: As announced by the Governor last Thursday, all Nebraska counties are in Phase 3.1 through November 30 starting October 21. The move to Phase 3.1 applies to every health department jurisdiction in the state. 

Here is an outline of changes to DHMs effective 10/21/2020-11/30/2020.

10/21/20: Reporting POC Testing Through NHSN: HHS has updated the Lab Data Reporting Requirements document to specify that nursing homes must report point-of-care testing through NHSN. Level 3 access in NHSN is required to report this data. Providers who do not have level 3 access or are not currently in the process of updating to Level 3 should reach out to nhsn@cdc.gov immediately (approximately 9,000 nursing homes have level 3 access currently). This does not prohibit a state from continuing to require this reporting take place through a state-specified platform, though CMS and CDC are hopeful that states will transition to this reporting mechanism to satisfy lab data reporting requirements. Read the updated requirement here (note that the document is updated though the data still reads "June 4"). PLEASE NOTE: The trainings on the NHSN Point of Care Test Reporting Tool scheduled for Thursday October 22nd and Friday October 23rd are cancelled but will be rescheduled.  Information regarding the new dates and times will be communicated as soon as they are identified.  In the meantime, questions related to the NHSN Point of Care Test Reporting Tool for long-term care facilities can be sent to NHSN@cdc.gov with the subject line of "POC test reporting". Providers should be aware of enforcement. It appears that CMS will be enforcing only whether you report positive/negative results, but CLIA will enforce the full 18 required data elements. Remember that tests must be reported within 24 hours.

10/21/20: Updated Guidance Defining Exposure to COVID-19 -  Cumulative Total of 15 Minutes or More: CDC issued updated guidance to clarify the amount of time it would take for someone to be considered a close contact exposed to a person with COVID-19. The updated guidance now defines a close contact as someone who has spent a cumulative total of 15 minutes or more, in a 24-hour period within six feet of an infected person. Previous guidance defined a close contact as someone who spent at least 15 consecutive minutes within 6 feet of a confirmed case.

10/21/20: Overview of Testing for SARS-CoV-2 (COVID-19): CDC updated guidance on the appropriate use of testing for SARS-CoV-2 in light of additional testing capacity throughout the country. CDC updated their COVID-19 testing overview with information on viral and antibody tests.

10/21/20: Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes: Here is the most recent update of the CMS Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes. It includes recent information and guidance on vaccinations to prevent infection with influenza virus, pneumococcus, and SARS-CoV-2, the virus that causes COVID-19.

10/21/20: Pharmacy Partnership for Long-Term Care Program: For assisted living and other providers who do not have access to NHSN, you may opt in to the Pharmacy Partnership for LTC Program by completing the RedCap form here: https://airc.cdc.gov/surveys/?s=R3TYTJDAW4.  LeadingAge has also provided an article about the HHS & CDC Pharmacy Partnership Program. Responses are being requested by 11:59pm EDT on October 29, 2020.

10/21/20: The State of Nebraska and the Department of Health & Human Services has Announced Round 2 of Community CARES Grants: If you read the LeadingAge Nebraska COVID-19 Update on Monday night, you would have seen a reference to the second round of Community CARES Grants through DHHS.  Application for the funding opens today and ends November 13, 2020. 

Organizations that received a Stabilization Grant in Round 1 (awarded in July 2020) are not eligible for Round 2 funding. The only exception to this rule is Assisted Living Facilities and Long-Term Care Facilities. These two types of facilities are eligible to apply for Stabilization Round 2 funding, regardless of whether they applied for Round 1 funding. If you are a provider of long-term care services and received assistance under Round 1 of these DHHS grants, you ARE eligible to apply again under Round 2.

Starting TODAY, October 21, charities -including non-profit 501(c)(3),  providers and centers of worship may apply by visiting the Coronavirus Relief Fund website. Please see tabs for each grant for eligibility, use of funds. For more information about the Coronavirus Relief Fund program visit:

https://home.treasury.gov/system/files/136/Coronavirus-Relief-Fund-Frequently-Asked-Questions.pdf.

On the state website, you can learn to apply for two grants overseen by DHHS - 1) the Stabilization Grant for Charitable Organizations & Licensed Providers and 2) the Healthy Places Grant for Centers of worship - and seven administered by the Department of Economic Development, which focus on assistance for businesses.

Link directly to the application portal: https://mcrcares.servicenowservices.com/nebraska.

Application deadline is November 13.

Program Overview: Charitable organizations and care providers across the state have struggled in the wake of COVID-19. The Community CARES Stabilization Grant offers organizations working capital to help them cover operating expenses such as PPE, rent and utilities. This will enable our charities and licensed/certified providers to continue serving Nebraska's children, families and communities.

Most eligible entities will receive $12,000. Organizations in areas disproportionately impacted by COVID-19 will receive $27,000. Disproportionately impacted areas are determined by DHHS through analysis of COVID-19 cases per capita, per zip code as of June 30, 2020. Grantees will be notified of their award amount at the time of award notification.

Eligible Assisted Living Facilities and Long-Term Care Facilities, licensed by DHHS, will be awarded funds based on their licensed bed capacity. Award amounts will be announced at a later date.

Data Sharing Authorization: By submitting an application, applicants certify and authorize the Nebraska Department of Revenue to release certain tax return information to the Nebraska Department of Health and Human Services. This information may be used to process this application or for audit purposes.

Additional Information: For more information about the Coronavirus Relief Fund program visit https://home.treasury.gov/system/files/136/Coronavirus-Relief-Fund-Frequently-Asked-Questions.pdf.

10/19/20: CDC Partnership Program for Vaccines- CVS and Walgreens: CDC is launching a partnership with CVS and Walgreens to provide vaccine services in nursing homes and assisted living once a COVID-19 vaccine has been approved and authorized. Participation in this program is free of charge. According to CDC, participating in this partnership will provide nursing homes and ALs with end-to-end support in the process of vaccinating residents against COVID-19.

  • Beginning October 19, providers will have the opportunity to choose to partner with either CVS or Walgreens. Nursing homes will indicate pharmacy preference through the NHSN portal. ALs will indicate pharmacy preference through an online REDcap (https://redcap.link/ltcf) sign-up form.
  • Once vaccination of this population launches, pharmacies will provide 3 vaccine clinics on-site at the nursing home/AL over a period of approximately 2 months in order to provide a 2-step vaccine to all residents and any staff who were not previously vaccinated.
  • The pharmacy will take responsibility for acquiring vaccines and associated supplies (including PPE).
  • The pharmacy will manage cold-chain storage for the vaccine.
  • The pharmacy will take responsibility for required vaccine reporting.

Nursing homes and assisted living facilities are not required to participate in this program. They may opt out through the same channels described above for signing up. However, if a nursing home or assisted living opts out of this program, they must have a plan in place to ensure vaccination of their population through alternative channels such as a state vaccine program or local pharmacy. State/local jurisdictions were required to submit vaccine plans by today and CDC will post these plans publicly later this month. Check out the new article by LeadingAge for links to the Program Overview and FAQ provided by CDC for more information on this program.

10/19/20: State Makes Additional CARES Funds Available: PROVIDERS OF Nursing Facility and Assisted Living Services ARE ELIGIBLE: Today Governor Ricketts announced the allocation plan for the remainder of Nebraska's CARE Act funds, which originally totaled $1.084 billion, to address coronavirus response. This round will provide assistance to non-profits, healthcare providers, and Nebraska businesses. 

  • Community CARES Grant Program
    • $48.5 million of additional funds will be awarded to assist non-profits and care providers as they respond to needs arising from the coronavirus pandemic. 
    • According to DHHS, eligible licensed assisted living facilities and long-term care facilities will be awarded funds based on their licensed bed capacity (if they apply). Award amounts will be announced at a later date. 
  • All nursing and assisted living facilities are eligible to apply for Stabilization Round 2 funding, regardless of whether they applied for Round 1 funding. Other organizations that received a Stabilization Grant in Round 1 (awarded July 2020) are not eligible for Round 2 funding.
     
  • Round 2 funding may be used to support expenses necessary to continue business operations and include eligible expenses, not limited to those incurred since March 13, 2020, for normal business operations, such as rent, utilities, and payroll. Round 2 funds also may be used for COVID-19-related expenses, such as PPE and cleaning supplies. 
  • Grant applications open on October 21, 2020 and will close November 13, 2020.  To apply, visit coronavirus.nebraska.gov/Programs&Grants. The grants will be issued by December 30, 2020.  

10/19/20: Nursing Home Testing Rule: Comments are due November 2 on CMS-3401-IFC, the testing rule. LeadingAge will be commenting on the following topics and ask you to please share feedback with Jenifer (jenifer.acierno@leadingagene.org) by Thursday, October 22.

  • Burden of testing requirements: LeadingAge is hearing that the main barriers to testing are the cost of testing, the significant staff time required to complete testing, and access issues including access to rapid turn-around test results. Routine staff testing (based on county positivity rates) seems to be the biggest pain point, with additional concerns around the low threshold for triggering outbreak testing.
  • Lack of surveyor testing: LeadingAge sent a letter to CMS on this topic a few weeks ago and plan to include in our comments. We advocate for testing of surveyors, since surveyors are in nursing homes including resident care areas, have close contact with both residents and staff, are observing COVID-19 testing, and live in communities (just like our staff) that may have high positivity rates.
  • Burden of reporting requirements: Point-of-care testing requires additional reporting according to CLIA requirements. CDC now allows for this reporting to be done through the NHSN platform; however, each state is responsible for adopting their own reporting process and are not required to utilize the NHSN option.
  • Barriers of unnecessary CMPs: LeadingAge has long criticized the use of CMPs. We feel that punishing by taking money away from the provider is detrimental to the quality improvement process.

10/19/20: NHSN Reporting on COVID-19 Testing: As was reported last week, CDC has built capability into NHSN to allow for reporting of point-of-care testing data in a way that would meet HHS Lab Data Reporting requirements. Last week, LeadingAge national confirmed with CMS that a state would have to adopt this method of reporting to meet requirements because no federal requirement existed. CDC announced that reporting through NHSN will become the required method of reporting. This is a step toward that goal of streamlined reporting.

 HOWEVER-

  • States may still require reporting through their own platforms. CDC does not support duplicative reporting.
  • Reporting through NHSN will require that upgrade to the level 3 security access. If a provider has not yet been contacted by NHSN to initiate this process, they can email nhsn@cdc.gov to request to get started. According to CDC, CMS intends to be flexible with those who have made a good faith effort to make their way through this security upgrade.

Check out this article by LeadingAge for more information, including a link to updated guidance from CDC on point-of-care testing. The ability to report through NHSN DOES NOT relieve the provider of requirements to report point-of-care testing according through the process outlined by their state (per CLIA requirements). CDC will host 2 webinars on this change next week (October 22 and October 23). Read the Table of Instructions for data element information and register for the webinars here.

10/19/20: Provider Relief Fund Nursing Home Infection Control Incentive Payments: HHS announced that their calculations for September show that 65-70% of nursing homes will qualify for a Nursing Home Infection control Incentive Payment to be issued by the end of October. It originally appeared that HHS would set aside 20% of the $400 million monthly to provide incentive payments based upon nursing homes' performance on a mortality measure. The disadvantage of this approach is providers with no infections and therefore no deaths from infection (a good thing) would not have been eligible for these funds. HHS explained late last week that instead of setting aside those payments, it will first determine which nursing homes meet the gateway criteria on infection rate and mortality. Then it will calculate a total infection control score which will be made up of the infection rate measure performance score modified based upon mortality performance, as applicable. The adjustment to the overall score will be no more/less than 20% for mortality. 

HHS noted that nursing homes have already shown a 5% improvement on infection control between August and September. Only 127 homes did not pass the mortality gateway, while 122 others who had deaths in their facilities will still qualify for an incentive payment once they complete their outreach to determine which COVID deaths were from infections obtained from within the nursing home versus those who were admitted with COVID. 

HHS did not yet provide the range of incentive payments but anticipates that payments may begin the week of October 27.  We are hoping that more information will be made available so members can calculate or at least better understand what data is being used to calculate these incentive payments. More to follow as it becomes available. 

10/19/20: Telehealth: On October 14, CMS expanded the list of telehealth services that Medicare Fee-for-Service will pay for during the COVID-19 Public Health Emergency (PHE).  These new telehealth services include certain neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services. The list of these newly added services is available on the List of Telehealth Services webpage.

CMS also released a new supplement to its State Medicaid & CHIP Telehealth Toolkit, Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version that provides numerous new examples and insights into lessons learned from states that implemented telehealth changes. The updated supplemental information is intended to help states strategically think through how they explain and clarify to providers and other stakeholders which policies are temporary or permanent. It also helps states identify services that can be accessed through telehealth, which providers may deliver those services, the ways providers may use in order to deliver services through telehealth, as well as the circumstances under which telehealth can be reimbursed once the PHE expires. They also released a preliminary data snapshot on Medicaid and CHIP telehealth utilization during the pandemic.

10/19/20: Hospice Guidance on Contracting for Core Services: On October 5, the Centers for Medicare & Medicaid Services (CMS) issued memorandum QSO-21-01 Hospice-"Nursing Shortage as an 'Extraordinary Circumstance' per 42 CFR 418.64 CORE SERVICES" to State Survey Agency Directors. CMS has issued memoranda authorizing use of contracted staff under extraordinary or other non-routine circumstances as authorized under the "extraordinary circumstances" core services provisions at 42 CFR 418.64 on a regular basis over recent years based on the ongoing nursing shortage. The most recent memo, issued in 2018, was applicable through September 30, 2020. The October 5th memo does not have an expiration date for the authority and does not explicitly limit the use of contract staff to nursing so could be used, when applicable, for counseling and social work staff as well as long as the other requirements of the guidance are met.

10/19/20: CMS Ties Lab Payment for PCR Tests to Turnaround Time: CMS announced this evening that starting January 1, 2021, Medicare will pay laboratories the current $100 for COVID-19 PCR tests only if labs turn them around within 48 hours. Labs will receive $75 to conduct each test.  Those that meet the two day requirement will receive an additional $25.  Labs that take longer than two days will only receive $75 per test.

10/19/20: BD Resources for Reporting and Batch Testing: BD shared with LeadingAge some new resources last week on the BD website for reporting and batch testing. The reporting updates cover the different options for connectivity on Veritor: https://www.bdveritor.com/long-term-care-facilities/reporting-long-term-care-facilities/

For batch testing, there is a video tutorial of the process on this training page: https://www.bdveritor.com/long-term-care-facilities/training/

10/19/20: Update on USPS/ Postal Carrier Screening: Questions have come up in some of our weekly member calls regarding the status of mail delivery and postal carrier screening. Early on, LeadingAge had sent on a note to the Post Master inquiring about this. HERE is the response letter from the Post Master. Options related to mail delivery are included and have not changed.

10/19/20: HUD Service Coordinator Reporting Deadline Extended: HUD has announced a one-month extension of the Standards for Success reporting requirements for 2020. Originally due at the end of October, the reports are now due on November 30th. HUD staff will join the regular LeadingAge Housing Advisory Group call on Monday, October 26th to share more updates about Service Coordinators, including payment and grant extension updates. To join the call, email jbilowich@leadingage.org.

10/14/20: DHHS Update on Test Nebraska and More: During today's Member Call with DHHS, Becky Wisell shared that there was an updated Test Nebraska testing calendar available for Nursing Facilities.  You can find it here.  Keep in mind that the dates identified are the dates that your tests are to be IN the lab, not the day that you are to test.  It was also indicated that in the next few days a letter will be coming out from DHHS that includes the testing capacity for NPHL and Test Nebraska for things like confirmatory testing that require a 48 hour turn around time.  The letter can be used as you document attempts to meet testing requirements based on your county positivity rate (color).  

DHHS is still working on both the BinaxNOW distribution playbook and the Assisted Living Infection Control document. In relation to the BinaxNOW plan, Assisted Living facilities that had not completed the DHHS survey regarding number of residents and staff received a follow up email from Becky yesterday.  If you received the email again and have not completed the survey, please do so. Here is the link to the survey. They are asking for surveys to be completed by 5pm on Thursday.  The survey will help in determining distribution of the test cards, including to your facility.

The DHHS team is still working to add the comment column to the reporting document that is being used to provide test results to the state, there will likely be an update on this during our Friday weekly Member Call with Dr. Anthone, Dr. Ashraf and others. There is more to come on surveyor testing in Nebraska as well, as plans are being put in place to begin testing surveyors.  

10/14/20: CDC Information on COVID-19 Vaccines: LeadingAge is hearing from some state health departments advising members to start working on their plans for COVID-19 vaccination. Unfortunately, not a lot of official and detailed information is available at this time. There is currently no approved or authorized vaccine. Many are under development or various stages of trials at this time and a vaccine may be available in the coming months, potentially under an emergency use authorization. CDC put out a few documents over the past 24 hours that are available here. Here is a quick overview of the main points:

  • 4 vaccines are currently in large-scale clinical trials. Of these 4 vaccines, 3 of them require 2 shots and 1 vaccine is a single-shot vaccine.
  • Supply may be limited initially. CDC's advisory committee is considering recommending prioritization of the following groups:
    • Healthcare personnel
    • Workers in essential and critical industries
    • People at high risk for sever illness due to underlying medical conditions
    • People aged 65 and older
  • The government is aiming for free and low-cost vaccines. Providers will be able to bill for administration of the vaccine.
  • Safety monitoring for adverse effects of the vaccine will take place through a number of platforms, including NHSN.
  • At this time, it has not been determined whether an individual who has recovered from COVID-19 will be recommended to receive a vaccine. There is limited information about natural immunity at this time, and it will also depend upon the vaccine that is ultimately approved.
  • The vaccine is not the key to returning to "normal life." Vaccines help the body fight the virus if exposed. Masks and social distancing are necessary to limit exposure and transmission. We will need to continue to mask and social distance, even after a vaccine is approved.

10/14/20: NHSN Reporting on Point-of-Care Testing: Beginning this Friday, October 16, providers will have the opportunity to report COVID-19 point-of-care testing through NHSN. Our understanding is that this will require the enhanced security of upgrade to Level 3 (SAMS grid card) in the NHSN system. CDC is hosting 2 webinars next week to share more information: Thursday, October 22 at 10:00am CST and Friday, October 23 at 1:00pm CST. Registration information is available here. It is important to note that this capability does not replace required reporting according to CLIA requirements. Providers must continue to report point-of-care testing according to the process outlined by your state. States will make the decision as to whether to adopt NHSN as the reporting platform.  

10/14/20: New HUD FAQs discuss COVID-19 testing, MORs: HUD has issued updated COVID-19 FAQs for Multifamily Housing providers, including HUD Section 202 and Section 8 providers. The agency had last issued updated FAQs on July 31. HUD's newest FAQs for Multifamily Housing providers include updated guidance on the CDC's order to halt evictions, offering COVID-19 tests and flu shots on premises, and REAC inspections and MORs. LeadingAge will continue to work with HUD to support housing providers navigating the pandemic. A summary of the FAQs is available here.

10/14/20: PPE Opportunity- Glove and Medical Grade Facemasks: We have been distributing PPE received from a number of generous donors.  Most recently we have received items from our friends at DonatePPE.  If you are in need of any of the following items, please email me (jenifer.acierno@leadingagene.org).  Here is the PPE that is currently available.

  • Vinyl gloves, size small.  Each container includes 10 boxes of 100 gloves.  
  • Medical grade face masks.

10/12/20: IRS Extends Non-Filer EIP Deadline Until Nov. 21: For the last time, according to the IRS, it has extended the deadline for non-filers to register to receive Economic Impact Payments from the IRS. Millions of non-filers were left out of receiving these stimulus checks but are nonetheless eligible for them. To receive these payments, they must register to do so by November 21.

10/12/20: Project ECHO Material for Nursing Home Members: If you are interested in some additional information about Project ECHO's National Nursing Home Action Network, HERE is a FAQ fact sheet that includes links to learn more and register to participate.  HERE is a shorter version of the basics with a link to get more information and connect to a hub or center.  Finally, HERE is the flyer on the half hour introductory webinar that will be repeated on October 13, 14, or 15.

10/12/20: Streamlined Forgiveness for Small PPP Loans: The Treasury and SBA announced a new forgiveness application for PPP loans of $50,000 or smaller- the smallest of the PPP loans. Under this new application, borrowers will need to certify that they used their loan funds in compliance with federal law and regulation but do not need to submit detailed data on how the loan funds were used. Loans of larger amounts still need to be processed through the regular or EZ application forms, both of which require reporting of how loan funds were used. See more here.

10/12/20: Provider Relief Fund: LeadingAge has written an article covering the changes on the interpretation of "hiring" for the purposes of eligible expenses under the Nursing Home Infection Control Distribution and covering additional information that HHS has posted regarding the Phase 3 General Distribution application process. As part of the article and listed separately on the LeadingAge COVID-19 page, is a table that summarizes the distributions to aging services providers from the PRF to date in an effort to help them track the allowable purposes for each set of funds received.

10/12/20: BD Veritor Batch Testing Training: Here is the recording of our latest training with BD staff on the BD Veritor system and batch testing. During this comprehensive training, BD experts explained how to properly use the BD Veritor system and utilize its batch testing process to simplify and help manage testing time commitments.

10/12/20: CDC Recommendations for Posting About Confirmed Cases: In response to questions about how long to leave up notices regarding confirmed cases on site, CDC staff have recommended that housing providers consult the following guidance for the discontinuation of isolation of persons not in healthcare settings. According to the CDC staff, as long as the only reason why the COVID-19 notices are posted is to signify that someone is potentially infectious, then the signs can come down as soon as that person has met criteria to discontinue isolation, i.e., the length of time discussed in the guidance available here.

10/12/20: CMS Announces New Repayment Terms for Medicare Loans Made to Providers During COVID-19: CMS announced a one year grace period for repayment of loans/advance payments received by providers.  Payments are to begin one year from the issuance date of each provider or supplier's accelerated or advance payment.  The amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program was passed by Congress and signed into law by the President as part of the Continuing Resolution.  The Medicare loan program had allowed CMS to make advance payments to providers and is typically used in emergency situations.  Under the Continuing Appropriations Act, 2021 and Other Extensions Act repayment will now begin one year from the issuance date of each provider or supplier's accelerated or advance payment.  CMS issued $106 billion in payments to providers and suppliers in order to alleviate the financial burden healthcare providers faced while experiencing cash flow issues in the early stages of combating the COVID-19 Public Health Emergency (PHE). For more information, CMS released a Fact Sheet and FAQs related to the Accelerated and Advance Payment Repayment and Recovery terms.

10/12/20: Information on Self-Collecting Anterior Nasal Samples for Health Care Providers: The FDA issued a letter to health care providers recommending that health care providers give clear, step-by-step instructions to patients who, in a health care setting, are self-collecting anterior nasal samples for SARS-CoV-2 testing. Without proper instructions, patients may not collect an adequate sample for testing, which may decrease the sensitivity of the test.

10/12/20: Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes: CMS updated the toolkit on state actions, including recent information and guidance on vaccinations to prevent infection with influenza virus, pneumococcus, and SARS-CoV-2, the virus that causes COVID-19.

10/12/20: Fight the Flu Vaccine Campaign Kickoff: HHS has developed this set of tools to spread the word - Getting an annual flu vaccine is more important than ever this fall. #FightFlu by getting vaccinated today. Say #BooToTheFlu: During the month of October, use #BooToTheFlu to encourage others to get their flu vaccine by Halloween. More Info:"Boo To The Flu" Toolkit

10/12/20: CDC Issues Eviction Ban FAQs: The CDC has issued FAQs for the eviction moratorium in place from September 4th through December 30th. The FAQs were issued jointly by the CDC, HUD, the Department of Health and Human Services (HHS), and the Department of Justice (DOJ); the document discusses the declaration used by tenants to certify eligibility for the protections, as well as timing for housing providers initiating evictions, among other outstanding questions. More information will be available HERE.

10/12/20: CDC Eviction Moratorium Resident Declaration: The CDC has posted the resident declaration, required of tenants seeking protection of the CDC's eviction moratorium for non-payment of rent, in twenty languages.

10/12/20: Weekly Senior Housing Recap for the week ending 10/9/2020.  Here's your weekly senior housing recap.

10/12/20: Weekly Nursing Home Recap for the week ending 10/9/2020.  Here's yourweekly nursing home recap.

10/9/20: LTC LAB Calendar link

10/7/20: DHHS Updates from Today's Member Call: During the member call with DHHS today, Becky Wisell indicated that the Baseline Testing link for Test NE is being removed from the DHHS website. She also recommended that facilities not direct PCR testing needs to Test NE due to a current staffing issue with the lab. If tests are submitted to Test NE she indicated to be prepared for an extended turn around time for results. IF you have a need a back-up for testing to move in to Phase 3, reach out to Becky Wisell, Dan Taylor, or Connie Vogt. If you need a PCR or a timely alternative. 

It was indicated that ALs are not required to do testing, however, if an AL received BinaxNOW testing supplies AND plans to do testing, the results of those tests are required to be submitted to DHHS under the same reporting guidelines provided to NFs.   

Facilities should be on the look out for an updated Test Ne LTC testing calendar.  

If you are a NF and have not yet received a Quidel or BD Veritor machine, please contact Jenifer-  jenifer.acierno@leadingagene.org.

10/7/20: Survey Regarding Assisted-Living Facility Resident and Staffing Count: Becky Wisell sent the following note out to AL providers today:

An e-mail was sent out this afternoon by DHHS employee Brian Harter. The e-mail includes a link to a Survey Monkey survey in which DHHS is asking all assisted-living facilities to identify the number of staff and residents for your facility. This information is being used in the development of the plan for distributing the Abbott BinaxNOW antigen test cards. We have asked that all assisted-living facilities complete the survey before noon on Thursday, October 8, 2020. I apologize for not providing more clear identification with the survey, but I want you to know the link provided by Brian is legitimate and we would appreciate your response. Thank you. 

10/7/20: Provider Relief Funds new FAQs on Infection Control fund uses and Phase 3 Application Clarifications: HHS clarified in its recently updated FAQs on Provider Relief that the Nursing Home Infection Control Payments can be used to hire AND retain staff.  The Terms and Conditions for the Nursing Home Infection Control limit use of payments to certain infection control expenses, including hiring staff, whether employees or independent contractors, to provide patient care or administrative support.  Is "hiring" limited to only bringing on new staff or may funds be used for existing staff?  (Added 10/5/2020)

Payments from the Nursing Home Infection Control Distribution may be used to cover "hiring" expenses related to both recruiting new hires and the continued payment and retention of existing staff to provide patient care or administrative support.  

The FAQs also provide additional details regarding the Phase 3 application process. The FAQs clarify that HHS will review all the applications prior to distributing any of the $20B from this tranche. So, this means these payments won't make their way to providers until mid to late November at the earliest. The goal appears to be to ensure all eligible providers first get their full 2 % and then provide add-on payments to those who demonstrate continued need beyond what has been received to date.

10/7/20: BD Veritor Batch Training for LeadingAge Members: Register for our BD Veritor Batch Testing Training. Please join representatives from Becton Dickinson(BD) for a second session on the point of care (POC) antigen testing machine, Veritor. The session will be held Thursday, October 8th at 2:00pm CST. You will learn about the Veritor and advanced usage in batching. Register for the training here.

10/7/20: Project ECHO Sign Up: The National Nursing Home COVID-19 Action Network is an opportunity for nursing homes to voluntarily join a Project ECHO learning collaborative.  Participants will work in small groups, with teams of four staff from each nursing home joining weekly calls to hear from experts and to share information with other participating nursing homes about what they've tried and how it has worked. Participating nursing homes will receive $6,000 each. There will be other ways to sign up, but currently the website is linked here.

10/7/20: Voting: CMS released this memo this week, reminding nursing homes of residents' rights to vote. The memo describes some different options for voting. Providers should be supporting residents to exercise the right to vote in this and all elections. LeadingAge has developed a "What's Your Voting Plan" toolkit that provides an easy to use self-assessment for both aging services providers and individuals to develop a plan to vote for this year's election.  

10/7/20: CDC FAQ on Nursing Home Testing: CDC updated an FAQ to include new information on Nursing Home Testing. In particular, providers should refer to the question on infection prevention and control measures for those who receive a positive antigen test result followed by a negative PCR result. Several factors need to be considered when determining how to proceed, and we know this has been a source of confusion/frustration with members and their health departments.

10/5/20: BD Veritor Batch Training for LeadingAge Members: Register for our BD Veritor Batch Testing Training.  Please join representatives from Becton Dickinson(BD) for a second session on the point of care (POC) antigen testing machine, Veritor. The session will be held Thursday, October 8th at 2:00pm CST.  You will learn about the Veritor and advanced usage in batching. Register for the training here.

10/5/20: Public Health Emergency Extended: Last week, HHS Secretary Alex Azar announced that he is extending the COVID-19 Public Health Emergency for another 90 days, effective October 23rd, 2020. This date ensures continuity of the PHE flexibilities (including 1135 waivers) that are in place. The PHE will now be in place until at least January 21, 2021 and the flexibilities allowed to providers will continue unless specifically ended by HHS or CMS.

10/5/20: BD Veritor Batch Training for LeadingAge Members: Register for our BD Veritor Batch Testing Training.  Please join representatives from Becton Dickinson(BD) for a second session on the point of care (POC) antigen testing machine, Veritor. The session will be held Thursday, October 8th at 2:00pm CST.  You will learn about the Veritor and advanced usage in batching.  Register for the training here.

10/5/20: Visitation Tool: CMS released updated visitation guidance on September 17. Over the past 2 weeks, CMS has been working with states to address conflicts between CMS guidance and state mandates. LeadingAge has created this quick reference tool to help refresh providers on the CMS guidelines for visitation as states issue updates that are more aligned with federal guidance.

10/5/20: BD Veritor Batch Training for LeadingAge Members: Register for our BD Veritor Batch Testing Training.  Please join representatives from Becton Dickinson(BD) for a second session on the point of care (POC) antigen testing machine, Veritor. The session will be held Thursday, October 8th at 2:00pm CST.  You will learn about the Veritor and advanced usage in batching.  Register for the training here.

10/5/20: Project ECHO Network Introductory Session: An introductory session will be offered multiple times over the next two weeks to learn about the ECHO National Nursing Home COVID-19 Action Network.  To learn more about the Network and project ECHO, nursing home providers can pick the date and time that works best for them. More information and webinar date choices are outlined in this flyer. The network is open to any nursing home in the country at no cost. The network will work with nursing home staff and administrators from across the country to share best practices, learn from peers, and hear from experts on nursing homes and quality improvement. Nursing homes that are eligible to receive Provider Relief Funds can receive $6,000 for participating. Many of you have heard about this opportunity from Dr. Ashraf and team and have already indicated your intention to participate in this network.  

10/5/20: Home Health and Hospice distribution of Binax Cards- SURVEY: Please respond to this survey. LeadingAge sent an email today to home health and hospice members with a survey asking for information requested by HHS in order to assist with the distribution of Abbott BinaxNOW testing cards to these provider types. If you are a LeadingAge Nebraska home health or hospice member, please complete the survey by Friday October 9. Completion of the survey does not guarantee that an agency will receive the Abbott BinaxNOW cards, but the information will be helpful in facilitating this if possible. 

10/5/20: CDC Update on Transmission: CDC updated guidance today on the transmission of COVID-19 to include airborne transmission. Airborne transmission means virus hangs in the air for minutes or even hours and can infect people further than 6 feet away or after the infected person has left the area. Evidence indicates that when airborne transmission has occurred, it has been in enclosed spaces with inadequate ventilation. Airborne transmission is uncommon. Close contact is still the most common source of spread of COVID-19. This new information highlights the importance of adequate ventilation and source control (masking of nose and mouth, social distancing). Here are 4 things providers can do:

  • Stress the importance of masks and social distancing with residents/patients, staff, and visitors.
  • Talk with your building engineer about ventilation.
  • Bring in fresh outdoor air as much as possible.
  • Allow ample time before entering spaces for cleaning and turn-over. Check out this CDC guide on air changes / hour for airborne contaminant removal.

10/5/20: Provider Relief Phase 3 Application: The application process for Phase 3 opened today and will remain open until 11:59p ET on Nov. 6.  Phase 3 is open to all providers who have applied before and received a full 2% General Distribution, in addition to all other previously eligible providers. There are two newly eligible groups for this application: 1) behavioral health providers including those who are exclusively private pay and/or accept commercial insurance, and 2) providers who opened/began delivering care in the first quarter of 2020.  Providers are encouraged to apply early as the distribution process is also different this time with a two-step process. The first step will be to review applicants to ensure they receive a full 2% payment in combination with any prior general distribution payments received. After that, HHS will seek to "calculate an equitable add-on payment" for providers demonstrating a continuing need for funds. All providers seeking funds in Phase 3 must submit an application and this application will require providers to submit additional information to support their financial losses and increased expenditures due to the coronavirus. LeadingAge is awaiting further information about HHS webinars that will provide additional instruction about the application process. This Phase 3 Primer pulls together all the new information from the HHS website regarding the Phase 3 application.

10/5/20: Housing Providers & Collaboration with Community Health Centers: LeadingAge hosted the National Association of Community Health Centers to discuss opportunities for collaborations. Staff from the health center association described how federally qualified health centers got their start and how they can partner with housing providers to improve resident health, on COVID-19, the flu, and more. First step for housing providers: Locate your community health center, and ask what kind of health services they provide (or may be able to start providing) for the older adults in your community. More information is available here.

10/5/20: Hospice FY 2021 Medicare Rate Tool: Members now have access to  Medicare rate tool for hospice services updated for fiscal year (FY) 2021. This incorporates the 2.4% rate update from the final rule and calculates the rates for routine home care, general inpatient care, continuous home care, and respite care by core-based statistical area (CBSA). Member login (national) is required to access the tool.

10/5/20: Affordable Housing Weekly RecapHere is your affordable housing weekly recap for last week. Nursing Home Weekly Recap.  Here is your nursing home weekly recap for last week.