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Coronavirus COVID-19 CMS Resources
CMS is providing updates and resources regarding action being taken to address the spread of the Coronavirus. Below are links to those resources and updates that are being provided daily. Please confirm that you are operating under the most recent guidance from all regulatory and healthcare organizations that govern and support the long-term care industry. If you have any questions please don't hesitate to contact the KACE office.
Coronavirus Commission for Safety and Quality in Nursing Homes Final Report
(Dated September 16, 2020)
On September 16, 2020 the independent Coronavirus Commission for Safety and Quality in Nursing Homes (Commission) provided their final report to CMS. "To help CMS inform immediate and future actions as well as identify opportunities for improvement, the Commission was created to conduct an independent review and comprehensive assessments of confronting COVID-19. The Commission’s report contains best practices that emphasize and reinforce CMS strategies and initiatives to ensure nursing home residents are protected from COVID-19."
To view the full independent Coronavirus Commission for Safety and Quality in Nursing Homes report, visit here: cms.gov/files/document/covid-final-nh-commission-report.pdf
To view the Trump Administration Response to Commission findings, visit here: cms.gov/files/document/covid-independent-nursing-home-covid-19-federal-response.pdf
To view the COVID-19 Guidance and Updates for Nursing Homes during COVID-19, visit here: cms.gov/files/document/covid-guidance-and-updates-nursing-homes-during-covid-19.pdf
Trump Administration Issues New
Reporting and Testing Requirements
(Dated August 27, 2020)
On a conference call Tuesday afternoon Secretary Verma Seema announced that CMS will require nursing homes to begin testing staff as part of the Medicaid and Medicare Rules of Participation. Few details were shared, but staff testing requirements will be based on forthcoming guidance, and local level of community spread will factor into the guidance. You can read the news release here. More information will be forthcoming as it becomes available by CMS.
UPDATE - We have our first look at guidance for staff testing. You can read the guidance here. According to the guidance staff testing will depend on the COVID-19 positivity rate in your county. If it's 5% or lower staff should be tested once monthly, if it's 5-10% staff should be tested weekly, and if it's over 10% staff should be tested bi-weekly. Starting this Friday, August 28, this website will help you determine what the positivity rate is in your county. It's going to be very important to monitor this website on a daily basis. KACE is actively engaging KDADS about how enforcement will work and we will provide further updates as more information becomes available.
CMS Issues Ref: QSO-20-35-ALL - Full Resumption of Survey Activity
(Dated August 17, 2020)
Read the QSO here.
CMS Announces Plans to End the Blanket Waiver
Requiring Nursing Homes to Submit Staffing Data
(Dated June 25, 2020)
Today, the Centers for Medicare & 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 memorandum released today also provides updates related to staffing and quality measures used on the Nursing Home Compare website and the Five Star Rating System.
View the memorandum to states and nursing home stakeholders here.
CMS Releases Nursing Home Covid-19 Data here
(Dated June 4, 2020)
Enhanced Enforcement for Infection Control Deficiencies and Guidance For Resuming Routine Surveys - Read CMS QSO - 20-31-All here
(Dated June 1, 2020)
Medicare Billing - Clarification for Using the "CR" Modifier and "DR" Condition Code Can be Found Here
(Dated June 1, 2020)
Trump Administration Issues Guidance to Ensure States Have a Plan in Place to Safely Reopen Nursing Homes
(Dated May 18, 2020)
Please note: CMS has issued guidance for re-opening nursing homes, but the re-opening plan will be created by the State. KACE and the other long-term care associations are engaging KDADS to provide more details regarding their planning. Please contact KACE with questions and concerns.
Trump Administration Issues New
Reporting and Testing Requirements
(Dated August 26, 2020 Updated no August 27, 2020)
On a conference call Tuesday afternoon Secretary Verma Seema announced that CMS will require nursing homes to begin testing staff as part of the Medicaid and Medicare Rules of Participation. Few details were shared, but staff testing requirements will be based on forthcoming guidance, and local level of community spread will factor into the guidance. You can read the news release here. More information will be forthcoming as it becomes available by CMS.
UPDATE - We have our first look at guidance for staff testing. You can read the guidancehere. According to the guidance staff testing will depend on the COVID-19 positivity rate in your county. If it's 5% or lower staff should be tested once monthly, if it's 5-10% staff should be tested weekly, and if it's over 10% staff should be tested bi-weekly. Starting this Friday, August 28, this website will help you determine what the positivity rate is in your county. It's going to be very important to monitor this website on a daily basis. KACE is actively engaging KDADS about how enforcement will work and we will provide further updates as more information becomes available.
CMS Issues Nursing Homes Best Practices Toolkit to Combat COVID-19 here
(Dated May 12, 2020)
Updates to Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) to Correct the Adjustment Process here
(Dated May 8, 2020)
CR 11727 contains updates to Medicare’s claims processing systems to make corrections to processing of adjustments and other billing issues for SNF Patient Driven Payment Model (PDPM) claims. Make sure your billing staffs are aware of these updates.
CMS Releases Interim Final Rule
(Dated May 8, 2020 - it is available to review now)
The Centers for Medicare & Medicaid Services (CMS) recently released an Interim Final Rule with Comment Period (IFC) building on the agency’s efforts to give the American healthcare system maximum flexibility to respond to the coronavirus disease 2019 (COVID-19) pandemic. Below is a summary of resources and information available on the rule. View the full rule here.
Section Y. Requirement for Facilities to Report Nursing Home Residents and Staff Infections, Potential - is of particular interest and can be found here.
Interim Final Rule Updating Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes Ref: QSO-20-29-NH
(Dated May 6, 2020)
- NHSN start date pushed back to May 17, 2020
- Failure to report by June 7 will result in CMP of $1,000.00
Nursing Home Five Star Quality Rating System updates, Nursing Home Staff Counts, and Frequently Asked Questions - QSO-20-28-NH
(Dated April 24, 2020)
CMS will be publish a list of the average number of staff members onsite at facilities each day. The information might be used to direct adequate PPE and testing to nursing homes at the state level. The CMS memo also communicates a pause to the nursing homes’ current star ratings on the Nursing Home Compare website following the suspension of certain survey inspections during the coronavirus pandemic.
Administration Announces New Nursing Homes COVID-19 Transparency Effort
QSO-20-26-NH
(Dated April 19, 2020)
Today, under the leadership of President Trump, the Centers for Medicare & Medicaid Services (CMS) announced new regulatory requirements that will require nursing homes to inform residents, their families and representatives of COVID-19 cases in their facilities. In addition, as part of President Trump’s Opening Up America, CMS will now require nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).
2019 Novel Coronavirus (COVID-19) Long-Term Care Facility Transfer Scenarios
(Dated April 13, 2020)
The U.S. Department of Health and Human Services Begins Distributing Covid-19 Relief Funds to Healthcare Providers.
(Dated April 10)
Who is eligible for this first distribution? All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution. You may have received funds via direct deposit beginning today. Read more about this first wave of funding here.
CMS Stakeholder Calls Recordings and Transcripts
CMS COVID-19 Updates: Video on telehealth; additional Medicaid waivers; and Ambulatory Surgical Center guidance.
(Dated April 3, 2020)
CMS released a video providing answers to common questions about the Medicare telehealth services benefit. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.
Administration Issues Key Recommendations to Nursing Homes
(Dated April 2, 2020)
Covid-19 Emergency Declaration Blanket Waivers for Health Care Providers
Long-Term Care Begins on Page 9
Kansas Receives Approval on 1135 Waiver Requests
- Temporarily suspend Medicaid fee-for-service prior authorization requirements. Section 1135(b)(1)(C) allows for a waiver or modification of pre-approval requirements, including prior authorization processes required under the State Plan for particular benefits.
- Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency.
- Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days.
- Provider Enrollment
- State Fair Hearing Requests and Appeal Timelines
Infection Control Self Assessment Tool
(Dated March 23, 2020)
Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit
(Dated March 29, 2020)
Administration Engages Hospitals in Data Sharing
(Dated March 29, 2020)
Financial Relief for Medicare Providers
(Dated March 28, 2020)
Kirkland Washington Inspection Results Create New Focus for Surveys
(Dated March 23, 2020)
Federal Inspection Survey Focus Document
(Dated March 23, 2020)
Prioritization of Survey Activities Ref: QSO-20-20-All
(Dated March 23, 2020)
CMS Provides Relief for Medicare Quality Reporting Programs
(Dated March 22, 2020)
CMS Creates Virtual Toolkit for CMS and HHS Coronavirus Materials
(Dated March 17, 2020)
CMS Waives 3 Day Stay Requirement
(Dated March 17, 2020)
The waiver comes as part of the national state of emergency issued by the Trump administration to combat and spread the Coronavirus. CMS will now provide coverage of skilled nursing facility services without a qualifying hospital stay.
CMS Announces New Measures to Protect Nursing Home Residents from COVID-19
Revised Ref: QSO-20-14-NH Dated March 13, 2020
(Dated March 13, 2020)
The new measures CMS announced today, which supersede prior CMS guidance, constitute the agency’s most aggressive and decisive recommendations with respect to nursing home safety in the face of the spread of COVID-19. They include:
- Restricting all visitors, effective immediately, with exceptions for compassionate care, such as end-of-life situations;
- Restricting all volunteers and nonessential health care personnel and other personnel (i.e. barbers);
- Cancelling all group activities and communal dining; and
- Implementing active screening of residents and health care personnel for fever and respiratory symptoms.
CMS Takes Actions to Address Coronavirus
(Dated March 13, 2020)
COVID-19 Emergency Declaration Healthcare Providers Fact Sheet
(Dated March 13, 2020)
Previous Guidance
You will find more information regarding CMS actions here, and below are the main points summarized as of March 4, 2020.
CMS is suspending non-emergency inspections across the country, allowing inspectors to turn their focus on the most serious health and safety threats like infectious diseases and abuse.
Effective immediately, survey activity is limited to the following (in Priority Order):
- All immediate jeopardy complaints (cases that represents a situation in which entity noncompliance has placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death or harm) and allegations of abuse and neglect;
- Find more information on survey activity you can review QSO-20-12 (dated March 4, 2020) here.
- Complaints alleging infection control concerns, including facilities with potential COVID-19 or other respiratory illnesses;
- Find more information on infection control practices, including monitoring and restricting visitors, for nursing homes you can review QSO-20-14-NH (revised on March 13, 2020) here.
- Statutorily required re-certification surveys (Nursing Home, Home Health, Hospice, and ICF/IID facilities);
- Any re-visits necessary to resolve current enforcement actions;
- Initial certifications;
- Surveys of facilities/hospitals that have a history of infection control deficiencies at the immediate jeopardy level in the last three years;
- Surveys of facilities/hospitals/dialysis centers that have a history of infection control deficiencies at lower levels than immediate jeopardy.
CMS Resources:
Long term care facility – Infection control self-assessment worksheet
Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) in Home Health Agencies (HHAs) (QSO-20-18-HHA Dated March 10, 2020)
CMS posted a fact sheet with information relating to the pricing of both the Centers for Disease Control and Prevention (CDC) and non-CDC tests dated March 12, 2020.
CMS Frequently Asked Questions on Essential Health Benefit Coverage here.
CMS Frequently Asked Questions on Catastrophic Plan Coverage here.