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Sept. 22nd COVID-19 Update

New COVID-19-related updates for providers of long-term/post-acute care (LTPAC) and senior services continue to be shared on a regular basis by both state and federal authorities. The latest developments are outlined below.

As a reminder, LeadingAge NY continues to convene weekly webinars on Mondays at 11 a.m. to address emerging questions on COVID-19. A recording of our most recent webinar, held on Sept. 21st, is available here. If you have questions for next week’s update, which will be held on Tues., Sept. 29th at 11 a.m. due to Yom Yippur, please send them to Ami Schnauber, and be sure to check your email for the access information, or contact Jeff Diamond.

Cross-Sector Updates

PRF Reporting Requirements

Over the weekend, the Department of Health and Human Services (HHS) issued reporting guidelines for providers who receive more than $10,000 in Provider Relief funding listing the data elements they will be required to report. Recipients will need to report their use of Provider Relief Fund (PRF) payments by submitting information on health care-related expenses attributable to COVID-19 that another source has not reimbursed and is not obligated to reimburse and PRF payment amounts not fully expended on health care-related expenses attributable to COVID-19 that are applied to lost revenues. However, please note that lost revenues must be represented as a negative change in year-over-year net patient care operating income (i.e., patient care revenue less patient care-related expenses), net of the health care-related expenses attributable to COVID-19 expenses and have set limits. Recipients may apply PRF payments toward lost revenue, up to the amount of their 2019 net gain from health care-related sources. Recipients that reported negative net operating income from patient care in 2019 may apply PRF amounts to lost revenues up to a net zero gain/loss in 2020.

Although the reporting system will not be available until early 2021, members should become familiar with the data elements that they will be required to report to ensure that they are compiling and documenting the needed information. Expenses attributable to COVID-19 may be incurred both in treating confirmed or suspected cases of COVID-19, preparing for possible or actual COVID-19 cases, maintaining health care delivery capacity, etc. Providers who receive in excess of $500,000 will be subject to more detailed reporting. Additionally, some distributions, such as the nursing home infection control allocation and reimbursement for testing and treating uninsured individuals, are likely to require separate reporting.

The guidance is available here, and a summary by LeadingAge National is here.

Main Street Lending Program Now Open to Not-for-Profits

The Federal Reserve Board has announced that the Main Street Lending Program is now fully operational and accepting submissions of eligible loans to not-for-profit organizations through the lender portal by registered eligible lenders. Click here for more information.

DOH Imposes New Requirements on COVID-19 and Flu Point-of-Care Test Providers

On Sept. 21st, the Department of Health (DOH) issued guidance requiring all laboratories, including health care providers conducting point-of-care testing, to collect additional demographic data concerning patients receiving COVID-19 tests and to report results of flu and COVID-19 tests within three hours. Click here for more information.

NYC PPE Stockpile Program Offers More Webinars and Go-Live Dates

The New York City Department of Health and Mental Hygiene (NYC DOHMH) is offering webinars this week to adult care facilities (ACFs) and other providers so they can learn how to access the NYPersonal Protective Equipment (PPE) Stockpile coordinated by Medline on behalf of NYC. Please note that, though not listed, certified home health agencies (CHHAs) are invited to this week’s webinar and are included in the Sept. 28th go-live rollout as well. Licensed home care services agency (LHCSA) members will have a specific webinar and go-live date coming soon. NYC DOHMH will consider rolling hospice into this resource at a later date.

Providers will receive invitations to attend the live Medline.com webinar training sessions, which will provide an overview of the steps to take to place an emergency request on Medline.com. This will be in preparation for “go-live,” when providers will be able to place requests through Medline.com. As a reminder, this is an emergency source for PPE, and by submitting a request through Medline.com, providers are confirming that the PPE they are requesting is required to protect staff and patients during the COVID-19 response and they currently have less than one week of the requested supplies on hand.

Go-Live Date

  • Adult Care, Office for People with Developmental Disabilities (OPWDD), BH-Cong, Federally Qualified Health Centers (FQHC), Primary Care, Dialysis, Opioid Treatment Programs (OTP), Regional Emergency Medical Services Council (REMSCO) – Sept. 28th

Webinars (only attend one)

  • Adult Care, OPWDD, BH-Cong, FQHC, Primary Care, Dialysis, OTP, REMSCO – Sept. 22nd, 10-10:30 a.m. ET; Sept. 23rd, 12-12:30 p.m. ET; Sept. 24th, 2-2:30 p.m. ET

If you are unable to attend the training, a training guide will be provided afterward. Additionally, following webinar training, you will receive access instructions from Medline.com with more information on accessing the requesting platform.

Please contact LeadingAge NY if you have questions, or reach out to PPEsupport@health.nyc.gov.

Travel Advisory States and Process to Request Exemption for End of Life

LeadingAge NY has been tracking the COVID-19 Travel Advisory requiring people to quarantine if traveling to New York from certain states, with certain conditional exceptions for essential workers. On Sept. 22nd, the Governor announced that five states – Arizona, Minnesota, Nevada, Rhode Island, and Wyoming – have been added to the list, while no states have been removed. Click here for more information and an archived list of states as they have been added or removed.

LeadingAge NY has received questions regarding residents, at end of life, having loved ones from states on the Travel Advisory who want to visit. Click here for information on how to request an exemption from the State for certain circumstances.

New York State Paid Sick Leave Law

Among the many paid sick leave laws set forth by New York State and the federal government in response to COVID-19 is a bill signed by Governor Cuomo requiring employers to provide paid sick leave to employees beginning Jan. 1, 2021. Beginning Sept. 30, 2020, employers must allow employees to accrue paid sick time. Employers must provide the following amounts of paid sick time:

  • Employers with 0 to 4 employees must provide up to 40 hours of unpaid sick leave;
  • Employers with 0 to 4 employees with a net income greater than $1 million must provide up to 40 hours of paid sick leave;
  • Employers with 5 to 99 employees must provide up to 40 hours of paid sick leave; and
  • Employers with 100 or more employees must provide up to 56 hours of paid sick leave.

Click here for more information.

LeadingAge to Hold National Day of Action for Older Adults on Sept. 23rd

With negotiations stalled on the next COVID-19 relief package, we need Congress to act for older adults before they leave Washington, DC. The Act for Older Adults campaign is rallying Americans from all walks of life to add their voice to ours. Join us tomorrow, Sept. 23rd, for a National Day of Action for aging services providers! Click here for more information.

Nursing Home Updates

CMS and DOH Issue Competing Visitation Guidance

Last week, the Centers for Medicare and Medicaid Services (CMS) and DOH issued separate and inconsistent guidance documents to inform nursing home visitation practices. Click here for more information.

Nursing Home Performance-Based Funding

HHS has provided some additional information on how the $2 billion in Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Provider Relief funding for nursing home infection control incentive payments will be distributed, although not enough to be able to predict who will receive funding or at what amounts. It appears that providers will not need to apply, as CMS will calculate rates for each facility, including performing “direct outreach” to homes that have COVID-19 deaths to validate information. What is clear is that the National Healthcare Safety Network (NHSN) COVID-19 module will be the source of key facility data used in the calculation, suggesting that homes should be focused on ensuring complete and accurate reporting.

Based on the most recent HHS communications:

  • Homes whose infection rates during a performance period are better than their county rate and that also meet an established mortality threshold will receive funding.
  • There will be four performance periods, each a calendar month long (September, October, November, December), with $400 million distributed based on performance in each month plus an additional $400 million distributed based on overall performance for the aggregated four-month period.
  • It appears that payments will be stratified, with those with the lowest infection rates receiving more funding.
  • 80 percent of each payment will be allocated based on infection rates, 20 percent on mortality rates.
  • Based on initial HHS modeling, about 75 percent of nursing homes are expected to receive some funding.
  • NHSN reporting will be the source of data, so it is critical to ensure that homes report accurately and correct any incorrect data.

Additional information is available here.

ACF/Assisted Living Updates

Abbott BinaxNOW Test Kits Being Sent to Assisted Living Facilities

On Sept. 18th, the Office of the Assistant Secretary for Health (OASH), the Centers for Disease Control and Prevention (CDC), and Abbott jointly presented a webinar regarding the current effort to send assisted living facilities the new Abbott BinaxNOW test kits. Click here for more information on this initiative and the implications for ACF/assisted living providers.

Affordable Housing Updates

HUD Releases Notice H-2020-09 and PIH-2020-26

On Sept. 18th, the Department of Housing and Urban Development (HUD) released Notice H-2020-09 and PIH-2020-26 amending Rental Assistance Demonstration (RAD) Notice Revision 4 due to the circumstances of the COVID-19 pandemic. Click here for more information.