Coronavirus Daily Update: Home Health OTs Given Assessment Power; CMS Proposes 2.6% Rate Increase for Hospice

During this critical time, Home Health Care News remains committed to bringing you all the essential news related to home-based care operations. At the same time, we also recognize the seriousness of the COVID-19 pandemic. In addition to our regular content, we’ll continue to highlight industry-related developments and mitigation strategies in this rolling bulletin.

What you need to know from Friday through Sunday (April 10-12)

— CMS announced it would be temporarily suspending certain rules to provide a boost for front-line medical staffing. The change further expands previous workplace flexibilities put in place by CMS at the end of March. Specifically, occupational therapists from home health agencies can now perform initial assessments on homebound patients, allowing a quicker and more efficient turnaround. In addition, this allows home health nurses to provide more direct patient care.”

The U.S. Department of Health and Human Services (HHS) announced Friday it is beginning delivery on the $30 billion set aside for relief funding to providers in response to the COVID-19 virus. The $30 billion is a part of the $100 billion fund included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act that was recently enacted. The funding will be used to support health care expenses or fill the gaps on lost revenue due to the public health emergency. All providers that received Medicare fee-for-service reimbursements in 2019 are eligible for relief.

The Centers for Disease Control and Prevention (CDC) laid out specific guidelines for employees still operating at the workplace for specific critical functions. The guidelines include constant screening and mask utilization at all times, among other precautions.

CMS proposed a 2.6% payment bump for hospice providers in 2021, totaling an additional $580 million for the Medicare hospice benefit. CMS also released its proposed payment rule for skilled nursing facilities (SNFs).

— President Trump said he’s creating a council of business people and doctors to plan the reopening of the American economy.

— LeadingAge President and CEO Katie Sloan Smith underscored the need for post-acute care providers to have solid COVID-19 data. “As reported cases of COVID-19 continue to increase, good data is more important than ever before in this pandemic,” the CEO said in a statement.

— A number of states have begun to implement adult-day funding initiatives. Adult day providers have been among the organizations hit hardest by the coronavirus, with some forced to close down their centers.

What you need to know from Thursday (April 9)

— The U.S Department of Labor Announced Thursday that there were 6.6 million unemployment claims filed last week, which brings the total number of claims filed up to 16 million over the past three weeks. With the sheer number of claims being filed, some are also being backlogged, which means the total is likely even higher than the reported number. Rising unemployment is likely to affect in-home care providers, though the nature of that impact is still up in the air.

— Washington lawmakers ended in a standstill Thursday as Republicans and Democrats blocked each other’s COVID-19 relief proposals, putting into question when a new agreed-upon bill would be put forward. Democrats blocked additional funding for the small business loan program set forth by Republicans, arguing that new relief for hospitals and state and local governments needed to be included. Republicans, in turn, denied the Democrats’ proposal, arguing that other issues could be dealt with later and that more funding for small businesses was urgent, with the CARES Act money running out.

— CMS announced this week that $30 billion would be dispersed to Medicare health care providers, including home health agencies, in the form of direct deposits.

— As of Wednesday, more than 700 cases of COVID-19 had been reported at assisted living complexes nationwide, Kaiser Health News reported. The public health crisis could wreak havoc on these facilities, with resulting bad financials forcing companies into bankruptcy. That could leave a portion of the 800,000 patients that rely on assisted living nationwide even more vulnerable — or, perhaps, send them into home-based care.

— Programs of All-Inclusive Care for the Elderly (PACE) could be authorized in the home without a license in North Carolina. The Secretary of Health and Human Services now has the power to waive or modify any regulations that keep PACE care from taking place in the home.

What you need to know from Wednesday (April 8)

— House Speaker Nancy Pelosi (D-Calif.) and Senate Minority Leader Chuck Schumer (D-N.Y.) issued a joint statement on what they’d like to see in an interim emergency coronavirus package. Among their goals, the top Democrats called for $100 billion for the hospitals, community health centers and health systems to help secure “desperately needed resources” for the front lines of the COVID-19 crisis.

— If home-based care agencies are interested in securing capital through the lending programs established under the CARES Act, they’ll need to act fast. But the electronic system the Small Business Administration uses to set up new coronavirus loans was down earlier this week, NBC News reported Wednesday.

In an interview with HHCN, New York-based Alliance Home Care CEO Gregory Solometo sounded off on difficulties in securing testing kits and PPE.

— CMS issued a series of updated guidance documents focused on infection control to prevent the spread of the 2019 novel coronavirus in a variety of in-patient and outpatient care settings. The guidance includes direction for dialysis facilities looking to treat patients at home.

— To avoid exposing their clients to the novel coronavirus, some personal care attendants are opting to move in with the people they care for. Anna Castillo, who is paid by Mass Health, is one such personal care attendant. WBUR has the story.

— California will begin using a new technology developed by Battelle that allows for the sterilization and reuse of N95 masks, an official from the California Governor’s Office of Emergency Services, announced Wednesday. PPE continues to be a pain point for providers throughout the continuum of care.

What you need to know from Tuesday (April 7)

— CMS announced Tuesday it has delivered almost $34 billion in the past week to home health providers and other health care organizations on the front lines battling the 2019 novel coronavirus. The funds have been provided through the expansion of the Accelerated and Advance Payment Program.

In a new report from the HHS Office of Inspector General, hospitals reported that their most significant challenges center on testing and caring for patients with known or suspected COVID-19 — and keeping staff safe. The fact that most hospitals continue to struggle with PPE does not bode well for home health providers, which federal decisionmakers aren’t prioritizing in terms of supplies.

— Nursing homes in Connecticut will get a 10%, “across-the-board increase” in their Medicaid reimbursements, with operators that volunteer to turn their facilities into dedicated COVID-19 treatment facilities eligible for even greater financial benefits. HHCN sister publication Skilled Nursing News has the story here.

— Health care workers treating COVID-19 patients should be rewarded financially, according to President Trump, speaking at a White House coronavirus task force this week. Trump, who called health care workers. “incredible,” was specifically answering a question about considerations for a fourth COVID-19 relief effort.

— New York, the District of Columbia, Alaska, Hawaii and New Jersey are among the most aggressive when it comes to measures aimed at stopping the spread of coronavirus, according to a new ranking from WalletHub. Texas, Utah, Florida, Mississippi and Arkansas are among the least aggressive.

CMS shares accelerated payments data

CMS has approved roughly $34 billion in payments to Medicare providers over the past week through the agency’s Accelerated and Advanced Payment Program.

So far, the faster accelerated payments process launched by CMS last month for COVID-19 has resulted in processing times of between four to six days, down from the normal three to four weeks.

Over the past week, CMS has received over 25,000 requests from health care providers and suppliers for accelerated and advance payments, approving over 17,000 of those requests. Prior to COVID-19, CMS had approved just over 100 total requests in the past five years, with most being tied to natural disasters such as hurricane.

“Health care providers are making massive financial sacrifices to care for the influx of coronavirus patients,” CMS Administrator Seema Verma said in a statement. “Many are rightly complying with federal recommendations to delay non-essential elective surgeries to preserve capacity and personal protective equipment. They shouldn’t be penalized for doing the right thing. Amid a public health storm of unprecedented fury, these payments are helping providers and suppliers – so critical to defeating this terrible virus – stay afloat.”

CMS announced a COVID-19 update to its accelerated payments program on March 28.

HHCN is attempting to get home health care-specific advanced patent totals from CMS.

What you need to know from Monday (April 6)

47% of home-based care providers believe COVID-19 will have a negative impact on the long-term health of their businesses, a new survey released by Axxess has found.

— PPE is in such short supply that thieves are starting to target valuable supplies. Over the weekend, roughly $250,000 of personal protective equipment was stolen from Wilson Care Group, a home health care provider and senior living operator in Hawaii.

— On Monday, Encompass Health Corp. (NYSE: EHC) announced it will award frontline employees in its 134 hospitals, 245 home health locations and 83 hospice locations with additional paid time off in recognition of their work during the COVID-19 outbreak. With more than 21,000 employees across the country that will benefit from the additional paid time off, Encompass Health’s investment is estimated at $50 million.

— In a recent poll of 266 home-based care professionals, only one-quarter reported that they are actively offering virtual care services. The poll was conducted during a recent HHCN webinar sponsored by AlayaCare.

— The number of new deaths in New York appears to be leveling off, though the state is still the epicenter of coronavirus in the U.S. The Home Care Association of New York State (HCA-NYS) and the Visiting Nurse Service of New York (VNSNY) will discuss the situation on the ground during an HHCN webinar on Friday.

— The government is starting to roll out new and faster tests, but there are still results delays and an overall lack of materials. In-home care providers have been mostly left out of the testing picture entirely.

For daily updates from the week of March 30, click here.

For daily updates from the week of March 23, click here.

For daily updates from the week of March 16, click here.

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