Coronavirus Daily Update: PQHH Sends New Letter to CMS; LeadingAge Responds to Trump’s Testing Statement

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-Sunday (June 19-21):

— Washington, D.C.-based trade group LeadingAge released a statement Sunday condemning President Donald Trump’s suggestion that COVID-19 testing needed to be slowed down. Trump made his comment during a campaign rally in Tulsa, Oklahoma Saturday. Testing is just becoming more available to home-based care agencies, and a slowdown could mean more scarcity for providers looking to test patients and workers. “There is simply no replacement for regular testing when it comes to managing COVID-19 in nursing homes and other aging services settings,” Katie Smith Sloan, LeadingAge’s CEO, said in the statement. “It is shocking to hear that, despite this clear need, the administration would willingly walk away from the most vulnerable citizens on the front line of the worst pandemic in a century.”

— The Partnership for Quality Home Healthcare (PQHH) sent another letter to Congress on behalf of home health providers.

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— The National Center for Assisted Living (NCAL) released a statement Friday emphasizing the continued need for PPE in long-term care facilities. More than half of assisted living communities have less than a two-week supply of PPE, a survey from NCAL found. If securing enough PPE is still a concern for long-term care facilities, it may be too early for home-based care providers to declare themselves out of hot water when it comes to their supply. Assisted living is generally considered higher on the priority list when it comes to PPE distribution. 

— CMS announced the selected members for the Coronavirus Commission on Safety and Quality in Nursing Homes on Friday. “The 25-member Commission is diverse, representing a variety of expertise, affiliations, backgrounds and geography, including resident advocates, infectious disease experts, directors and administrators of nursing homes, academics, state authorities, clinicians, a medical ethicist and a nursing home resident,” CMS said in a statement.

PQHH letter demands more from CMS

Keith Myers, the Partnership for Quality Home Healthcare’s chairman, wrote a letter to CMS on Friday, demanding a handful of actions from the agency to unlock some of the abilities of home-based care.

Among its recommendations, the letter called for the use of presumptive homebound determinations to support access to care and the ability for the home health face-to-face visit to be provided via telehealth.

Additionally, PQHH suggested ways for improving access to care during the public health emergency. Specifically, it called for flexibility in the timing for obtaining physician signatures and for changes to the plan of care for incorporating use of technology.

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The PQHH letter also said CMS should allow providers to perform the initial and comprehensive assessments remotely or by record review. The full letter is available here.

What you need to know from Thursday (June 18):

— The Federation of American Hospitals (FAH) is urging CMS to give Medicare providers — including home health agencies — more time in paying back any advanced or accelerated payments they received during the COVID-19 crisis. “The Medicare Accelerated and Advance Payment Programs’ loans saved access to lifesaving care and provided hospitals and other providers vital funding to weather the COVID shutdown,” FAH President and CEO Chip Kahn said in a statement. “But if the loan repayment terms aren’t fixed, this lifeline could become an anchor that sinks the recovery of hospitals across the country.” Home health providers have received roughly $1.7 billion in advanced and accelerated payments since the public health emergency began.

— While some businesses are recovering as states lift shelter-in-place orders and move into the later stages of their reopening plans, mass layoffs haven’t stopped. Another 1.5 million people applied for state unemployment benefits last week, the U.S. Department of Labor reported Thursday.

— Nizhoni Health CEO Joe McDonough discussed the critical importance of home-based care in a new op-ed published in the Boston business Journal. McDonough, a recent guest on HHCN’s Disrupt podcast, specifically touched on how home care providers are alleviating overcrowded hospitals and ensuring continuous care following handoffs from one setting to the next. “Through investments in new innovative approaches and technologies, home health care providers are working hard to fill in that gap, to address social determinants, and to ensure patients remain safe and well cared for in the community,” he wrote.

— Senate health committee Chairman Lamar Alexander (R-Tenn.) is calling on the federal government to make recent temporary telehealth waivers permanent. Specifically, Alexander said the federal government should permanently extend policy changes that allow physicians to be reimbursed for telehealth appointments wherever patients are located, including inside the home. The congressman also said the government should permanently extend the policy change that nearly doubled the number of telehealth services that could be reimbursed by Medicare. “As dark as this pandemic event has been, it creates an opportunity to learn from and act upon these three months of intensive telehealth experiences, specifically what permanent changes need to be made in federal and state policies,” Alexander said in a statement.

— Federal watchdogs are cracking down on three companies for selling at-home coronavirus blood tests, the Associated Press reports. Regulators warn that the products have not been shown to safely and accurately screen for COVID-19.

— CMS posted the second set of COVID-19 nursing home data, with findings available here.

What you need to know from Wednesday (June 17):

— While all 50 states have begun reopening efforts, 10 states are seeing their highest seven-day average of new COVID-19 cases a day, reports CNN. New data from Johns Hopkins shows that Alabama, Arizona, California, Florida, Nevada, North Carolina, Oklahoma, Oregon, South Carolina and Texas are seeing a record high when it comes to new cases of the virus. As of Wednesday, there were more than 2.1 million cases of coronavirus in the U.S.

— Vice President Mike Pence recently called concerns over a second wave of the coronavirus “overblown” in an op-ed for the Wall Street Journal. In the piece, Pence says the media is “sounding the alarm bells.” Generally, Pence stated that the U.S. public health system has seen an improvement compared to four months ago.

— In May, assisted living occupancy declined to 85.2% across the 31 largest metropolitan areas in the U.S. That’s a decrease from 86.1% in April and 87.8% in March, according to data from the National Investment Center for Seniors Housing & Care (NIC). The exodus of patients leaving long-term care facilities is primed to be a tailwind for home care agencies in 2020 and beyond.

Target announced it is raising its starting wage to $15 per hour, making the $2 COVID-19-initiated salary bump permanent. The announcement comes as its hazard pay period was set to expire. Retailers increasing wages or extending hazard pay could hurt the recruiting efforts of home-based care agencies, considering that some executives figured COVID-19’s hit on the retail industry may help their own.

— On Monday, President Donald Trump hosted a roundtable discussion on protecting America’s seniors and the federal government’s efforts thus far. LeadingAge President and CEO Katie Smith Sloan described the event as “troubling” in light of the rising death tolls across nursing homes and other long-term care settings. “As new coronavirus cases are at 20,000 a day and hot spots are spiking around the country, the situation in nursing homes and other aging service providers remains very serious,” Sloan said in a statement. “Our government has failed to provide the leadership and critical resources they need, including personal protective equipment (PPE), testing and a comprehensive plan for emergency funding. And because the virus has been most deadly for older people of color, we must ensure that they are not overlooked.”

What you need to know from Tuesday (June 16):

— On Tuesday, a House subcommittee launched an investigation into the government’s handling of the COVID-19 crisis in long-term care facilities. Rep. James Clyburn (D-S.C.) asked CMS Administrator Seema Verma to provide the subcommittee with information regarding its attempts to slow and stop the spread of COVID-19 in facilities, among other demands. “The Subcommittee is concerned that lax oversight by the Centers for Medicare and Medicaid Services and the federal government’s failure to provide testing supplies and personal protective equipment to nursing homes and long-term care facilities may have contributed to the spread of the coronavirus and the deaths of more than 40,000 Americans in these facilities,” Clyburn wrote in a statement.

— Hospitals have begun to organize care plans for COVID-19 survivors that suffer from lasting effects of the infection, reports MedPage Today. The lasting effects could present a business opportunity for home-based care agencies as more patients begin to recover from the virus. “We have some insights from experiences around the world where the pandemic got a head start,” Matthew Tomey, director of the cardiac ICU at Mount Sinai St. Luke’s Hospital in New York City, told MedPage. “In New York, it’s still early in determining what the intermediate and, certainly, longer-term outcomes will be.”

— As COVID-19 increases in-home care demand, pricing could skyrocket, too. A pay option seniors are exploring is reverse mortgages. “Staying at home isn’t always affordable,” writes U.S. News’ Rachel Hartman. “Among older adults, 80% are concerned about being able to afford home health care costs, according to a 2019 SCAN Health Plan survey. Paying for personalized in-home senior care can add up quickly and isn’t always easy on a fixed income.”

— Recent changes in health care employment were caused by decreases in health spending, according to a new analysis. From February through April, home health care saw a 7% loss in employment. Overall, employment in health care drastically decreased from February through April, but rebounded slightly in May. HHCN has the story here.

For daily updates from the week of June 8, click here.

For daily updates from the week of June 1, click here.

For daily updates from the week of May 26, click here.

For daily updates from the week of May 18, click here.

For daily updates from the week of May 11, click here.

For daily updates from the week of May 4, click here.

For daily updates from the week of April 27, click here.

For daily updates from the week of April 20, click here.

For daily updates from the week of April 13, click here.

For daily updates from the week of April 6, click here.

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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