Coronavirus Daily Update: The Early Impact of CMS’s Telehealth Expansion

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 (July 17-19):

— CMS is considering making the telehealth flexibilities and waivers the agency granted during the COVID-19 emergency permanent, Administrator Seema Verma wrote in a new Health Affairs op-ed. “With these transformative changes unleashed over the last several months, it’s hard to imagine merely reverting to the way things were before,” Verma noted. “As the country re-opens, CMS is reviewing the flexibilities the administration has introduced and their early impact on Medicare beneficiaries to inform whether these changes should be made a permanent part of the Medicare program.”

— The New York Times once again highlighted the shift toward in-home care to better address the coronavirus. In a story published Saturday, the newsroom took an inside look at Northwell Health’s in-home care strategy. “So-called wraparound home care services were created, on the fly, by Northwell Health to deal with the surge in coronavirus cases that New York experienced this spring,” New York Times reporter Roni Caryn Rabin wrote. “Now this model may help relieve health systems in the Sun Belt and other parts of the United States, where rising numbers of cases are putting extraordinary pressure on hospitals, filling intensive care units and sending providers scrambling to hire extra nurses and secure medical supplies.”

— Los Angeles Mayor Eric Garcetti told CNN’s Jake Tapper that he is on the “brink” of reissuing a stay-at-home order for the city. If more cities and states follow suit, it could lead to renewed patient anxieties around allowing home health clinicians into the home, a challenge many providers deal with this spring.

— The Medicare Payment Advisory Commission (MedPAC) released new data on the home health industry on Friday. Among the highlights: From 2018 to 2019, the number of home health agencies dropped by about 3.6%, a decrease of 427 individual providers.

— Home-based care providers who received loans under the Paycheck Protection Program could face unexpected expenses when it comes time to file their 2020 taxes. HHCN has the story here.

What you need to know from Thursday (July 16):

— The Trump Administration has made the U.S. Department of Health and Human Services (HHS) the new primary collector and overseer of COVID-19 data and information, removing those responsibilities from the CDC. The CDC has been tracking available hospital beds, hospitalizations, deaths and more since the beginning of the COVID-19 crisis. Some have expressed concerns over the fact that the nation’s top health agency would no longer be in charge of data collection. But others in the administration have said the CDC is not up for the job. “The CDC’s old data gathering operation once worked well monitoring hospital information across the country, but it’s an inadequate system today,” Michael Caputo, the HHS assistant secretary for public affairs, said in a statement shared with reporters.

— Around the same time as the COVID-19 crisis began spreading rapidly on U.S. soil, the Trump administration waived a requirement that required nurse’s aides to receive at least 75 hours of training. In lieu of that, prospective caregivers were now able to take an eight-hour course. Inexperienced workers could have played some part in the large case count and death toll in nursing homes across the country. “Working in nursing homes is complicated,” Jesse Martin, VP of the SEIU in Connecticut, told Politico. “You have PPE, you have infection control procedures. Putting someone brand new into the care setting with COVID is a recipe for disaster.”

— With COVID-19 ravaging the U.S. and causing historical unemployment levels, it was logical to expect increased enrollment in government programs such as Medicaid. But thus far, that hasn’t necessarily been the case. Medicaid enrollment grew just 5% on average from February to May, but that could be due to a lag in enrollment, Matt Salo, the executive director of the National Association of Medicaid Directors, told MedPage Today. “The pandemic is forcing social distancing not just in everyday life but in health care utilization, too.” Salo said.

— Speaking of unemployment, the U.S. Department of Labor released its latest unemployment statistics on Thursday. Another 1.3 million workers filed new unemployment claims last week, a testament to the persistent troubles that COVID-19 is causing the American economy.

— There were over 67,300 new COVID-19 cases reported Wednesday, according to the New York Times. That is the second-highest single-day total since the start of the public health emergency. Overall, the country has hit over 3.5 million total cases.

What you need to know from Wednesday (July 15):

— Last week, regulators announced they plan to proceed with the rollout of the Review Choice Demonstration (RCD), an initiative by CMS to reduce improper billing in the home health care industry. But restarting RCD will only place greater stress and administrative burden on providers already overwhelmed by the COVID-19 public health emergency, according to the Partnership for Quality Home Healthcare. “Proceeding with the Review Choice Demonstration in two states seeing some of the highest COVID-19 surge rates in the nation is ill-advised and could result in negative, unintended consequences impacting patient care. This is the last thing providers should be asked to manage at a time when many agencies are still struggling to navigate pandemic challenges,” Joanne Cunningham, executive director of PQHH, said in a statement. “We strongly urge CMS to institute an immediate pause on this policy announcement.”

— More than 15,000 home-based care providers nationwide received loans of less than $150,000 under the Paycheck Protection Program. Combined, those loans total more than $666 million, according to a new analysis by HHCN.

— In a special article in the July issue of JAMDA, leaders of The Society for Post-Acute and Long-Term Care Medicine presented five keys to solving the COVID-19 crisis that relate to policy, collaboration, individualization, leadership and reorganization.

— In Virginia, the state’s House appropriations chairman, Luke Torian, is intensifying pressure on Gov. Ralph Northam to use federal emergency coronavirus aid to provide hazard pay and other benefits to in-home care workers, reports the Richmond Times-Dispatch.

— The U.S. economy is headed for a likely difficult fall, reports The New York Times. Threats of school closures, new government lockdowns and more could reverse the economic progress the nation has made over the past four months in recovering from the initial spread of COVID-19.

What you need to know from Tuesday (July 14):

— The federal government on Tuesday announced that it will send point-of-care testing supplies for COVID-19 to all skilled nursing facilities in the country, starting next week. Skilled Nursing News has the details here. Home health providers have yet to receive federal assistance in securing COVID-19 testing supplies, with no signs of that changing anytime soon.

— It’s “way past time” for the federal government to provide more extensive long-term care coverage for a senior population that is swelling by the day, argues Max Richtman in a new op-ed. Richtman is the president and CEO of the National Committee to Preserve Social Security and Medicare. On the state level, Washington passed a law requiring residents to pay into a long-term care program in May 2019.

— The COVID-19 virus has made it more difficult to live with Parkinson’s disease, according to a recent survey of more than 7,000 people who have the disease or care for someone with it. Many home care agencies have launched specialized service lines aimed at providing care for individuals with Parkinson’s disease. USA Today has the highlights from the survey here.

— A new study out of the U.K. suggests that the coronavirus is having a profound impact on hospital utilization among certain critical populations. Specifically, a team of researchers found that the number of hospital admissions from heart attacks fell by 35% by the end of March compared to historic norms. Admissions with the most serious type of heart attack, caused by a complete blockage of an artery supplying part of the heart, fell by about 25%. These trends are likely playing out in the U.S., too, placing further importance on in-home heart care programs.

— Financial relief sent to home health care organizations and other providers has been helpful in stabilizing operations, but it’s making a major dent in the federal budget deficit. The federal government’s budget deficit soared to a monthly record of $864 billion in June, reports MarketWatch.

— Many big-name retailers across the nation have stopped paying their employees “hero pay,” despite surging virus numbers, reports The New York Times. Meanwhile, for the most part, in-home care agencies continue to do everything in their power to secure hazard pay for their front-line workers. The latest example: Excel Home Care.

What you need to know from Monday (July 13):

— Despite many suspecting that the first, most brutal wave of COVID-19 was over, hospitals in California are just now experiencing their worst surges, according to the LA Times. “I’m expecting things to go from bad to worse over at least the next couple of weeks,” Mary Lynn Briggs, an intensive care unit nurse at Mercy Hospital in Bakersfield, told the newspaper. Home-based care agencies have been at their best during the COVID-19 crisis when they’ve been able to ease the burden on hospitals and unload patients safely to make room.

— The American Health Care Association released a statement Monday suggesting the hasty re-opening of certain areas in the U.S. has put vulnerable populations at great risk. The association also reiterated that widespread testing, quick test results and adequate personal protective equipment was the best way to fight the virus. There is still a ways to go in those three areas, particularly in current hotspots like Florida.

— Former Democrat presidential candidate Amy Klobuchar wrote an op-ed focusing on the toll that COVID-19 has taken on the senior population. She also announced that she will be putting forth legislation to increase telehealth usage in Minnesota moving forward. “I am leading bipartisan legislation in the Senate that would further enhance telehealth and other virtual services in skilled nursing facilities,” Klobuchar wrote. “My bill would provide funding to expand the use of telehealth services, and help nursing facilities get technology to support virtual visits to help seniors stay connected.”

— Given all the troubles that nursing homes have experienced during the COVID-19 crisis, some have begun to wonder whether nursing homes — as they currently exist — should be defunded. “Despite the $90 billion paid annually by Medicare and Medicaid to nursing homes, and exacting regulatory requirements addressing quality of care and quality of life for the nation’s 1.3 million nursing home residents, we as a society have failed to keep frail elders safe — let alone in an environment that older adults look forward to residing in,” Charles Sabatino, director of the American Bar Association Commission on Law and Aging, wrote in a new op-ed. Sabatino suggests that it is time for a different and new model. If the nursing home model collapses, home-based care providers likely stand to benefit.

— President Donland Trump’s advisers are reportedly looking to undercut Dr. Anthony Fauci, who has gained fame as the nation’s top infectious disease expert in the last several months. Fauci has become more outspoken over concerns in surges across the country and recently said he lacks access to the president. There were reports that the Trump administration was pointing to some of the comments Fauci made earlier in the year to discredit him, yet White House Press Secretary Kayleigh McEnany denied that on Monday.

— Families of health care workers killed by COVID-19 have been denied workers’ compensation benefits, according to Kaiser Health News. Without the help, families are being left behind without their loved ones and also without the primary incomes they once had. Data from the CDC shows that nearly 100,000 health care workers have been infected — a figure that is almost certainly lower than the real number.

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

For daily updates from the week of June 29, click here.

For daily updates from the week of June 22, click here.

For daily updates from the week of June 15, click 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.