NIC Notes

Insights in Seniors Housing & Care

By: Bill Kauffman  |  March 27, 2020

Summary of CMS and Policy Actions Taken for the Coronavirus Crisis

Regulatory Environment  |  Skilled Nursing

The Centers for Medicare and Medicaid Services (CMS) have taken numerous actions in response to the coronavirus pandemic. Importantly, some are actions to assist with continued access to care and many to ensure the safety of residents and staff. Initial responses included restricting visitors to skilled nursing facilities and changing the rules for covered facility stays. Patients who remain in the hospital fewer than three days may now receive Medicare-reimbursed skilled nursing care. The following are the summaries and links to CMS for further details. 

CMS Approves 12 Additional State Medicaid Waivers to Give States Flexibility to Address the Coronavirus Disease 2019 (COVID-19)

CMS approved an additional 10 state Medicaid waiver requests, bringing the total number of approved waivers for states to 23. The waivers offer states new flexibilities to focus their resources on combatting the outbreak and providing the best possible care to Medicaid beneficiaries in their states.

In addition, CMS also approved one additional Appendix K Amendments request to existing Home and Community Based Services (HCBS) Waivers under Section 1915 (c) of the Social Security Act (Act), bringing the total to 3 approved waivers to date. Appendix K is a tool states may use to temporarily modify approved HCBS Waivers during emergency situations.

https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/index.html  

https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/hcbs/appendix-k/index.html

New Guidance Regarding Enhanced Medicaid Funding for States – Federal Medical Assistance Percentage (FMAP)

CMS has released new guidance under the Families First Coronavirus Response Act that provides states with more federal Medicaid funding during the COVID-19 pandemic. This includes a 6.2 percentage point FMAP increase which all states are eligible for provided they meet certain requirements. This is effective beginning January 1, 2020 and extending through the last day of the quarter in which the public health emergency declared by the Secretary of Health and Human Services for COVID-19 ends.

https://www.medicaid.gov/state-resource-center/downloads/covid-19-section-6008-faqs.pdf

CMS is Prioritizing and Suspending Certain Surveys

CMS is prioritizing surveys by authorizing modification of timetables and deadlines for the performance of certain required activities, delaying revisit surveys, and generally exercising enforcement discretion for three weeks. During the three week time period, only the following surveys will be prioritized and conducted:

  1. Complaint/facility-reported incident survey
  2. Targeted Infection Control Survey
  3. Self-assessments

https://www.cms.gov/files/document/qso-20-20-allpdf.pdf

CMS is Expanding Telehealth Benefits

CMS is expanding Medicare’s telehealth benefits under the Coronavirus Preparedness and Response Supplemental Appropriations Act. Beneficiaries will be able to receive telehealth services in any healthcare facility including a physician’s office, hospital, nursing home or rural health clinic, as well as from their homes. Considering the safety of residents and the need to continue physician care within nursing homes, telehealth will enable care to still take place in addition to mitigating COVID-19 infection.

https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak

Coronavirus Stimulus Bill Includes $200M for Nursing Home Infection-Control Efforts

Given the fact that CMS has made infection control a priority for nursing and current surveys of nursing homes, this bill will put additional support behind the current efforts of CMS to help ensure the safety of nursing home residents and staff. In addition, this is targeted to help the states' efforts to prevent the spread of the virus.

https://www.appropriations.senate.gov/imo/media/doc/Coronavirus%20Supplemental%20Appropriations%20Summary_FINAL.pdf

About Bill Kauffman

Senior Principal Bill Kauffman works with the research team in providing research and analysis in various areas including sales transactions and skilled nursing. He has lead roles in creating new and enhanced products and implementation of new processes. Prior to joining NIC he worked at Shelter Development in investing/acquiring, financing, and asset management for over $1 billion in assets. He also had key roles in the value creation and strategic planning and analysis for over 65 entities. He received his Master of Science in Finance from Loyola University Maryland and holds the Chartered Financial Analyst Designation (CFA).

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