The Centers for Medicare & Medicaid Services (“CMS”) and the Centers for Disease Control and Prevention (“CDC”) recently issued new recommendations to state and local governments and skilled nursing facilities (“facility”) to help mitigate the spread of COVID-19. Two states also recently announced they will pay facilities a premium to identify as COVID-only facilities.
CMS and CDC Recommendations
CMS and CDC are recommending the following immediate actions to keep patients and residents safe which include working with state and local leaders to designate separate facilities or units within a facility to separate COVID-19 negative residents from COVID-19 positive residents and individuals with unknown COVID-19 status.
CMS and CDC emphasized that any COVID-19-positive facilities must:
- Be capable of maintaining strict infection control practices and testing protocols, as required by regulation;
- Exercise consistent assignment of residents and have separate staffing teams for COVID‑19-positive and COVID-19-negative patients;
- Have the capacity, staffing, and infrastructure to manage higher intensity patients, including ventilator management; and
- Inform residents and their families of limitations of their ability to leave and re-enter the facility, as well as any requirements and procedures for placement in alternative facilities for COVID-19-positive or unknown status.
Advantages
- State Incentives
The Connecticut Department of Social Services recently announced that it will pay a $600 per diem for COVID-19 presumptive residents of: (1) currently operating facilities that are designated as COVID-only; and (2) reopened entities that are designated as COVID-only. Connecticut will also pay the actual costs of deep cleaning and other restoration of the physical plant, as well as pay a negotiated transition per diem rate for a limited period of time.
In Indiana, the Indiana State Department of Health and the Indiana Family and Social Services Administration announced that COVID-19 dedicated facilities will receive a 50 percent increase to the current average nursing facility rate of $215.36.
In Maine, the Maine Department of Health and Humans Services is providing additional payments to support facilities’ efforts related to infection control and visitor screening to protect workers and the residents in their care.
- Centralization of Personal Protective Equipment (“PPE”)
The CMS and CDC have directed state agencies to ensure designed COVID-only facilities have adequate staff supplies and PPE.
- Develop COVID-19 best practices and COVID-19 care experts in a single facility
COVID-only facilities will have a platform to develop practices and procedures regarding deliveries and operations that, with training and repetition should lead to reduced errors as facilities develop staff that become experts.
Challenges
- Staffing
Some staff may be reluctant or refuse to work in a COVID-only facility.
- Resident and Families
Some residents and families may not want to be transferred to the COVID-only facility. If transforming an existing facility to become a COVID-only facility, residents and families may resist being relocated due to family proximity and stress caused to residents.
- Insurance
Facilities will need to work with their insurance providers to confirm that insurance policies cover this type of specialty facility.
Practical Takeaways
- Providers with multiple facilities in areas with growing COVID-19 cases may consider identifying one facility as a COVID-only facility to optimize PPE and staff availability.
- The financial incentives available may help facilities compensate and retain staff.
- Providers should consider family reactions and concerns regarding moving their loved ones.
- Providers should interact with their State regulatory authority to coordinate resident relocations.
If you have questions or would like additional information about this topic, please contact:
- Sean Fahey at (317) 977-1472 or sfahey@wp.hallrender.com;
- Todd Selby at (317) 977-1440 or tselby@wp.hallrender.com;
- Brian Jent at (317) 977-1402 or bjent@wp.hallrender.com; or
- Your regular Hall Render attorney.
More information about Hall Render’s Post-Acute and Long-Term Care services can be found here.
Hall Render’s attorneys and professionals continue to maintain the most up-to-date information and resources at our COVID-19 Resource page, through our 24/7 COVID‑19 Hotline at (317) 429-3900, or your regular Hall Render attorney.
Hall Render blog posts and articles are intended for informational purposes only. For ethical reasons, Hall Render attorneys cannot—outside of an attorney-client relationship—answer specific questions that would be legal advice.
