News

Beginning April 1, HUD-assisted properties enrolled in HUD's NSPIRE Demonstration program will switch from receiving "advisory" housing safety inspections to receiving "inspections of record." HUD's NSPIRE Demonstration program has been running since 2019 as a pilot to test the agency's new physical inspection standards and scoring through HUD REAC. Because the new NSPIRE safety standards and scoring have not yet been finalized, the pilot program was conducting advisory-only inspections. HUD's Jan. 25 announcement states that the demonstration program will switch to inspections of record for NSPIRE Demonstration inspections conducted between April 1 and Sept. 30, 2023, after which HUD plans to end the demonstration and fully implement NSPIRE for all applicable properties. Properties who want to opt out of the demonstration program because of the change to scored inspections must do so by submitting a request via email to NSPIRE-Demo-Opt-Out@hud.gov. HUD's announcement is available here. LeadingAge national will host a discussion about HUD's announcement during their next monthly workgroup meeting on HUD Oversight and Compliance (Feb. 23, 1-2 p.m.). Please reach out to Juliana (jbilowich@leadingage.org) for more info.

The January 2023 quarterly refresh for the Home Health Quality Reporting Program is now available on Care Compare. For this refresh, Home Health (HH) Outcome and Assessment Information Set (OASIS) will be based on the standard number of quarters.

The CDC has new resources to assist nursing homes with implementation of enhanced barrier precautions. Recall that enhanced barrier precautions are an accepted standard of care, referenced by the Centers for Medicare and Medicaid Services (CMS) in the updated RoPs guidance on infection control effective Oct. 2022, that may be implemented in the nursing home to protect residents from the threat of multidrug-resistant organisms (MDROs). CDC hosted a continuing education webinar on Nov. 15. The video recording of this webinar is available here and the slides are available here. CDC has also shared the following tools: o Pre-Implementation Tool - Enhanced Barrier Precautions: https://www.cdc.gov/hai/pdfs/containment/Pre-Implementation-Tool-for-Enhanced-Barrier-Precautions-508.pdf o Observations Tool - Enhanced Barrier Precautions Implementation: https://www.cdc.gov/hai/pdfs/containment/Observations-Tool-for-Enhanced-Barrier-Precautions-Implementation-508.pdf o Observations Tool Summary Spreadsheet: https://www.cdc.gov/hai/excel/containment/Spreadsheet-to-Capture-and-Summarize-EBP-Observations.xlsx o Enhanced Barrier Precautions Letter to Nursing Home Leadership: https://www.cdc.gov/hai/pdfs/containment/Enhanced-Barrier-Precautions-Letter-for-Nursing-Home-Leadership-508.pdf

The DHS Office of Long-Term Living (OLTL) sent out the “NF Quality Incentive Learning Network Attestation” form earlier this month via the OLTL NF listserv. Click here to download the form which must be completed and submitted to RA-PWNFLNATTEST@pa.gov by Jan. 31 for sessions attended in 2022. Facilities must attest that one or more of their employees attended at least one Learning Network session during 2022 to be eligible for payment from the state’s Nursing Facility Quality Incentive Program.

On Jan. 25, the Department of Human Services (DHS) sent a listserv announcement clarifying the recent increase to the Personal Care Home (PCH) Supplement for PCH residents currently receiving Supplemental Security Income (SSI) or currently meeting SSI disability and income criteria while applying for SSI. Review the listserv announcement for information on the increase amount, retroactive payment status, and how to calculate a resident’s monthly income. Questions about the status of individual retroactive and/or monthly SSI and PCH Supplement payments can be addressed by calling SSA at 1-800-772-1216. Additional questions about the application of the retroactive PCH Supplement increase can be directed to ra-pwarlheadquarters@pa.gov. For information about applying for SSI and or the PCH Supplement, please contact your local Area Agency on Aging.

All three Medicare Administrative Contractors (MAC), NGS, CGS, and Palmetto, notified providers that CMS reactivated Reason Code (RC) 31755 effective Jan. 3 and some HH claims from January 2022 are being returned to providers due to billing errors associated with an artificial admission date not matching the 0023 revenue code line. Providers are advised to enter the date of the first covered visit during the period with Revenue Code 0023. For subsequent periods, providers are advised to report the date of the first visit during the period, regardless of whether the visit was covered or not covered.

The U.S. Dept. of Housing and Urban Development (HUD) announced that it will publish a Notice of Proposed Rulemaking in the Federal Register to update the agency’s Affirmatively Furthering Fair Housing rule. The proposed rule will implement the Fair Housing Act’s affirmatively furthering fair housing mandate, which directs the government to promote fair housing choice, eliminate disparities in housing, and foster inclusive communities. In particular, the proposed rule is designed to simplify the required fair housing analysis, emphasize goal-setting, increase transparency for public review and comment, foster local commitment to addressing fair housing issues, enhance HUD technical assistance to local communities, and provide mechanisms for regular program evaluation and greater accountability, among other changes.

The Hospice Quarterly Update for the fourth quarter of 2022 is now available.

The Centers for Disease Control and Prevention (CDC) has released two new dashboards for tracking respiratory disease including COVID-19, flu, and RSV. The Respiratory Virus Hospitalization Surveillance Network (RESP-NET) interactive dashboard is updated weekly and can be used to follow trends and see comparisons of COVID-19, influenza, and RSV-associated hospitalization rates in different demographic groups including by age, sex, race and ethnicity, and across seasons. A second dashboard provides a view of emergency department visit data for multiple respiratory diseases tracked by the National Syndromic Surveillance Program (NSSP). These dashboards will prove useful to providers implementing infection control surveillance systems and in determining appropriate infection prevention and control strategies based on the prevalence of these respiratory infections in the surrounding community.

CMS released the Hospice Quality Reported Program 2022 Information Gathering Reporting. This report provides information from literature reviews and expert interviews that supports expansion of the hospice quality reporting program.

As we shared in November, PA Health & Wellness had previously been extending some flexibility in meeting the requirements for their Quality Incentive Program (QIP) but for the next quarter would no longer offer these flexibilities. We reported that if the correct information was not submitted, as few as 20% of our members would receive the incentive for the next quarter based on the status of submissions as of November. We are happy to report that in the most recent quarter, even without the previous flexibilities applied, 67% of participating LeadingAge PA members were able to take action and qualified for the QIP. As a reminder, the three elements that must be satisfied to qualify involve submitting timely census information, providing EMR access, and completing a Learning Network training (click here to register for the next Learning Network training coming up on Feb. 2; you must include your NPI number when registering to receive credit for attending). If you are unsure if your community qualified for the most recent quarter, or have additional questions, reach out to Director of Regulatory Affairs Anna Warheit.

During office hours hosted this week, LeadingAge national provided an overview of COVID-19 supplemental payments (CSPs) and a review of their FAQs with the latest info from HUD. The deadline to request reimbursement through HUD for COVID-19 expenses is Feb. 22 for expenditures completed or committed by Jan. 31.

The skilled nursing facility (SNF) Provider Preview Reports are now available for review. The data contained within the Preview Reports are based on quality assessment data submitted by SNFs from Quarter 3, 2021 through Quarter 2, 2022. Additionally, the CDCs COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) measure reflects data from Quarter 2, 2022. The data for the claims-based measures will display data from Quarter 3, 2019 through Quarter 4, 2019 and Quarter 3, 2020 through Quarter 2, 2021 for this refresh, and for the SNF Healthcare-Associated Infections (HAI) measure, from Quarter 4, 2020 through Quarter 3, 2021. Providers have until Feb. 16, 2023 to review and request changes on performance data. Corrections to the underlying data will not be permitted during this time. However, providers can request CMS review of their data during the preview period if they believe the quality measure scores that are displayed within their Preview Reports are inaccurate. Separately, providers can make changes to data submitted for Quarter 4, 2022. Providers have until February 16 to review and make changes to this data. Providers will not be able to make changes to Quarter 4 2022 data after February 16.

For more information about the Quality Incentive Program (QIP) or Value Based Program (VBP) offered by each MCO and the state, view the below resources to ensure your community is qualifying for all incentives you are eligible for: PA Health & Wellness (PHW): See this memo that PHW sent out in December regarding their eligibility requirements. You can also reach out to your assigned Provider Network Specialist. If you are unsure of who your Provider Network Specialist is, reach out to PHWProviderRelations@pahealthwellness.com to be connected UPMC: View this powerpoint UPMC presented to nursing facilities announcing their program in December and this announcement with detailed attachments that was sent to providers in November o Amerihealth Caritas: Visit the Value-Based Program page on Amerihealth Caritas’ website and view the Program Manual for more detail DHS – Office of Long-Term Living: OLTL sent out the “NF Quality Incentive Learning Network Attestation” form earlier this month via the OLTL NF listserv. Click here to download the form which must be completed and submitted to RA-PWNFLNATTEST@pa.gov by Jan. 31 for sessions attended in 2022. Facilities must attest that one or more of their employees attended at least one Learning Network session during 2022 to be eligible for payment from the Nursing Facility Quality Incentive Program.

LeadingAge PA’s government affairs team met with representatives from the UPMC Community HealthChoices (CHC) Managed Care Organization (MCO) and Community Care Behavioral Health (CCBH) on Jan. 25 to discuss issues with services coordination for CHC participants living in nursing facilities who have behavioral health (BH) needs. Some potential solutions were discussed, but UPMC and CCBH both feel they need more direct input from providers to help them understand the issues better in order to make true improvements. If you have feedback and specific stories related to your experiences obtaining BH services for your residents (both successes and shortfalls!), please send them to Director of Regulatory Affairs Anna Warheit. Your firsthand accounts and specific examples of the challenges you’re facing will go a long way in helping these organizations improve the responsiveness and support you receive. LeadingAge PA will be discussing the issues with PA Health & Wellness and Amerihealth Caritas at upcoming meetings as well.

Each year, the Pennsylvania Department of Human Services’ Bureau of Human Services Licensing (BHSL) provides approximately 500 hours of training for PCH and ALR administrators and staff. To help shape and maximize the impact of these training programs, BHSL is asking for participation in completing a 10-question survey; click here to complete the survey. This survey is intended only for administrators and staff of a licensed PCH/ALR and will be available until Feb. 28. Questions can be directed to ra-pwarlheadquarters@pa.gov.

On Jan. 20, DHS sent a listserv announcement sharing reminders for Personal Care Home (PCH) and Assisted Living Residence (ALR) providers related to the lifting of suspension of various regulatory provisions that were in place during the state disaster emergency declaration. The suspensions expired on Nov. 1, 2022, requiring providers to again be in compliance with the full regulatory requirements of 55. PA Code Chapter 2600 (PCH) and 55. PA Code Chapter 2800 (ALR). Some of the suspensions included a 90-day grace period for facilities to fully comply. That 90-day period will come to an end on Jan. 30, and facilities are expected to be able to demonstrate compliance with these regulations beginning Jan. 31, 2023. Please view this Guidance Document for a list of all applicable regulations that were suspended under the emergency declaration, the dates and details of the suspensions, and clarification on what providers can expect when compliance is being measured in their facilities. You can also view the full listserv announcement for details on how timing of annual training requirements will be assessed. Questions about this announcement and the attached guidance can be directed to ra-pwarlheadquarters@pa.gov.

CMS published the first nursing home related QSO memo of 2023 on Jan. 18. QSO-23-05-NH outlines CMSs new initiative that involves conducting off-site audits of the Minimum Data Set (MDS) to identify potentially inaccurate coding of schizophrenia diagnoses. The memo also says that CMS will begin publicly reporting nursing home citations under dispute. You can read a full article on the memo here.

CMS is planning to issue a proposed rule to establish national minimum staffing levels for nursing homes. In PA, imposition of a Federal requirement could undo the work that was done in 2022 by LeadingAge PA to mitigate the 4.1 Nursing Hours Per Patient Day (NHPPD) staffing minimums proposed by the PA Dept. of Health. Please join us in taking action by sending an email and sharing your community’s perspective to CMS Administrator Chiquita Brooks-LaSure expressing your opposition of a staffing ratios mandate without the necessary workforce investments and reimbursement levels. Take Action here!

On Jan. 24, U.S. Representatives Brett Guthrie (KY-02) and Madeleine Dean (PA-04) led the reintroduction of the Building America’s Health Care Workforce Act with 19 of their bipartisan colleagues. This bill would extend the temporary nursing assistant (TNA) waiver flexibilities for 24 months following the end of the COVID Public Health Emergency (PHE). Although we anticipate the PHE to end in the next few months, the demand for staffing will continue long after that. If enacted, this bill would allow TNAs to continue in their current roles and put their on-the-job experience and training toward the 75-hour CNA training requirement. It would maintain patient safety protections by requiring competency evaluations that assess TNAs on a variety of factors, including interpersonal skills, performing basic nursing skills, personal care skills, and mental health and social service needs. It would also allow continuity of care for nursing home residents so they can retain their direct caregivers who have been by their side throughout the pandemic. The bill text can be found here. LeadingAge PA will be launching a call to action once the bill is officially assigned a number.