Here are some home health related updates for this week: AMITY’S NEWS
Amity Healthcare Group Consulting Services
Amity Healthcare Group is providing continuous support to home health providers. We have been closely monitoring the events and information associated with COVID -19 vaccination mandates. If you need assistance with developing Policies & Procedures related to Mandatory COVID-19 Vaccination Requirements, please call 303-690-2749 or email at ig@amityhealthcaregroup.com
We also provide assistance with:
- Medicare Certification/Accreditation Survey preparation
- Regulatory and clinical compliance review
- QAPI implementation and analysis
- Emergency Preparedness
Do not forget to schedule your in-person and/or virtual competencies at https://amityhealthcaregroup.com/virtual-nursing-competency/
Home Care and Hospice Association of Colorado Annual Conference
Join Irina Gorovaya, Owner and President of Amity Healthcare Group, for a presentation on Practical Guide to Home Health Competency Program at Home Care and Hospice Association of Colorado Annual Conference in beautiful Keystone, Colorado on October 11, 2021 from 2:15-3:15 pm.
Don’t forget to stop by our booth and meet Amity Healthcare Group team.
We are looking forward to seeing you!
NATIONAL NEWS
COVID-19 Provider Funding- Phase 4
In our September 17th issue, we informed you of the Provider Relief Fund Phase 4. Just a quick reminder that the application portal for PRF Phase 4 opened on September 29, 2021 and will be open for a period of four weeks. Providers must submit their completed application by October 26, 2021 at 11:59 PM ET.
Please also note that providers who have previously created an account in the Provider Relief Fund Application and Attestation Portal and have NOT logged in for more than 90 days will need to first reset their password before starting a new application.
In addition, Health Resources and Services Administration (HRSA) will be hosting webinar sessions for Phase 4 and ARP Rural applicants, featuring guidance on how to navigate the application portal.
- Tuesday, October 5, 3:00 – 4:00 p.m. ET – register to attend
- Two additional webinars will be available during the weeks of October 11th and 18th (dates, times, and registration details to be available at a later time)
The Department of Health and Human Services has also recently hosted a briefing session to provide information about these upcoming funding opportunities – view the video.
For more information about eligibility requirements, the documents and information providers will need to complete their application, and the application process for PRF Phase 4 and ARP Rural payments, visit: https://www.hrsa.gov/provider-relief/future-payments.
OIG, Home Health Agency Infection Control and More…
Office of the Inspector General (OIG) completed an audit of eight home health agencies (HHAs) on infection control policies and procedures to assure that they met the standards set by the Centers for Medicare & Medicaid Services (CMS) and followed CMS COVID-19 guidance to safeguard patients, caregivers, and staff during the coronavirus pandemic. The focus of the review was to assure that policies and procedures included the following:
(1) guidance for following standards of practice,
(2) a coordinated agencywide infection control program, and
(3) infection control education for HHA staff, Medicare beneficiaries, and caregivers.
Additional review was completed to determine whether the agencies followed CMS COVID-19 guidance for:
(1) screening patients,
(2) screening staff, and
(3) treating patients with known or suspected COVID-19.
As the selection of the eight agencies for the audit was based on a judgmental sample (the agencies were chosen because they were cited for infection prevention and control deficiencies during surveys conducted in 2019 and 2020), the results cannot be projected to HHA providers not included in the sample.
With that said, the OIG was able to provide some potential best practices identified as part of the audit (please see below):
Recommendation for Screening Staff for COVID-19
- Having policies and procedures that require daily COVID-19 screenings for staff conducted and documented prior to starting the workday to assess for symptoms, possible exposure, and recent travel.
- Using a variety of methods to instruct staff on the appropriate actions to take if they develop symptoms or are exposed to a person with known or suspected COVID-19.
Recommendations for Caring for Patients with Known or Suspected COVID-19
- Having policies and procedures for using PPE while treating patients during the COVID-19 pandemic
- Using a variety of tools to instruct staff on using PPE properly.
- Updating infection control education for staff, patients, and caregivers to be consistent with the latest guidance from CMS and CDC.
Recommendations for Screening Patients for COVID-19
- Having policies and procedures that require COVID-19 screening for patients and caregivers prior to a visit to assess for symptoms, possible exposure, and recent travel.
- Utilizing a variety of tools to document patient screening – policies and procedures, COVID-19 exposure decision trees, and reporting systems to record symptoms and infections and track actions taken by staff to safeguard the patient.
CMS concurred with the OIG’s recommendation to develop and share with the HHA industry information on COVID-19 infection prevention and control best practices that HHA providers can use to comply with CMS requirements and follow CMS guidance.
As of a special note is the data that was shared on the number of Medicare home health claims submitted with a primary diagnosis of COVID-19 in 2020. During 2020, 4,854 HHA providers submitted 79,131 Medicare claims with a COVID-19 principal diagnosis code for 54,849 beneficiaries from 54 States and U.S. Territories.
COLORADO NEWS
Rocky Mountain Human Services- Provider Town Hall Meeting is Today!!!
If you got this email on time, you still may be able to join the Provider Town Hall Meeting that will be held by Rocky Mountain Human Services Single Entry Point today, Friday-October 1, 2021 at 9:30 am.
The topics of discussion will include:
- Updates to RMHS
- New Care and Case Management System
- A new contact center at RMHS
- Helpful information for assessments and service plan
- IHSS process
- Q&A
To participate, please log in at 9:30 am to https://mailchi.mp/bc24c8b89a4a/our-town-hall-series-continues-5646557?e=e312e8000e
The COVID-19 Vaccination Mandates- Reporting and Waivers
- Reporting:
Please remember that October 1, 2021 is the first due date for COVID-19 Vaccination Reporting.
CDPHE announced that COVID-19 Vaccination Reporting function is now available in the Colorado Health Facilities Interactive (COHFI) portal. The application is similar to the Flu Vaccination Reporting function.
Currently, only COHFI Account Managers will be able to access the COVID Vaccination Reporting application. If you do not have the Manage Users button next the facility name, you will not be able to submit the report. CDPHE is working to add the functionality of being able to assign that role to facility users.
Submitting your facility’s COVID Vaccination Report:
Sign into COHFI, select the facility you would like to submit a report for, in the top navigation menu select Vaccination Reporting and then COVID Vaccination Reporting. Complete the form and select the Submit Vaccination Report button. A detailed guide will be available in the User Manual.
Publishing the reports:
All reports will be published publicly. CDPHE is working on building the dashboard to publish the reports.
- Waiver
Please note that waiver application is now available for submission to CDPHE. Mandatory Vaccination Waiver Application Form is only applicable if your agency cannot meet the 100% COVID-19 vaccination rate requirement for employees, direct contactors and support staff due to RELIGIOUS EXEMPTION ONLY. If the 100% COVID-19 vaccination rate cannot be met due to medical exemptions only, a waiver request is not necessary.
The waiver form can be found at: file:///C:/Users/eduar/AppData/Local/Temp/Mandatory%20Vaccination%20Waiver%20Application%20Form%20FINAL%2009.17.21.pdf
The completed Mandatory Vaccination Waiver Application Form can be sent to:
E-mail: covid_waivers@state.co.us
OR
Fax: 303-756-3973 (On cover sheet, please send to the attention of: Waiver Intake)
Private Duty Nursing and Pediatric Long-Term Home Health PARs
- PDN: Group Rate Billing for Private Duty Nursing (PDN)
HCPF issued a reminder related to group rate billing for PDN.
Skilled nursing services under private duty nursing (PDN) shall be reimbursed in units of one hour, at the provider’s usual and customary charge or the maximum Medicaid allowable rates established by the Department, whichever is less, per 10 CCR 2505- 10, Section 8.540.8.E. Units of one hour may be billed for registered nurse (RN), licensed practical nurse (LPN), RN group rate (registered nurse providing PDN to more than one member at the same time in the same setting), LPN group rate (licensed practical nurse providing PDN to more than one client at the same time in the same setting) or blended RN/LPN rate (group rate by request of the home health agency only).
Home health providers are reminded to use applicable group codes when an RN or LPN in their employ is serving more than one member at the same time in the same setting, regardless of whether a home health provider has only one member in their care for purposes of billing. Claims which are found to be inconsistent with this policy may be subject to recovery. If a provider believes they have violated this policy, they may contact the Department’s Program Integrity unit to begin the process of self-disclosure. For more information, visit the Provider Self-Disclosure web page.
Contact Matthew Colussi at Matthew.Colussi@state.co.us for any questions regarding this policy
- Private Duty Nursing (PDN) and Pediatric Long-Term Home Health (PLTHH) Providers: Prior Authorization Request (PAR) Requirement Re-start Delay
Prior authorization request (PAR) requirements were suspended for private duty nursing (PDN)and pediatric long-term home health (PLTHH) on July 1, 2020. PAR submission will not resume until November 1, 2021. Effective November 1, 2021, providers will be required to submit PARs to the new utilization management (UM) vendor Kepro via the online PAR portal, Atrezzo. A phased-in approach of at least six months has been agreed upon but a longer phased-in implementation is currently being evaluated. Providers will be responsible for submitting a percentage of their PARs throughout the month for each phase of implementation, and providers will be responsible for deciding how to organize PAR submissions. Additional guidance regarding the implementation plan and timeline will be provided via the provider bulletin, the PDN/PLTHH Project web page and the ColoradoPAR Program web page. The Department will:
- Issue a 60-day administrative approval prior to any denial going into effect
• Issue continuation of benefits for any member appeal as normal
• Step down process for PDN denial that reduce services by 30% or more will continue as normal
• Send weekly reports to Regional Accountable Entities (RAEs) of any denials to allow for
care coordination
Provider Training
Recorded benefit-specific training sessions for PDN and PLTHH will be available on the Kepro Provider Training Information web page prior to November 1, 2021. Provider training information updates will be posted on the ColoradoPAR Program web page. PDN and PLTHH providers are required by the Department to watch recorded Atrezzo provider portal training videos and PDN or PLTHH benefit-specific training prior to submitting a PAR for PDN or PLTHH services.
For additional information and links to the referenced videos, please review October Provider Bulletin at: https://hcpf.colorado.gov/sites/hcpf/files/Bulletin_1021_B2100469.pdf
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Thank you,
Irina Gorovaya, RN BSN, MBA
Amity Healthcare Group, LLC
Home Health Consulting, Education and Outsourcing Services
720-353-7249 (cell) 303-690-2749 (office) 720-398-6200 (fax)