AHCA: COVID-19 Update #31 - CMS Releases Recommendations to Nursing Homes

Carl J. Pucci and Jackie Pappalardi in Clinical & Quality, Finance & Reimbursement

In This COVID-19 Update:

  • CMS Releases Additional Recommendations to Nursing Homes
  • FAQs - Alignment of Isolation Waivers, MDS, and Payment Policies 
  • WPS Posts Updated Accelerated Payment Request Form

CMS Issues New Recommendations to Nursing Homes, State & Local Governments

Late yesterday (Thursday, April 2), the Centers for Medicare & Medicaid Services (CMS), in consultation with the Centers for Disease Control and Prevention (CDC), issued new recommendations to state and local governments, as well as nursing homes, to help mitigate the spread of COVID-19 in nursing homes.

The recommendations announced last night include:

  • Nursing homes should immediately ensure that they are complying with all CMS and CDC guidance related to infection control, particularly focusing on consistent hand washing and changing and removing of PPE based on preliminary data from infection control focused surveys. 
  • CMS/CDC urges State and local leaders to consider the needs of long term care facilities with respect to supplies of PPE and COVID-19 tests.
    • Medicare is now covering COVID-19 testing when furnished to eligible beneficiaries by certified laboratories.  These laboratories may also choose to enter facilities to conduct COVID-19 testing. 
  • Nursing homes should immediately implement symptom screening for all staff, residents, and visitors – including temperature checks.
    • An exception to this is Emergency Medical Service (EMS) workers responding to an urgent medical need. They do not have to be screened, as they are typically screened separately.
    • Facilities should limit access points and ensure that all accessible entrances have a screening station. 
    • Patients and residents who enter facilities should be screened for COVID-19 through testing, if available.
      • This new guidance can be provided to get the hospitalized patient tested before admission to the nursing home. 
  • Nursing homes should ensure all staff are using appropriate PPE when they are interacting with patients and residents, to the extent PPE is available and per CDC guidance on conservation of PPE. The recommendations provide NEW detail on steps to take including:
    • All long-term care facility personnel in the country should wear a facemask while they are in the facility.
    • Full PPE should be worn per CDC guidelines for the care of any resident with known or suspected COVID-19 per CDC guidance on conservation of PPE. 
  • To avoid transmission within nursing homes, facilities should use separate staffing teams for residents to the best of their ability, and the administration urges nursing homes to work 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. The recommendations provide detail on steps to take.   

FAQs - Alignment of Isolation Waivers, MDS, and Payment Policies

AHCA has developed a FAQ document to help providers navigate how the various CDC and CMS COVID-19 guidance and Section 1135 waivers interact with current MDS-RAI coding guidance and payment models in SNFs, specific to situations where it is determined that a resident requires isolation related to the COVID-19 virus. This guidance is intended to provide context to help guide provider decisions and will be updated as necessary as new government policies and guidance are issued.

WPS Posts Updated Accelerated Payment Request Form

On March 31, AHCA posted an Accelerated and Advanced Payments FAQ document that described the simplified process for providers to request accelerated payments to help with cash-flow during the next three months. The document included direct links to the MAC webpages where request forms could be completed, and submission instructions were detailed.

At the time, the Wisconsin Physician Services (WPS) J5 and J8 contractor sites did not have the COVID-19 related forms posted. Go to the updated WPS Medicare Part A Jurisdiction 5 and Jurisdiction 8 accelerated payment requests pages.

Please email COVID19@ahca.org for additional questions, or visit ahcancal.org/coronavirus for more information.


Carl J. Pucci
Chief Financial Officer
518-462-4800 x36

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16