News

As we noted in last week’s newsletter, new CMS criteria for what triggers focused infection control (FIC) surveys in nursing homes will have the effect of reducing the volume and frequency of FIC surveys for many care centers. The Minnesota Department of Health (MDH) signaled this week that these changes may free up enough time for surveyors to resume standard recertification surveys. MDH did not say definitively that it plans to do this, or identify any concrete timeline, but they told us they are exploring it.

Minnesota’s 2021 legislative session began Tuesday at noon, but thanks to the record seven special sessions held from June through December, it feels like the 2020 session never really ended.

CMS issued a revised memo QSO-20-31-ALL-REVISED on Jan. 4 detailing new triggers for focused infection control (FIC) surveys. In addition to the two triggers previously identified, CMS has added 5 additional scenarios that will be used to help state survey agencies more narrowly target FIC surveys. The new criteria are effective immediately and will have the effect of reducing the volume of FIC surveys for many providers.

LeadingAge Minnesota received information this week from the Minnesota Department of Health (MDH) about the status of implementation of monoclonal antibody therapies for COVID-19, and we wanted to share the lates with members.

On Monday evening, the Congress passed a $900 billion COVID-19 relief package that includes provisions that provide some additional assistance to long-term care providers. However, last night President Trump threatened to derail the bill and called on Congress to send a more suitable bill or wait until the next administration to deliver a COVID relief package.

On Monday, the Minnesota Department of Health (MDH) published Proposed Rules and Notice of Hearing in the State Register. This effectively begins the formal public comment period on the proposed rules that will govern licensed assisted living settings after Aug. 1, 2021.  This is a significant advocacy opportunity for LeadingAge Minnesota members, as the process invites the public to weigh in on the rules and express support or concerns.

Legislature Adjourns without Bridge Funding for LTC COVID-19 Response

The Minnesota Legislature met yesterday for the seventh special session of 2020, required as the Governor extended the Peacetime Emergency for another 30 days, and to pass the latest round of COVID-19 relief.  A $216 million COVID 19 relief package received bipartisan support in both the House and the Senate and is on its way to the Governor for his signature. The bill includes:

Today, the Department of Health and Human Services (HHS) started distributing the second round of infection control incentive payments to care centers who earned them for the month of October.  They also released the details about which providers received payments and how much the payments were.

Centers for Medicare and Medicaid Services (CMS) modified how surveyors should look at staff screening procedures and they have removed the requirement for active screening. Requirements for the organization in reference to staff screening include the need for a screening process that all staff must complete prior to or at the beginning of their shift.

First Phase to Include Healthcare Personnel and LTC Residents

The Minnesota Department of Health (MDH) issued two documents on Tuesday, Dec. 8, 2020 discussing several topics regarding vaccines.  Recommendations for initial Phase 1a vaccination include healthcare personnel and residents of long-term care facilities.

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) held an emergency meeting on Dec. 1 to review allocation recommendations for vaccines in phase 1 distribution. The advisory committee voted to include resident’s of long-term care communities in Phase 1A of vaccination. Long-term care residents now join healthcare workers in Phase 1A vaccination recommendations. For more information on ACIP you can visit the CDC’s Advisory Committee on Immunization Practices website.

Earlier this year, the state produced two special budget updates to look at the impact of the COVID-19 pandemic on the state’s economy. Those updates showed disturbing projected budget shortfalls of $2.4 billion for the current biennium and $4.7 billion for the biennium starting July 1, 2021. Since that time, state revenue collections have exceeded expectations and the budget looks more positive.

Today the Minnesota Department of Health published guidance entitled “Long-term Care Guidance Under Executive Order 20-99” specific to residents who leave a long-term care building for reasons other than essential medical appointments. The document references the Governor’s executive order 20-99 and makes the following points:

Receiving a vaccination is one of the most effective ways for people to protect themselves and those around them including residents. Development of a COVID-19 vaccination has been on a fast-track since the beginning of the pandemic in early 2020. Many teams working toward vaccines for the SARS-CoV-2 (COVID-19) virus previously worked on vaccines for similar viruses such as the original SARS virus, influenza, and other coronavirus pathogens contributing to the speed at which vaccines for COVID-19 are developing. On November 18, 2020 Pfizer applied for the first COVID-19 vaccination emergency use authorization (EUA) and will shortly be followed by other manufacturers such as Moderna, Astra-Zeneca, and others. Currently, vaccines are projected to be available the end of December 2020 or the beginning of January 2021.

We received good news today on two fronts:

Background Studies: The Minnesota Department of Human Services will be returning to emergency COVID-19 background studies that were previously in place. The Department is finalizing its implementation plan and anticipates this will be effective Thursday morning (Nov. 19).

Monoclonal antibody therapy is a COVID-19 treatment that appears to prevent the progression of COVID-19 disease, decrease the length of illness, and may prevent hospitalizations. An Emergency Use Authorization (EUA) was published today allowing the emergency use of monoclonal antibody therapy (Bamlanivimab) for adults and children with a positive COVID-19 test. Recipients must be 12 years of age or older or at least 40kg in weight. There are specific criteria for use of this therapy including:

• The recipient should have a confirmed COVID-19 infection;
• The recipient should be early in the disease progression; and
• The recipient should be symptomatic but not severely ill.    

DHS has posted the materials for the annual care center statistical and cost report for the year ending September 30, 2020 and the corresponding instruction manual on the DHS Nursing Facility Provider Portal. DHS also indicates that there will be a Supplemental Schedule to the 2020 cost report that is not yet final but is being developed to address various issues including use of federal relief funds. DHS expects the 2020 Supplemental Schedule to be available in mid-December, and they ask that providers refrain from submitting any 2020 Cost Reports before December 15. As always, cost reports are due by February 1.

LeadingAge sent all care center members their Five-Star Analysis reports this week. The pandemic has taken a toll on the collection and reporting of quality data, so while the staffing data is relatively new, the data on inspections and quality measures is from many months ago. We will continue to provide these reports regularly and expect CMS to be updating the data more regularly soon.

Last week, CMS released the final CY2021 Home Health Prospective Payment System Rate Update rule. The final rule includes updates of interest to Medicare Certified Home Health Agencies. The rule:

As of the writing of this article, votes are still being counted in several close races in St. Cloud, Rochester, Austin and a few key suburbs, however, it is looking like there will not be a major shift in party control in the Minnesota Legislature. Minnesota entered the 2020 election with the only divided Legislature in the country. DFLers were seeking to gain control over the Minnesota Senate, allowing for single party control of the state Government, something that hasn’t happened since 2013. It needed only to knock off two Republican incumbents and hold its own seats to retake the Senate.