Alert your clinical assessment staff! Omnibus Reconciliation Act (OBRA) Minimum Data Set (MDS) assessments completed as quarterly or annuals for Medicaid residents may be rejected because of an error in requiring the completion of Section GG and portions of Section J.
The Michigan Department of Health & Human Services (MDHHS) Medicaid Division is working with the Centers for Medicare & Medicaid Services (CMS) to correct an error requiring the completion of these two sections for OBRA required assessments. These sections were inadvertently set to be required effective October 1, 2020. As of today, an expected date of correction remains pending, although both MDHHS and CMS are aware of the urgency to correct. Members are advised to follow closely to ensure rejected assessments can be resubmitted soon to avoid non-compliance. For any assessments unable to be re-submitted within the required window of time, document the submission attempts and rejection error at the CMS level to support in the case of review during a survey.
In discussions with MDHHS leaders, they shared the department is interested in collecting the Patient Driven Payment Model (PDPM) data for comparison, however did not anticipate making this change until a later point in time. Section GG includes data covering functional abilities and goals, while Section J covers health conditions, including pain management, and major surgery. Although portions of Section J are currently required, the additional information gathered would include those questions related to major surgery.
HCAM will update members as additional information becomes available.
Medication Aide Bill Receives Hearing in Senate Committee
Yesterday October 7th, the Senate Health Policy and Human Services Committee took testimony on House Bill 4098. Bill sponsor Representative Ben Frederick, Richie Farran from HCAM and Bob Norcross COO of Prestige Healthcare provided testimony in support of the bill. Please click HERE to view the testimony of Mr. Norcross.
HB 4098 establishes a medication aide registry in the state of Michigan, bringing us in line with twenty-two states that allow for the use of medication aides in nursing facilities. The legislation provides an opportunity for a qualified Certified Nurse Aide (CNA) to complete additional education and testing to be registered as a medication aide. Responsibilities of medication aides would include administering regularly scheduled medication under the supervision of a registered nurse. The legislation clarifies that medication aides would not be permitted to administer controlled substances, medications in injectable forms, or the initial administration of medications.
You may find the bill and track its progress by clicking HERE.
HHS Updates Provider Relief Fund FAQs
The US Department of Health and Human Services (HHS) recently updated the Provider Relief Fund (PRF) FAQs with Phase 3 information. Several of the FAQs also provide helpful insights into other PRF requirements. AHCA/NCAL has developed a summary of these updates. You can also view specific updates to the HHS PRF FAQs HERE.
The updated FAQs are lengthy. Highlights discussed in the October 6 additions include:
Support for Providers Missing PRF Dollars;
Phase 3 Methodology/Formula Overview;
Eligibility and Receipt of Other Funding;
VBP and PRF; and
Infection Control & Current Staff.
CMS Releases Additional Guidance - Emergency Preparedness & Resident Rights to Vote
Last week, the Centers for Medicare & Medicaid Services (CMS) released S&C Memo QSO-20-41-ALL, covering requirements and guidance related to Emergency Preparedness Exercise requirements. This guidance clarifies changes made by the Interim Final Rule, and allow for an exception to the testing Emergency Preparedness testing requirements during or after an actual emergency. Allowing for an actual natural or man-made emergency requiring activation of the facility emergency plan to count as a testing exercise. In addition, CMS is allowing a workshop establishing strategy and structure of emergency plans as an accepted testing exercise.
On Monday October 5th, CMS also released S&C Memo QSO-21-02-NH, affirming and reiterating the continued right of residents to exercise their rights to vote. Despite the restrictions and protections in place secondary to the COVID pandemic, nursing facilities must still ensure residents are supported in their Constitutional rights to vote in the upcoming election. CMS advises providers to consider methods to support this right such as mail-in, absentee ballots or other authorized processes.
New Guidance from CDC on Discordant Test Results
This week, the Centers for Disease Control & Prevention (CDC) released new information on testing in nursing homes via their FAQs website. The new guidance addresses discordant test results (i.e. false positives and false negatives) and how nursing homes should handle these situations.
Among other information, in the FAQs, CDC addresses:
Optimal frequency for testing residents and staff in response to an outbreak
How to determine a false positive test result on an antigen device
What action should be taken while waiting to confirm a false positive or negative
What action should be taken once a false positive is confirmed
Providers who have adopted CDC guidance into their infection control policies should review and compare to their current COVID testing program.