MDHHS Announces Infection Prevention Funding Opportunity

The Michigan Department of Health & Human Services (MDHHS) in partnership with the Michigan Department of Licensing & Regulatory Affairs (LARA) issued notice of a MDHHS funding opportunity.  The purpose of these grants is to support permanent improvements to a facility's equipment to achieve more effective infection prevention and control. Infection prevention and control was an area of concern prior to the pandemic, and the pandemic underscores how important it is to make lasting improvements in nursing facilities. These grants can be used to pay for all or a portion of the costs of infection control equipment.

Facilities may receive up to $22,000 for improvements or technology that will impact infection prevention.  Examples of uses include things such as ventilation supplementation, HEPA filtration, electrostatic foggers, or touchless temperature screeners, to name a few.  It is important to note these funds may not be used to replenish personal protective equipment (PPE).

MDHHS is encouraging facilities to take advantage of this opportunity to receive grant funds to improve infection prevention. Applications are due October 31, but it is important to submit as soon as you can.  The funds must be spent by December 31, 2020.

Send questions and applications to MDHHS-ICGRANTS@michigan.gov.

 

Nursing Facility COVID Testing & Required Documentation

The Centers for Medicare & Medicaid Services (CMS) COVID testing requirements go into effect tomorrow, September 2, 2020.  The COVID testing requirements issued earlier this summer by the Michigan Department of Health & Human Services (MDHHS) are more rigorous in most instances than the newly released federal requirements, except in the instance of Outbreak Testing or for counties with a high positivity rate as identified by CMS. 

Outbreak Testing will require providers to test both staff and residents weekly if a new case is identified in either a staff member or a resident.  This weekly testing of all continues until a minimum of 14 days has elapsed since the last positive test.

Screening Testing in counties with a high positivity rating as identified on the CMS COVID-19 Nursing Home Data webpage requires bi-weekly testing.  For staff members who only work weekends, this could require testing on consecutive days, Saturday and Sunday, to meet the bi-weekly requirements.

Documentation of testing is required to demonstrate compliance with requirements and will be reviewed by surveyors in upcoming surveys.  Michelle Roepke, Director Federal Certification and Survey Division recommends members review page 9 & 10 of QSO-20-38-NH to ensure capture of required documentation.  The elements include:

• Documentation the date & time of identification of signs or symptoms, when testing was conducted, when results were obtained and the actions facilities took based on results for both residents & staff.
• Outbreak Testing - document the date the case was identified, the date(s) all other residents and staff were tested, dates of repeat testing, and all test results.
• Screening Testing - document the county positivity rate, corresponding frequency of testing if higher than required by MDHHS and dates testing was performed for each staff and results of the testing.
• Policies or procedures for handling refusals to test by both residents and staff.
• Document communications with local health departments, MDHHS, and your Survey Manager for testing supply shortages or other circumstances that preclude compliance with the testing cadence.
• Document communications with local health departments, MDHHS, and your Survey Manager when test results are not obtained within 48 hours.

Noncompliance with COVID testing requirements may result in a citation for F-886.  Documentation to demonstrate attempts to resolve any circumstances that may lead to noncompliance and communicate them to LHD, MDHHS, and Survey Managers is your best defense to a citation.

 

NHSN LTCF COVID-19 Module and Responses to Common Module Questions Webinar

The National Healthcare Safety Network (NHSN) is offering a webinar to share information and answer questions related to long-term care facility (LTCF) COVID-19 data reporting.  Topics covered include, counts suspected and laboratory positive COVID-19 residents and staff, counts of suspected and laboratory positive COVID-19 related deaths, staffing shortages, personal protective equipment (PPE) status, and ventilator capacity and supplies. 

Two offerings are available:

Tuesday, September 1, 2020
1:00 - 2:00 p.m. EST
Space is limited, register in advance.

Thursday, September 3, 2020
1:00 - 2:00 p.m. EST
Space is limited, register in advance. 

 

MDHHS Shares Day of Discharge Reminder

The Michigan Department of Health & Human Services (MDHHS) issued a reminder to skilled nursing facilities (SNF) and hospice providers regarding day of discharge reimbursement.

 

Based on current MSA policy hospice providers are only reimbursed for the date of discharge in the following scenarios:

• If the discharge matches the beneficiary's date of death.
• The beneficiary has revoked their Hospice benefit in favor of Skilled Nursing service at the Nursing Facility they currently reside in.
• The Beneficiary transfers from one hospice provider to another and both providers render service on the same day.
  

Nursing facilities are reimbursed for the discharge date if the discharge matches the beneficiary's date of death.

 

When billing for a month that includes a facility discharge, providers are allowed to bill through the date of discharge on the claim (from/to dates) but should not include the actual discharge date in the number of billed units on the claim.  Discharge payment guidelines for the respective provider types are in the Medicaid provider manual, Hospice chapter, Section 7.3.C. Date of Discharge and Billing and Reimbursement for Institutional chapter, Section 8.2.E Billed Facility Days.

Claim example:

 

If a Medicaid Beneficiary's admission date 6/01/2020 with a discharge date 7/31/2020, the discharging facility would bill their room and board service line for July 2020 as:

From date of service: 7/01/2020

To date of service: 7/31/2020 

Units = 30

When billing for the same dates but the beneficiary expired in the facility, the month of July 2020 would be billed as:

From date of service: 7/01/2020

  

To date of service:  7/31/2020

 

Units = 31 (with the Patient Status Code 20)

 

Providers with further questions please contact Provider Support at 1-800-292-2550 or by email ProviderSupport@Michigan.gov.

 

MDHHS Making Change to COVID-19 Reporting Schedule

The Michigan Department of Health & Human Services (MDHHS) announced it is making a change to the cadence for COVID-19 data posted to the Michigan.gov/coronavirus website.  This posting change will not change the required daily reporting into EMResources for skilled nursing providers or the weekly reporting into Survey Gizmo for assisted living providers. 

 

Beginning Sunday, September 6 2020, data on cases, deaths and testing will be reported Monday - Saturday. Weekend data are often erratic and generally lower than other days due to reduced testing and lab staffing. With respect to policy matters, MDHHS focuses its review of trends on the number of reports for each date that individuals experienced the onset of symptoms and not the daily reported cases which represent the day test results were received. Onset date reporting is shown on the MI Safe Start Map as well the Daily Cases by Status report on theMichigan.gov/Coronavirus website and this reporting will not be affected by this change.

 

"At this time, reporting on Sunday rather than Monday is not critical to our understanding of the virus," said MDHHS Director Robert Gordon. "This change will allow staff who have not had a real day off since February to get some relief and allow the department to prioritize more valuable data reporting, including school outbreak information."

 

Sunday and Monday data will both be reported on Mondays, including Labor Day. This change will not affect the department's ability to provide onset date information for COVID-19 cases.

 

For questions or concerns please contact Cathy Sunlin at CathySunlin@HCAM.org. 

 Sept. 1, 2020