Skilled nursing facility operators must recognize that partnerships with hospitals have never been more important than now. HealthPRO Heritage offers strategy & tangible resources to support efforts to collaborate with local hospitals amidst the COVID-19 crisis.
Regulatory Changes Shape a ‘Go-Forward’ Strategy
In response to the COVID-19 crisis, CMS has temporarily relaxed Social Security Act Medicare regulations. The intention of this new directive is to facilitate quicker/easier access to skilled care for Medicare beneficiaries and reduce burden on hospital resources. This expansion of Medicare benefits also represents significant flexibility/changes for how skilled nursing providers can support safe, efficient care transitions by:
- Admitting patients directly from hospital Emergency Rooms
- Admitting patients with less than 3 day hospital stay
- Providing care “in place” under physician direction without transferring patients to hospitals that are overburdened
- Re-activating Medicare benefits even in cases where patient has not had 60 days since the last “skilled stay”
This change allows for skilled nursing facilities to provide necessary services in order to alleviate pressure on hospital infrastructure, open up bed space for critical patients, and avoid putting SNF residents at potential exposure risk at a hospital setting (if their condition can otherwise be managed within a SNF setting, i.e. “skilling in place”). In these situations, SNFs should take advantage of permissible reimbursement by using “DR” in the condition code box on the UB04 for disaster related – boxes 18-25. (Additionally, effective April 1, use of a new diagnosis code U07.1 should be used for patients impacted by COVID-19 or experience secondary symptoms following a respiratory event.) According to the CDC, this unprecedented off-cycle update is due to the “urgent need to capture the reporting of this condition in our nation’s claims and surveillance data.”
Be Prepared: Checklist of Questions: All skilled nursing providers must be prepared to respond to important questions from hospital partners:
- Do you have an updated listing of your current clinical capabilities to share with your hospital partner and has it been updated for newly arising needs and conditions?
- Is your facility admitting patients receiving IV fluids or medications? Does your facility have 24-hour nursing staff that can manage these services?
- Does your facility admit patients diagnosed (or have signs/symptoms) related to flu virus and/or COVID-19?
- Is your facility well-prepared to isolate patients? How many patients on isolation measures can be accommodated? (Specific bed counts will help upstream providers plan for quicker discharges to make much-needed acute beds available.)
- Is your facility able to designate a unit or floor dedicated to managing patients with COVID-19?
- Does your facility admit post-trach patients? How many post-trach patients can be accommodated?
- What is the status of your facility’s PPE supplies? Are masks being made/donated? Is your facility willing to issue a call to action to make masks?
HealthPRO Heritage offers for your convenience:
- A template letter to address to regional hospital systems & networks for your convenience available here.
- Assistance with responding to all COVID-19 1135 waiver related questions: SNFwaiversinfo@healthpro-heritage.com