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 HHS Extends CARES Act Relief Patient Portal Information Gathering

In the latest round up of COVID-19 developments, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) said on May 22 the Department of Health and Human Services (HHS) extended the CARES Act Provider Relief Fund attestation window to 90 days from the original 45 days.

This allows time to address additional questions and to offer providers time to collect necessary payment portal information, the association said.

In its press statement, HHS said the attestation window and related acceptance of Terms and Conditions has been extended from 45 to 90 days from the date a provider received a payment to attest to and accept the Terms and Conditions or return funds.

Providers should have received emailed letters from HHS on May 22, AHCA/NCAL said. Also, the association said providers need to identify the dates of each relief payment and identify their new attestation and Terms and Conditions acceptance date based on the extension. HHS recently updated the Fund FAQs
AHCA/NCAL has updated the 
COVID-Related Cost and Loss Calculator and prepared a guidance document on the CARES Act Provider Relief Fund (member login required for both resources). The guidance includes: 

--Updated AHCA/NCAL CARES Act Provider Relief Fund FAQs; 

--A merged version of Tranches 1 and 2 Terms and Conditions with easily identifiable changes as well as a redline version of the SNF Allocation Terms and Conditions showing differences relative to the Tranches 1 and 2 Terms and Conditions. SNF Allocation has its own Terms and Conditions. Each of the three versions of the Terms and Conditions must be attested to using Tax Identification Numbers (TINs) and award dollar amounts; and

--A table containing key FAQs and AHCA/NCAL interpretations of HHS guidance. 

AHCA/NCAL said if providers have questions or concerns about Tranches 1, 2, or 3 awards, contact the HHS Hotline at (866) 569-3522.

Separately, NCAL said it has updated guidance on notifications and reporting of confirmed cases of COVID-19 in assisted living communities. NCAL encourages all assisted living communities to follow state and local requirements for reporting. Providers should use documented reporting information when reaching out to local county and state health departments when requesting assistance for supplies. 

On another topic, AHCA/NCAL said nursing facilities were required to submit their first set of data to National Health Safety Network (NHSN) by 11:59 p.m. on May 17 to be compliant with the new requirements .

Facilities may choose to report more frequently, but at minimum must report at least once every seven days. The initial two-week grace period ended at 11:59 p.m. on May 24. Facilities that fail to begin reporting after the third week, ending at 11:59 p.m. on May 31, will receive a warning letter reminding them to begin reporting the required information to the Centers for Disease Control and Prevention (CDC)/NHSN.

Facilities that have not started reporting in the NHSN system by 11:59 p.m. on June 7, ending the fourth week of reporting, will see the Centers for Medicare & Medicaid Services impose a per day (PD) Civil Money Penalty (CMP) of $1,000 for one day for the failure to report that week. Each subsequent week that the facility fails to report will result in an additional one-day PD CMP imposed at an amount increased by $500, AHCA/NCAL said. 

NHSN updated the instructions for the pathway forms on May 12. When completing the data collection and upload, providers should be sure to use the most current instructions. Providers can find the new instructions on the NHSN website.

During one of the NHSN data reporting webinars, the NHSN team identified that each item question must have an answer entered or it will be counted as missing data and it will be counted as not being reported. “When you enter count data, even if the answer is nothing or zero, you must enter 0 in the data field. If you leave it empty, it will be flagged as ‘no answer,’” AHCA/NCAL said. 

According to CDC, “To maintain consistency in reporting, if a facility is using crisis-level strategies,” the facility is experiencing a shortage. “In other words, PPE [personal protective equipment] strategies that do not commensurate with U.S. standards of care are considered as a shortage,” the association said.

For information in relation to CDC’s optimization strategies for PPE (standard, conventional, and crisis), AHCA/NCAL said it encourages facilities to refer to the Optimize PPE Supply website

A center can easily identify if it is missing data in the NSHN module by reviewing the calendar view page. Any pathway that is incomplete will be highlighted as a tan color. Pathways highlighted as green indicated all questions were answered. A missing pathway means the pathway has not been started. As of right now, NHSN does not send notices for incomplete data, the association said.

Centers are encouraged to review the calendar view to ensure all four pathways are highlighted in green to ensure compliance with reporting to NHSN. 

Also, nursing centers are continuing to report a delay in being able to register and upload data to NHSN. There are also facilities that are reporting significant delays in having their questions answered via NHSN help desk. “Centers experiencing delays are encouraged to keep documentation of all attempts of contacting NHSN and any communications you have with them,” AHCA/NCAL said.

In addition, some facilities are reporting they are not receiving the Agreement to Participate and Consent email. If this is happening, follow these instructions: 

1. Log-in to SAMS.

2. Select Long-term Care Facility Component and your facility/group name. 

3. Click “Submit” to review the “Agreement to Participate and Consent.” 

4. Click “Accept” next to the appropriate contact name. 

5. Click “Submit.” A pop-up notification will appear confirming this action. 

6. Click “ok” to acknowledge the notification. 

If logged in to SAMS and see the “Annual Survey” alert on a facility homepage, follow these steps to remove the alert: 

1. On the facility homepage, click "Survey Required 2020" alert on the facility homepage to be directed to the online survey.

2. Complete the “Facility Characteristics” section, and scroll to the bottom to click “save” to submit your survey.

In other news, CDC said the COVID-19 Module Overview for Long-term Care Facilities recorded video presentation and slideset are now available on the COVID-19 LTCF Module webpage, as well as COVID-19 Module Enrollment Guidance for LTCF under Training. 
CDC is also offering a webinar for providers and their concerns about hurricane season during the pandemic. The webinar is May 27 from 1 to 2 p.m. ET.

Finally, on May 21, the Senate Special Committee on Aging Committee held a hearing titled,
Caring for Seniors Amid the COVID-19 Crisis . AHCA/NCAL submitted a statement for the record. Watch a video recording of the hearing, and read the majority and minority press statements.

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