The ongoing coronavirus (COVID-19) pandemic has created many challenges for long-term post-acute care (LTPAC) providers. One of the most pressing is ensuring timely and safe (i.e., low-risk for infection) visits between practitioners and patients. Increasingly, telehealth – i.e., the delivery of health-related services and information via electronic information and telecommunications technology – is being used as a primary means to achieve this. In part, this has occurred due to recent regulatory changes that expanded telehealth’s role in caring for Medicare patients across the health care continuum.
Skilled nursing facilities (SNFs), senior care facilities and long-term care facilities come in all shapes and sizes, but they all have a common goal: optimizing resident care and enhancing outcomes. Achieving this is no easy feat—it takes skill, planning, foresight and execution in many areas, including revenue cycle management, accounting and finance, Medicare compliance, EHR implementation and ongoing usage and more.
As part of a long-term post-acute care (LTPAC) facility’s regular risk assessment, leadership and staff should collaboratively develop written emergency preparedness plans to prepare for and respond to an array of disasters and crises—including epidemics and/or pandemics.
Enter the coronavirus (COVID-19), which has rocked the LTPAC landscape during 2020. While its effects are wide-ranging and profound, COVID-19 has exposed a particularly glaring hole in many facilities’ disaster preparedness plans: personal protective equipment (PPE).
The year 2020 has undoubtedly put coronavirus (COVID-19) in the spotlight. We are quarantining, self-isolating and wearing facemasks when we venture out in public. COVID-19 is already proven to be the deadliest virus humans have encountered since the H1N1 influenza pandemic of 1918. Accordingly, medical and public health professionals have focused considerable efforts and directed resources toward managing its spread.
That said, COVID-19 is only one of many viruses, bacteria, parasites and fungi that could cause an epidemic or pandemic. With the high number of patients who are currently being treated in our hospitals and the overwhelming lack of personal protective equipment (PPE), we could see a marked increase in any one of these—or in multiple human pathogens.
The Patient-Driven Payment Model (PDPM) was launched on Oct. 1, 2019, so as of this writing, observers have had ample time to see how it is taking shape. Thus far, the Centers for Medicare and Medicaid Services (CMS) has determined that PDPM has not been budget-neutral compared to the last model, as it was intended to be. PDPM is part of the larger, industry-wide shift toward value-based payment systems that reward providers for delivering high-quality care for people in need. While PDPM now requires more tracking and reporting for long-term care (LTC) providers and skilled nursing facilities (SNFs), particularly in terms of ICD-10 coding, the ultimate goal is providing better patient care.
Here at Richter, our Clinical Consulting team has fielded an array of questions lately from skilled nursing facility (SNF) clients regarding what to skill residents for under Medicare A, and what the criteria is.
Based on our decades of experience in the industry, we’ve found that such questions aren’t out of the ordinary in “normal circumstances.” Indeed, under previous PPS payer rules, when a Medicare resident was discharged from an acute-care hospital, the general assumption was that they were eligible for skilled services through their need of therapy services. Accordingly, during this time, much of the documentation burden also lay with the therapist.
In “normal” times, your skilled nursing facility staff should be taking all necessary steps to prevent and control infections throughout the facility. As the current COVID-19 pandemic continues to unfold, it’s safe to say these are anything but normal times.
Fortunately, skilled nursing facilities here in the U.S. up to now haven’t had to deal with major outbreaks beyond seasonal flu. Unfortunately, that has partly caused too many skilled nursing and senior care organizations to overlook basic steps that help prevent and control infections throughout a facility.
As the coronavirus (COVID-19) crisis continues to spread throughout the U.S., hospitals in current “hot spots” are facing unprecedented capacity issues—and similar prospects await hospitals in other areas that soon will experience spikes in COVID-19 cases.
When hospitals approach or reach patient capacity, they must turn to outside facilities to handle patient overflows. In this regard, skilled nursing facilities across the country with empty beds are receiving queries from hospital administrators about accepting overflow patients.