COVID-19 Resource Center

COVID-19 Resource Center

TCC Wants to Keep You Informed with Relevant COVID-19 Updates


COVID-19 Updates/Discussion Open to Any Members  Tuesday, April 28th, 2-2:30pm. Access to the COVID-19 call will be sent to Hospice Directors and Quality/Compliance staff. Please ask them for the call information to be sent via email.


CARES Act Funding

We continue to acknowledge the dilemma many of you feel regarding the CARES Act Emergency funding you received. While TCC is not able to provide advice to you regarding your decision to keep or return the money, we will provide information that we think is credible and applicable. Our friends at Acevedo Consulting, Judy and Chris, have shared an article that may be helpful to you. Click here to access


Review of Waivers and Flexibilities for the Hospice Industry

  1. Increasing Provider Funding through Immediate Medicare Sequester Relief: Will temporarily lift the Medicare sequester, which reduces payments to providers by 2 percent, from May 1 through December 31, 2020. The Medicare sequester will be extended by one-year beyond current law to provide immediate relief without worsening Medicare’s long-term financial outlook.
  2. Telehealth for Hospice Face to Face for Certification/Recertification:
    •  The face-to-face encounter conducted by a hospice physician or hospice nurse practitioner may occur via a telecommunications technology and is considered an administrative expense.
    • Telecommunications technology means the use of interactive multimedia communications equipment that includes, at a minimum, the use of audio and video equipment permitting two-way, real-time interactive communication between the patient and the distant site hospice physician or hospice nurse practitioner.
  1. Waive requirement for hospices to use volunteers. CMS is waiving the requirement at 42 CFR §418.78(e) that hospices are required to use volunteers (including at least 5% of patient care hours).
  2. Waiver of requirements related to the timeframes for updates to the comprehensive assessment (§418.54(d)). Hospices must continue to complete the required assessments and updates, however, the timeframes for updating the assessment may be extended from 15 to 21 days.
  3. Waived onsite visits for Hospice Aide Supervision: CMS is waiving the requirements at 42 CFR 418.76(h), which require a nurse to conduct an onsite visit every two weeks. (For patients receiving services from the aide, continue to evaluate these services via phone or other methods)
  4. Waiver of hospice requirement to provide physical therapy, occupational therapy, and speech-language pathology.
  5. Telecommunication visits allowed for Routine Home Care visits, if appropriate and feasible to ensure that Medicare patients can continue receiving services that are reasonable and necessary for the palliation and management of a patients’ terminal illness and related conditions.

o   The use of such technology in furnishing services must be included on the plan of care,

o   Must be tied to the patient specific needs as identified in the comprehensive assessment

o   The plan of care must include a description of how the use of such technology will help to achieve the goals outlined on the plan of care.

o   For the purposes of the hospice claim submission, only in-person visits (with the exception of social work telephone calls) should be reported on the claim.

  1. There is currently uncertainty regarding the ability of hospice physicians and NPs to bill for Part A services provided via telehealth. Hospice Organizations are seeking clarification of this policy.
  2. Covered health care providers subject to the HIPAA Rules may seek to communicate with patients, and provide telehealth services that may not fully comply with the requirements of the HIPAA Rules.  OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.  https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html
  3. HIPAA Enforcement Discretion During COVID-19 Spread: The HHS Office for Civil Rights will allow good faith uses and disclosures of protected health information by business associates for public health and health oversight activities in response to COVID-19, effective immediately. The full Notice of Enforcement Discretion is available HERE.


Federal News and Updates

ICD-10 COVID-19 Code

As of April 1, a specific ICD10 code has been established for patients with COVID19…U07.1

This is to be used as the primary diagnosis when the patient is known positive.  The hospice should list additional effects of infection, such as pneumonia after U07.1, such as “other viral pneumonia J12.89.”   The U07.1 code is not to be used if COVID-19 is only suspected.

 

New/Updated CDC Resources

  1. Resources for Hospitals and Healthcare Professionals Preparing for Patients with Suspected or Confirmed COVID-19
  2. Downloadable Videos are now available on a variety of COVID-19 prevention topics.
  3. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) (3/30/20).
  4. Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19 (4/9/20)
  5. How to Use PPE (Personal Protective Equipment)…How to Put On (Don) PPE and How to Take Off (Doff) PPE
    This webpage includes a 3 ½ minute video instruction on taking off PPE as well as printable flyers you can use for staff.
  6. Interim Infection Control Guidance for Public Health Personnel Evaluating Persons Under Investigation (PUIs) and Asymptomatic Close Contacts of Confirmed Cases at Their Home or Non-Home Residential Settings
  7. Strategies to Optimize the Supply of PPE and Equipment
  8. Personal Protective Equipment Burn Rate Calculator


State Data:

North Carolina: NC Data COVID-19

South Carolina: SC Data COVID-19


Summary of New COVID-19 Long-Term Care Facility Guidance Issued April 2, 2020
(This article contains information that Hospice organizations may want to consider)
CMS and the CDC issued new recommendations to State and local governments and long-term care facilities to help mitigate the spread of COVID-19. Long-term care facilities are unique, as they serve as both healthcare providers and as full-time homes for some of the most vulnerable Americans. To provide critical, needed leadership for the Nation’s long-term care facilities to prevent further spread of COVID-19, CMS and CDC are now recommending the following immediate actions to keep patients and residents safe: (For the full article containing all detailed guidance, click here)

  1. Nursing Homes should immediately ensure that they are complying with all CMS and CDC guidance related to infection control.
  2. As long-term care facilities are a critical part of the healthcare system, and because of the ease of spread in long-term care facilities and the severity of illness that occurs in residents with COVID-19, CMS urges State and local leaders to consider the needs of long-term care facilities with respect to supplies of PPE and COVID-19 tests.
  3. Long-term care facilities should immediately implement symptom screening for all.
  4. Long-term care facilities should ensure all staff are using appropriate PPE when they are interacting with patients and residents, to the extent PPE is available and per CDC guidance on conservation of PPE.
  5. To avoid transmission within long-term care facilities, facilities should use separate staffing teams for COVID-19-positive residents to the best of their ability, and work with State and local leaders to designate separate facilities or units within a facility to separate COVID-19 negative residents from COVID-19 positive residents and individuals with unknown COVID-19 status.


Telehealth Information and Resources: 

New Video Available on Medicare Coverage and Payment of Virtual Services
CMS released a video providing answers to common questions about the Medicare telehealth services benefit. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.


Providing Spiritual and Pastoral Care During COVID-19 Free Webinar

This webinar was provided by Hospice Foundation of America and provides 1.5 complimentary CE credit hours. You may access the webinar recording here: https://hospicefoundation.org/Education/Spiritual-Care-and-COVID-19.aspx


Additional questions please contact Alicia Sterritt: asterritt@cchospice.org