LTC Pharmacy News
March 2020
New Project: Health Policy Pro
Do you find Medicare and Medicaid health policy confusing? You're not alone. The payment rules for these major federal and state health programs are difficult to comprehend, especially when they are hidden in documents with hundreds of pages.
We're working on a website project to deliver bite-sized chunks of health policy tutorials directly to you. The goal is mastery of health policy one course at a time.

We're in the formative stages now, and hope to launch soon. If you want to keep up to date on our progress. Subscribe below.
From Elise Smith
Legendary SNF reimbursement professional Elise Smith is currently on a well-earned hiatus. Until she returns, we will maintain a vault of her wisdom at your disposal for your edification and education.
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President Signs Coronavirus Spending Package
President Trump signed into law a bill passed by Congress to respond to the coronavirus outbreak, which includes spending for development of drugs, prevention and foreign assistance. Congressional approval was nearly unanimous.

Federal Agency Updates
CMS Releases 2019 PASRR Report
The Social Security Act requires that residents of Medicaid-certified nursing homes be screened for mental illness and intellectual disability and provided specialized services if qualified.

This report summarizes the states' efforts to comply with this requirement.
CMS Publishes FAQ on COVID-19
On March 6, CMS issued frequently asked questions and answers (FAQs) for health care providers regarding Medicare payment for laboratory tests and other services related to the 2019-Novel Coronavirus (COVID-19). The agency is receiving questions from providers and created this document to be transparent and share answers to some of the most common questions.
CMS releases updated data on geographic variation in the Medicare program
CCMS has posted the annual release of the Geographic Variation Public Use File and dashboards with data for 2018. The Geographic Variation Public Use File is a series of downloadable tables and reports that contain demographic, spending, utilization, and quality indicators for the Medicare fee-for-service population. It presents data at the state-level (including the District of Columbia, Puerto Rico, and the Virgin Islands), hospital referral region (HRR)-level, and county-level. For 2018, the PUF includes data for 33.5 million Medicare beneficiaries and $357.8 billion in Medicare costs.

CMS Suspends Normal Surveys, Focusing on Infection Control
In a memo to State Survey Agencies, CMS announced that it will suspend normal nursing home surveys and pivot to focus on facilities that are at high risk of non-compliance with infection control procedures.CMS also advises nursing homes to screen visitors and transfer residents who test positive for COVID-19

CDC Coronavirus Report
The Center for Disease Control and Prevention published a special edition of its Morbidity and Mortality Report devoted to COVID-19, the coronavirus. 

The report details the short history of the viral outbreak and the current status of reported exposure and infection in the United States

Trends in electronic health record use among residential care communities
This report from the National Center for Health Statistics shows a steady increase in the use of electronic health records in residential care communities between 2012 through 2016.

The report also shows the increase in support for electronic interchange with pharmacies over the same period. Adoption rates appear to be highest among for-profit facilities with more than 100 beds and are affiliated with chains.

Predicting Medication-Related Harm in Older Adults
The Agency for Healthcare Research and Quality report on a study to validate effectiveness of the PRIME tool to predict the risk of medication-related harm following discharge from a hospital.

Dept of Justice Creates National Nursing Home Initiative
US Attorney General William Barr announced an initiative to "pursue nursing homes that provide grossly substandard care to their residents."

The Justice Department will focus its early efforts on the nation's 30 worst facilities. Among the abuses noted by the Department are failure to provide adequate pain relief and failure to wash and feed residents of the facility.

The effort appears to be directed at investigation and prosecution rather than remediation based on the seriousness of the neglect involved.

Everything Else
LTC Facilities at Risk From Corona Virus?
Recent deaths of residents with coronavirus infection have focused attention on the vulnerability of frail seniors to the effects of the virus.

COVID-19, as the virus is officially designated, appears not to be a threat to the very young, but those with comorbidities and compromised immune systems seem to be most at risk.

Surgeon General Says Don't Buy Face Masks
The US Surgeon General advises the public not to buy face masks in response to heavy public demand. Staying home when you're sick and washing your hands frequently are much more effective methods to prevent infection.

The Surgeon General's admonition came in the form of a tweet.

Medication Management Post-Discharge Helps Prevent Readmissions
A review of published research conducted by British researchers suggests that careful management of meds for seniors following discharge from a hospital reduced the risk of hospital readmission. 

Nursing Homes Prepare for Coronavirus 
Nursing homes across the country are increasing their inventories of masks and thermometers in anticipation of an increase in COVID-19 exposure and infection.

Already under a microscope, nursing facilities are trying to stay ahead in their efforts to limit resident exposure to the virus and respond quickly with aggressive efforts at infection control.

Is PDPM Success Sustainable?
The Patient-Driven Payment Model has proven to be a boon to SNF operators, driving concern among industry experts and observers that CMS is likely to respond by tinkering with the payment formula to accomplish its original goal that the new payment model would be budget neutral.

CMS Administrator on PDPM Oversight
Speaking at a recent CMS Quality conference in Baltimore, CMS Administrator Seema Verma  responded to questions about the agency's intentions concerning oversight of SNFs relative to the new payment model, she indicated that CMS is currently focused on work inside the agency to conduct more effective oversight.