STATE NEWS

Kansas COVID-19 Vaccination Overview

• 1,326,134 People Vaccinated with One Dose
• 2,410,047 Total Doses Reported as Administered
  – First Dose: 1,326,134
  – Second Dose: 1,083,913
• 2,952,820 Total Doses Distributed
  – State Distributed: 2,038,180
• 45.5% of Kansans Vaccinated with One Dose
• 40.1% of Kansas Completed COVID-19 Vaccine Series

Source: https://www.kansasvaccine.gov/158/Data

Kansas COVID-19 Cluster Summary

As of July 21st, there are 6 long-term care facility with clusters and 2 are LeadingAge Kansas Members.

Statewide Active COVID-19 Clusters

• Clusters: 71
• Cases: 739
• Hospitalizations: 34

Kansas COVID-19: Case Rates

• Cases: 325,728
• Total Case Rate Per 1,000: 111.81
• Daily Cases Diagnosed: 394

Long-Term Care Facilities with Active Cluster Case Information

Source: https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas

FEDERAL NEWS

No Changes (yet) to 1135 Waivers
Many of you are hearing from local hospitals that the 3-day stay waiver has ended. CMS has not announced termination of the 3-day stay waiver. With yesterday’s extension of the national public health emergency due to COVID-19, the 3-day stay waiver and all other 1135 federal blanket waivers remain in effect unless otherwise noted by CMS. We continue to monitor and will keep you updated.

Interim Public Health Recommendations for Fully Vaccinated People
CDC updated their interim guidance for fully vaccinated individuals. Specifically, CDC updated considerations for people who are immunocompromised. People who are immunocompromised should be counseled about the potential for reduced immune responses to COVID-19 vaccines and to follow  current prevention measures (including wearing a mask, staying 6 feet apart from others  they don’t live with, and avoiding crowds and poorly ventilated indoor spaces) to protect themselves against COVID-19 until advised otherwise by their healthcare provider.

5 Things to Know about Reporting PRF Lost Revenue  

HRSA have outlined three options that providers can use to calculate lost revenue for the required reports on the provider’s use of the PRF. Here is a summary of the three options to calculate lost revenue:

1. Option 1 requires providers to report their 2019, 2020 and first half of 2021 revenues and the reporting portal calculates lost revenues by comparing year-over-year actual revenues.
2. Option 2 is available to providers whose organizational budget was approved by March 27, 2020. It compares budgeted to actual revenues during the period of availability, which is January 1, 2020 – June 30, 2021 for the first report due Sept, 30, 2021.
3. Option 3 allows a provider to calculate lost revenue using an alternate method that they describe through a narrative. In this scenario, providers calculate and report their lost revenues based upon their proposed methodology. HRSA will determine if the proposed methodology is reasonable and if not, the provider will be notified that they have 30 days to resubmit their lost revenue information via Option 1 or 2. Providers who utilize option 3 may be at higher risk of an audit.

Additional detail on the options and what data must be reported for each can be found in the June 11 PRF reporting guidance and PRF Reporting Portal User’s Guide – Reporting. 

Here are five other things you should know about lost revenues:

• Providers can choose to use PRF payments only for their lost revenues. While the reporting portal will ask providers to report their unreimbursed expenses related to coronavirus first in the overall use of funds calculations, a provider can enter “0”. This makes the PRF payments available to be applied solely to lost revenues. As PRF is likely the only source of reimbursement for lost revenues, providers may want to consider this approach. It should be noted that PRF payments can also be applied to lost revenues after they are applied to coronavirus related expenses. Nonetheless, PRF remains the payer of last resort and so expenses, and where applicable, lost revenues should be applied to other assistance received first before applying PRF payments.
• Lost revenues are calculated per quarter as a standalone calculation. This means you can apply PRF payments to lost revenue in any given quarter during the period of availability. Previous guidance had indicated that lost revenues would be calculated on an annual basis, which may not have allowed providers to use PRF if they came out even by yearend. This is how it works. If you are using option 1 or 2 for calculating lost revenues, a provider will report revenue for each quarter during the Period of Availability (for the first reporting period this is Jan 1, 2020 – June 30, 2021). The reporting portal will calculate the provider’s lost revenues for each quarter based upon the data entered. It will add up all quarters with lost revenues for an annual total, which will be compared to the remaining PRF payments. More information can be found on this on page 24 of the July 1, 2021 PRF FAQs and in the PRF Reporting Portal User’s Guide.
• For option 3, providers will calculate and report their own lost revenues. In quarters where there is an increase in revenue, you will enter “0”. What this means is, if a provider has a quarter of positive growth, this will not offset the lost revenue from a prior quarter. Just the quarterly lost revenues will be totaled. Specifically, you can apply PRF payments to quarters where you lost money to backfill even if you had other quarters that were revenue positive or neutral. More information on this topic can be found in the PRF Reporting Portal User Guide on p. 47 and is discussed in HRSA’s July 8th webinar (recording available) on PRF reporting.
• Unreimbursed lost revenues due to coronavirus from one reporting period can be carried forward to a future reporting period. If you get to the end of all of these calculations and your lost revenues exceed what you received for PRF in a given reporting period, you can apply the balance to PRF funds from future reporting periods. For example, if you only received $100,000 in April 2020 General Distribution payments, but your PPE costs and lost revenues during the period of availability were $2 million, then you will carryforward $1.9 million to the next reporting period which will cover payments received between July 1 – December 31, 2020.
• Other assistance received related to coronavirus will not be used in calculation of lost revenues. Under the PRF Terms and Conditions you attested that you “will not use the Payment to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse.” Therefore, it is expected that you will apply expenses and losses to other assistance first and if any eligible expenses remain, you will then use PRF. More information on this topic can be found on page 29 of the PRF Reporting Portal User Guide.

Let Nicole Fallon at LeadingAge know if you have questions about PRF Reporting. HRSA materials on reporting can be found here.  Also, sign up now for the LeadingAge July 27th webinar, “Complying with New Provider Relief Fund Reporting Requirements, “.

LEADINGAGE KANSAS NEWS

Weekly Webinar Update
Make plans to join us each Friday at 10 AM. Register here. Let Nicole if you have specific topics we should add to the agenda.

LEADINGAGE NATIONAL NEWS

Nursing Home Advisory Group Call July 27^th, 1 PM  
Members who provide nursing home services are invited to the Nursing Home Advisory Group. Here is the agenda and here is a handout of resources that will be addressed on the call. This month’s call will feature the OSHA Emergency Temporary Standard, other policy update and member feedback. Join the Zoom Meeting. Or call 1- 312-626-6799. Meeting ID: 835 3396 2904. Passcode: 916668. A summary of the call will be posted after the meeting.

RESOURCES

Project Echo Conversation Series – SNF Medical Directors and Administration Post COVID-19 Collaboration Webinar
Project ECHO is offering a conversation for nursing home medical directors on Wednesday, July 21, 2021 at 3:00 PM CDT. The session will focus on the role of nursing home medical directors in COVID-19 vaccinations and post COVID-19 vaccination practices.  Janine Fink Boyle is a featured speaker; she’ll provide the Administrators perspective.  Interested medical directors and others may register here:  REGISTER

What Severe COVID-19 Does to the Brain
NIH released new research on COVID-19’s effects on the brain. Neurological effects were extremely common, appearing in about 80% of patients who had been hospitalized with COVID-19. The most common symptoms reported by patients were headache, which affected 37% of participants, and loss of taste or smell, which affected 26%. The most common neurological problems observed in patients by hospital staff were acute encephalopathy (affecting 49% of patients), coma (17%), and stroke (6%). Patients whose neurological symptoms were observed by hospital staff were more likely to die in the hospital than people with self-reported neurological symptoms — likely because symptoms reported by hospital staff occur in more severe cases of COVID-19. The researchers also found that people with pre-existing neurological conditions such as chronic migraines, brain or nerve diseases, or dementia were more likely to have neurological symptoms of COVID-19 than other people were.