The Department of Health and Human Services (HHS) announced on Wednesday, October 28, 2020, that an additional $333 million in performance payments will be granted to nursing homes that reduced their COVID-19 death and infection rates during August and September of the COVID-19 pandemic. HHS will allocate these payments to more than 10,000 nursing homes that successfully addressed the COVID-19 pandemic and continue to incentivize infection control, training, safety improvements, and protection of the vulnerable elderly population.
These payments represent phase one of the Nursing Home Quality Incentive Program, a five phase, $2 billion incentive program, announced by HHS and the Trump Administration in September 2020. For a nursing home to qualify for payments under the incentive program, current certification as a nursing home or skilled nursing facility (SNF) is required, and the facility must receive reimbursement from CMS. Nursing facilities are also required to submit a minimum of one of three types of data sources to check eligibility and collect important provider information. These data sources include: Certification and Survey Provider Enhanced Reports (CASPER), Nursing Home Compare (NHC), and Provider of Services (POS).
The incentive program will be divided into five phases, with nursing homes receiving September payments early in November and an additional four opportunities to receive incentive payments in the following months. The five phases of the program correspond with five successive monthly periods in which nursing homes can receive incentive payments for reaching certain goals. Specific goals will vary based on local COVID-19 statistics.
HHS will evaluate nursing homes based on an entire month of data submissions as well as other HHS determinations. Every facility that meets the necessary qualifications will be eligible for each performance period. Nursing homes do not have to apply to receive incentive payments from the program but they must submit the requisite data submissions for HHS to evaluate performance and determine distribution. HHS will compare a nursing home’s ability to keep new COVID-19 infection rates and mortality rates low among residents, measured against baseline CDC data of infection and mortality rates in the community where the nursing facility is located. Facility infection and mortality rates will be measured using data from the National Healthcare Safety Network (NHSN) LTCF COVID-19 module, the program in which certified nursing facilities are required to submit data. This data will then be used to evaluate performance and decide payment.
Under the Provider Relief Fund program, nursing homes received $5 billion in May and an additional $2.5 billion in September to assist nursing homes in addressing COVID-19 related needs, including testing, staffing, and personal protective equipment (PPE). Using this funding, 76% of eligible nursing homes met the Nursing Home Quality Incentive Program infection control and mortality requirements and reduced COVID-19 associated deaths by 1,200 from August to September. Overall, nursing homes that met the requirements contributed to 5,000 fewer infections in August and September. HHS allocated an additional $2 billion from the Provider Relief Fund to create this five-phase incentive program. These results indicate that, with more funding and resources, nursing homes can successfully reduce COVID-19 infections and keep workers and residents safe.
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