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HHS announces $2 billion incentive payment for NFs
By Patti Cullen, CAE | September 11, 2020 | SNF/NF providers
Late last week, the US Department of Health & Human Service (HHS) announced its $2 billion quality incentive program for nursing facilities as part of the $5 billion tranche announced on August 7 of CARES Act funding for COVID-19 relief. Each month, starting in September through December, $500 million will be distributed to nursing facilities according to performance on COVID-19 case rates and risk adjusted COVID-19 death rates. Performance will be determined from NHSN data submissions and audits relative to county per-capita rates.
Nursing facilities will not have to apply to receive a share of this $2 billion incentive payment allocation; HHS will be measuring nursing facility performance through required nursing facility data submissions and distributing payments based on these data. HHS will use two outcomes to measure providers’ performance: how well they keep coronavirus infection rates and mortality down. Community-level data based on where the facility is located will be used to quantify those performance measures. Data on mortality and infection rates will come from the National Healthcare Safety Network LTCF COVID-19 module, which is populated by provider submissions.
Providers must have an active state certification as a nursing facility or skilled nursing facility and receive reimbursement from the Centers for Medicare & Medicaid Services in order to qualify for the payments through the incentive program. They must also report to at least one of three data sources to establish eligibility: Certification and Survey Provider Enhanced Reports (CASPER), Nursing Home Compare (NHC), and Provider of Services (POS).
The incentive payment program is scheduled to be divided into four performance periods (September, October, November, December), lasting a month each with $500 million available to nursing facilities in each period. All nursing facilities or skilled nursing facilities meeting the previously noted qualifications will be eligible for each of the four performance periods. Nursing facilities will be assessed based on a full month's worth of the aforementioned data submissions, which will then undergo additional HHS scrutiny and auditing before payments are issued the following month, after the prior month's performance period.
Using data from the Centers for Disease Control & Prevention (CDC), HHS will measure nursing facilities against a baseline level of infection in the community where a given facility is located. CDC's community profile reports (CPRs) include county-level information on total confirmed and/or suspected COVID-19 infections per capita, as well as information on COVID-19 test positivity. Against this baseline, facilities will have their performance measured on two outcomes:
- Ability to keep new COVID-19 infection rates low among residents
- Ability to keep COVID-19 mortality low among residents
To measure facility COVID-19 infection and mortality rates, the incentive program will utilize data from the National Healthcare Safety Network (NHSN) LTCF COVID-19 module. CMS issued guidance in early May
requiring that certified nursing facilities submit data to the NHSN COVID-19 module. Data from this module will be used to assess nursing facility performance and determine incentive payments. Incentive payments will be subject to the same terms and conditions applicable to the initial infection control payments available here
Patti Cullen, CAE | President/CEO | email@example.com | 952-851-2487